Parkinson’s, Constipation and Care: The Smoothie Routine That Saved Our Mornings
Parkinson’s and Constipation: A Carer’s Routine That Actually Fits Real Life
When constipation joins Parkinson’s, it can become one of the most exhausting problems for both the person affected and the people who love them. It slows movement, disturbs sleep, worsens nausea and appetite, and can even interfere with how well medications are absorbed. For many of us, keeping bowels moving regularly turns into a quality‑of‑life project in its own right, not a side issue.pmc.ncbi.nlm.nih+3
While we have been partners for nearly 20 years, we only married in 2021. Not long after, my wife was diagnosed with Parkinson’s disease, and about a year later with Parkinson’s dementia / Lewy Body Dementia. So this “bowel routine” sits inside a much bigger roller coaster of diagnosis, loss, adaptation, and trying to preserve as much ordinary joy as we can in each day. Constipation is just one piece of that, but it’s one that can easily dominate a week when things go wrong.pmc.ncbi.nlm.nih+1
What follows is the pattern that currently works for us: a small, repeatable routine using food, fluids, and Laxido that a carer can realistically deliver most days, plus some smoothie recipes that help to hide the taste of the laxative.
Why constipation shows up so often in Parkinson’s
In Parkinson’s, the “automatic” nervous system that drives the gut often runs in slow motion. The bowel becomes sluggish, so in practical terms:pmc.ncbi.nlm.nih+1
Stools creep along more slowly and lose water on the way, becoming harder and drier.pmc.ncbi.nlm.nih+1
People move less, drink less (especially if they worry about getting to the toilet or about swallowing), and often cut back on food volume and fibre.betterhealth.vic.gov+1
Parkinson’s drugs, painkillers, and some mood medicines can all add extra “brakes” to the bowel.michaeljfox+1
In our experience this becomes a loop: hard stool, straining, bloating, loss of appetite, and sometimes days of tiny, incomplete bowel movements. Breaking that loop usually needs three things working together rather than one “magic bullet”:
A laxative plan that actually matches the level of constipation (and is reviewed when needed).
Fibre and fluid that the person can tolerate in real life, not a theoretical “ideal”.
Simple routines that can be followed even on bad days.
Principles that have helped us
Standard advice often boils down to “drink more and eat more fibre”. For many people with Parkinson’s, that just doesn’t fit reality. In our house, the sticking points have included:parkinson.bc+2
Big drink volumes being overwhelming.
Raw, bulky salads or “worthy” high‑fibre foods increasing bloating or discomfort.
Certain vegetables and grains creating too much gas.
Strong‑tasting medicines causing nausea or refusal.
So the principles that have actually helped us are:
Use an osmotic laxative (Laxido/macrogol) consistently, at a dose agreed with the prescriber, instead of relying on diet alone.nhs+1
Build around fruits and cooked vegetables that are clearly tolerated, rather than chasing maximum fibre at any price.nhs+2
Keep drink volumes modest but steady across the day, especially around laxatives and fibre‑rich foods.parkinson+1
Make the laxative as drinkable as possible (smoothies, strong flavours) so it doesn’t quietly fall off the daily checklist.
The routine below assumes a prescription of Laxido 1 sachet in the morning and 1 in the evening, and a person who can manage fruits such as banana, kiwi, apple, prunes, watermelon, and berry flavours.
A day that works for us: one example routine
Morning: “wake up” the gut and get the first sachet in
On waking
Offer a small drink they like (tea, coffee, or water). The aim is a gentle start to hydration, not forcing down a large glass.nhs+1
Breakfast
Tolerated fruits such as:
1 banana
1 kiwi
1 small apple (skin on if comfortable)
Optional: a probiotic drink such as Yakult, if dairy and sugar are not a problem and it’s well tolerated. That can support gut bacteria but does not replace fibre or laxatives.pmc.ncbi.nlm.nih+2
Late‑morning Laxido smoothie (first sachet)
For us, this is often the single most important “job” of the morning.
Base rule (for all recipes):
Empty 1 sachet Laxido into a glass.
Add 125 ml cold water and stir until fully dissolved and clear or slightly hazy; this amount of water is needed for the macrogol to work properly.valeofyorkccg+2
Once dissolved, tip this “Laxido water” into a blender and turn it into a small, strongly flavoured smoothie (see annex recipes below).
We aim for mid‑morning, drunk over 20–30 minutes, often with a straw to soften the taste and smell.
This timing keeps the volume manageable, separates it from bigger meals, and reduces the chance that it gets endlessly postponed.
Midday and afternoon: food, movement, and steady drinks
Lunch
We try to keep lunch gentle on the gut but still interesting:
1–2 handfuls of vegetables or salad, with a bias toward cooked veg when raw food feels too harsh.eatright+1
Some wholegrain or pulses if tolerated (e.g. wholemeal bread, brown rice, a lentil‑based soup).betterhealth.vic.gov+2
A normal, modest drink with lunch (water, tea, or diluted juice) rather than big extra volumes.
Mid‑afternoon
This is where we top up fibre and fluid in a friendly way:
Snack ideas:
A portion of watermelon (for easy hydration and gentle fibre).
2–3 prunes if they help and are tolerated; these can be split across the day rather than all at once.ucsfhealth+3
Movement:
Even a short walk, a few laps around the house, or “pottering” can support bowel motility in Parkinson’s, if it’s safe from a falls perspective.stgeorges+1
Evening: second sachet and a calmer wind‑down
Dinner
We try to make the main meal supportive but not overwhelming:
Cooked vegetables such as carrots, courgettes, green beans, squash, which are often easier to manage than large raw salads.nhs+1
Moderate portions of fibre‑starch (potatoes with skin, brown rice, wholemeal pasta) if those are tolerated.eatright+2
Avoiding very heavy, late‑night meals helps reduce bloating and reflux.
