Constipation is as common as it is uncomfortable. Add in a neurologic disorder, and it becomes even more common. In Parkinson's disease, for example, constipation may be one of the first symptoms and may occur as early as 20 years before motor symptoms, says Ronald F. Pfeiffer, MD, FAAN, professor of neurology at Oregon Health & Science University in Portland.

Two factors contribute to constipation in people with Parkinson's disease. One is that the anal sphincter—a ring of muscles that opens and closes the end of the rectum and controls the release of stool—often doesn't work well, says Dr. Pfeiffer. "If you can't relax your anal sphincter, you can't properly defecate," he says. The other is that food takes longer to pass through the gastrointestinal (GI) system, particularly the colon. "[The slow transit] could be related to local nerve damage in the GI tract or in regions of the brain or spinal cord that exert control over the bowels, or both," Dr. Pfeiffer says.

Damage to those same regions may result in constipation in people with spinal cord injuries, stroke, and multiple sclerosis, according to a 2018 review by researchers at University College London Hospital. Constipation after a stroke can also be caused by medications, reduced mobility (lack of exercise contributes to constipation), and swallowing problems that make it hard to consume high-fiber foods, according to a 2017 review in the journal Medicine.

The reason for constipation in muscular dystrophies is different, says Gyula Acsadi, MD, PhD, FAAN, head of neurology at Connecticut Children's Medical Center in Hartford. "The muscles in the digestive tract that move food from the mouth through the esophagus, stomach, intestines, colon, and out the body are weakened in people with muscular dystrophies, resulting in slower movement, which often causes constipation," he explains.

Medications that treat neurologic diseases can themselves be constipating. "The irony is that levodopa—used to treat Parkinson's disease—occasionally can cause constipation, which in turn can prevent the drug from being properly absorbed. So the dose you take may be ineffective," says Dr. Pfeiffer. Other potentially constipating drugs include anticholinergics, anticonvulsants, opioid painkillers, and some antidepressants, as well as anti-inflammatories (aspirin, ibuprofen), antihistamines for allergies (Benadryl, Zyrtec), blood pressure medications, antipsychotics, diuretics (water pills), and iron pills. People with muscular dystrophy are more prone to infection and tend to take more antibiotics than the average person, which can change the bacteria in the gut and lead to constipation, says Dr. Acsadi.

If you're prone to constipation, experts recommend exercising regularly, drinking more fluids, and getting ample dietary fiber. "But if you're like a typical American, you're getting only about 16 grams of fiber. The recommended dose is 25 grams for an adult woman and 38 grams for an adult man," says Heather Rasmussen, PhD, RD, associate professor in the department of nutrition and health sciences at the University of Nebraska-Lincoln.

"Fiber helps normalize bowel function and can prevent or alleviate constipation in a few different ways," she says. Insoluble fiber, the main type in wheat bran, speeds up the time from swallowing food to eliminating it. Soluble fiber, plentiful in psyllium husks (the basis for Metamucil and other fiber supplements) as well as oats and oat bran, holds water, helping stools stay soft.

When you eat more fiber, be sure to increase your fluid intake, says Dr. Pfeiffer. "If fiber, fluids, and exercise don't work after a month, then talk to your health care provider about a laxative," he advises. "Ideally, start with something like Miralax, which draws fluid into the colon."

Aside from helping to keep things moving, fiber may protect against heart disease, type 2 diabetes, and colon cancer, according to a 2015 review by the Academy of Nutrition and Dietetics.

4 Fiber-Rich Recipes to Try

White Beans with Fennel, Red Pepper, and Carrots

Serves 4

2 15-oz. cans cannellini beans, drained and rinsed
½ cup diced fennel and 2 tablespoons fennel fronds
½ cup diced red bell pepper
¼ cup diced carrots
¼ cup diced red onion
3 tablespoons lemon juice
1 tablespoon rice vinegar
¼ cup olive oil
½ cup fresh basil leaves
2 tablespoons roughly chopped fresh spearmint
1 clove garlic, minced
¼ teaspoon salt
1/8 teaspoon ground black pepper

Put white beans in a large bowl. Add fennel, red peppers, carrots, and onion; combine with the beans.

In a blender, combine lemon juice, rice vinegar, olive oil, basil, mint, garlic, salt, and pepper. Blend until smooth and no large pieces remain. Pour over beans and vegetables, and toss evenly to coat.

Add fennel fronds, and toss to combine. Can be served immediately or chilled and served cold.

Per serving: Calories: 317 / Protein: 11 g / Carbohydrate: 35 g / Dietary Fiber: 10 g / Total Sugars: 2 g / Total Fat: 15 g / Saturated Fat: 1.9 g / Cholesterol: 0 mg / Sodium: 230 mg

Quinoa Pilaf with Tempeh

Serves 4

Tempeh Ingredients:
½ cup orange juice
3 tablespoons reduced-sodium soy sauce
1 tablespoon apple cider vinegar
1 tablespoon maple syrup
½ teaspoon ground coriander
¼ teaspoon ground cinnamon
1 clove garlic, minced
1 teaspoon peeled and minced or grated fresh ginger root
8 ounces tempeh, cut into ½-inch pieces
1 tablespoon olive oil

Pilaf Ingredients:
2 cups low-salt vegetable broth
1 cup quinoa
1 tablespoon olive oil
¼ cup thinly sliced scallions, white and green parts
2/3 cup diced fresh apricot
1/3 cup diced red bell pepper
1/3 cup diced cucumber
2 tablespoons minced parsley
¼ teaspoon salt
1/8 teaspoon ground black pepper
1/3 cup roughly chopped low-salt roasted pistachios

In a medium bowl, whisk together orange juice, soy sauce, apple cider vinegar, maple syrup, coriander, and cinnamon. Add garlic, ginger, and tempeh. Stir to coat tempeh. Allow tempeh to marinate while you cook the quinoa. Stir occasionally while marinating so all tempeh pieces get coated with marinade.

