Lifestyle Modifications
Patients should be provided assistance for regular toileting to maintain a regular bowel regimen. Encourage and assist patients to promote defecation in the morning especially 90 minutes after meals to respond to the gastrocolic reflex.
Sikirov studied defecation effort in 2 sitting (regular toilet seat and lowered toilet seat) and 1 squatting position. Time to satisfactory bowel emptying and straining in the squatting position was much less when compared with both sitting positions. The study confirmed that the squatting position necessitates much less expulsive effort owing to a straightening of the anorectal angle. Whereas a squatting position is not feasible for many elderly individuals, a sitting position is still to be preferred over a supine position.
There is evidence that CTT can be decreased by physical activity. Physical activity in PD also benefits improved gait, balance, posture, and energy. Stretching exercises improve rigidity as well. Exercise, particularly in elderly individuals, can improve chronic constipation and certainly improve quality of life.