Early‑evening Laxido smoothie (second sachet)
We’ve found early evening better than “last thing at night”:
Repeat the base steps:
1 sachet Laxido + 125 ml cold water, fully dissolved.eric+2
Then turn it into a small, strong‑flavoured smoothie or a cordial‑based drink from the annex.
Using a different flavour in the evening (e.g. cocoa‑berry rather than forest fruits) can help avoid taste fatigue.
Taking it in early evening keeps fluid load away from bedtime and, in our case, seems kinder to sleep and toileting patterns.
When we bring in the professionals
I’ve learned the hard way that there are times when tinkering with diet and timing isn’t enough and you genuinely need clinical input. Clinicians usually want to hear from you if:
There’s no meaningful bowel movement for 7 or more days despite taking Laxido as prescribed.parkinson.bc+2
There are only tiny “smears” or pellets over a week, with growing discomfort or distress.
New or worsening abdominal pain, visible swelling, vomiting, or inability to pass wind appears.parkinson+1
There’s rectal bleeding, unexplained weight loss, or a sudden change in bowel habit.
In those situations, it’s reasonable to ask the GP or Parkinson’s nurse about:
A short “disimpaction” schedule (higher macrogol doses for a limited period) followed by a lower maintenance dose, tailored to age and other health issues.bbuk+2
Whether an extra agent such as a stimulant laxative, suppository, or enema is appropriate in the short term.pmc.ncbi.nlm.nih+1
Whether any of the current medications might be making constipation worse, and if alternatives or dose changes exist.michaeljfox+1
Annex: small‑volume Laxido smoothies that actually hide the taste
These recipes are deliberately strong‑flavoured and relatively low in volume, leaning on berries and cordials that are good at masking medicine tastes.iere+3
Shared method for all smoothies
Put 1 sachet Laxido into a glass.
Add 125 ml cold water and stir thoroughly until the powder is fully dissolved.nhs+2
Pour this “Laxido water” into a blender (except for the no‑blender recipe).
Add the flavouring ingredients listed.
Blend until smooth and serve chilled, ideally with a straw.
You can tweak sweetness with a little ripe banana or a suitable sweetener if clinically appropriate.
1. Forest Berry Masker (our “heavy‑duty cover”)
1 sachet Laxido + 125 ml cold water (dissolved).
40–50 g frozen “fruits of the forest” mix (raspberries, blackberries, blackcurrants, redcurrants).
20 g ripe banana (a couple of slices) to round off the texture.
Optional: 1–2 teaspoons natural or lactose‑free yoghurt if dairy is tolerated.
This gives a dark, tart‑sweet smoothie with strong berry flavour and colour, which in our experience hides the Laxido taste very effectively.wholefoodsoulfoodkitchen+1
2. Blueberry Velvet (for people who dislike sharp flavours)
1 sachet Laxido + 125 ml cold water.
40 g frozen blueberries.
About 30 ml milk, lactose‑free milk, or a spoon or two of yoghurt.
Tiny extra slice of banana (10–15 g) if more sweetness is needed.
The result is a smooth, purple, gently sweet drink that avoids the sourness of some mixed‑berry blends.kristineskitchenblog+1
3. Blackcurrant Punch (no blender needed)
1 sachet Laxido + 125 ml cold water, fully dissolved.
15–25 ml strong blackcurrant squash/cordial (undiluted), stirred in.
Optionally add ice or chill for 20–30 minutes.
This produces a small glass of intensely flavoured blackcurrant drink that keeps the total volume low but offers a robust taste “cover”.kingswaycompounding.com+2
4. Berry & Cocoa Evening Smoothie (dessert‑style option)
1 sachet Laxido + 125 ml cold water.
30 g frozen mixed berries.
10 g banana.
1 teaspoon cocoa powder or a small amount of hot chocolate powder.
20–30 ml milk or lactose‑free milk.
Blend until smooth. This can be drunk cold, or just‑warm if the milk is gently warmed (never boiling) after the Laxido has already been dissolved in cold water.kingstonandrichmond+1
5. Watermelon Sidekick (companion rather than mixer)
Because watermelon’s flavour is subtle, we use it alongside Laxido rather than as the primary mask:
Make the Laxido drink using a strong‑flavour recipe (e.g. Blackcurrant Punch).
Serve a small bowl or a few chilled cubes of watermelon just before or after the Laxido drink.
This way, watermelon contributes comfort and hydration without diluting the flavour that hides the medicine.allrecipes+1
What I’d say to another carer at the kitchen table
For many Parkinson’s carers, the exhausting part is not just the constipation itself but the constant second‑guessing: “Am I giving too much fibre? Too little? Is this the right laxative? Am I overdoing the drinks?” From where I’m sitting, a realistic approach looks something like this:
Anchor the day around what the person will reliably take every day, not what they “ought” to take in theory.
Treat the Laxido routine (for us, two smoothies a day) as a core safety net rather than an optional extra.
Let fruits, vegetables, and movement be supporting actors that you adjust gently, rather than a source of pressure or guilt.
And if, despite your best efforts, there are still long gaps between bowel movements or worrying symptoms, that is not you failing as a carer. It’s a sign that the situation needs more medical input, and it’s entirely appropriate to pull the GP or Parkinson’s team back into the conversation.parkinson+2
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