Rinse quinoa thoroughly under cold water and drain. In a medium pot, combine rinsed quinoa and vegetable broth. Bring to a boil, then turn to low and allow quinoa to simmer for 10 to 15 minutes until it appears soft and translucent and water has been absorbed. Remove from heat and set aside while you cook the tempeh.

To cook the tempeh, heat a medium skillet over high heat. Add 1 tablespoon olive oil. Drain the tempeh, reserving the marinade for later, and add tempeh to skillet. Lower heat to medium and cook tempeh, turning pieces occasionally, for about 5 minutes or until pieces are browned on all sides. Add marinade and cook another 5 minutes, or until most, but not all, the marinade has been absorbed. Turn off heat.

Transfer the quinoa into a large bowl, and fluff with a fork. Add 1 tablespoon olive oil and stir to coat quinoa. Add scallions, apricot, red peppers, cucumbers, parsley, salt, and pepper. Stir to mix all ingredients. Add tempeh and any remaining marinade from the pan. Stir to mix in tempeh. Pilaf can be served room temperature, or chilled and served later. Just before serving, top with pistachios.

Per serving: Calories: 442 / Protein: 21 g / Carbohydrate: 53 g / Dietary Fiber: 10 g / Total Sugars: 12 g / Total Fat: 17 g / Saturated Fat: 2.5 g / Cholesterol: 0 mg / Sodium: 706 mg

Whole Wheat Noodles with Chickpeas

Serves 4

8 oz. uncooked whole wheat spaghetti
2 tablespoons olive oil
3 cloves garlic, minced
1 medium shallot, thinly sliced
¼ to ½ teaspoon red pepper flakes (depending on how spicy you want it)
6 oz. spinach leaves, roughly chopped
½ cup corn kernels
1½ cups canned chickpeas, drained and rinsed
½ cup low-salt vegetable broth
1 cup diced tomatoes
¼ cup thinly sliced basil leaves
¼ teaspoon salt
1/8 teaspoon ground black pepper
½ cup grated Parmesan cheese

Cook spaghetti in large pot of boiling water according to package directions. Drain and set aside.

Heat olive oil in large skillet over medium-high heat. Add garlic, shallot, and red pepper flakes. Cook until garlic begins to brown. Lower heat, add spinach, corn, chickpeas, and vegetable broth. Cook until spinach begins to wilt, about 1 to 2 minutes. Add spaghetti, tomatoes, and basil and stir to combine. Turn off heat and add salt and pepper. Toss to combine.

Serve immediately. Top each serving with 2 tablespoons Parmesan cheese.

Per serving: Calories: 434 / Protein: 18 g / Carbohydrate: 65 g / Dietary Fiber: 11 g / Total Sugars: 7 g / Total Fat: 14 g / Saturated Fat: 3.3 g / Cholesterol: 11 mg / Sodium: 561 mg

Brussels Sprout Salad with Maple Mustard Dressing

Serves 4

1/3 cup whole raw almonds
¼ cup olive oil
2 tablespoons apple cider vinegar
2 tablespoons maple syrup
1 tablespoon Dijon mustard
¼ teaspoon salt
1/8 teaspoon ground black pepper
1 lb. brussels sprouts
1 large Granny Smith apple, sliced into ½-inch pieces
1 large kohlrabi, diced into ¼-inch pieces
½ cup pomegranate seeds

In a small, dry skillet, toast almonds for 8 to 10 minutes until they begin to darken a bit. Stir frequently so they don’t burn. Remove from heat and set aside to cool. Once cool, roughly chop.

Make the dressing by putting olive oil, vinegar, maple syrup, mustard, salt, and pepper in a small bowl. Whisk to combine, then set aside while you prepare the salad.

Trim and discard bottom ends of brussels sprouts. Thinly slice sprouts with a knife or a food processor with slicing attachment. Put sliced sprouts in large bowl and add apple, kohlrabi, and pomegranate seeds; toss to combine.

Pour dressing over salad and toss to evenly coat. Can be served immediately or chilled and served cold.

Toss in almonds just before serving.

Per serving: Calories: 326 / Protein: 7 g / Carbohydrate: 33 g / Dietary Fiber: 10 g / Total Sugars: 18 g / Total Fat: 20 g / Saturated Fat: 2.4 g / Cholesterol: 0 mg / Sodium: 284 mg

Swap these Foods to Get More Fiber

Try these swaps to reach the daily recommended amount of fiber for adults: 25 grams for women and 38 grams for men.