Lazy bowel syndrome is characterized by difficulty in fecal evacuation, which can be occasional or constant, and is a symptom rather than a specific pathology. This condition may indicate a pre-existing disease, making a thorough medical evaluation important. Some of the most notable symptoms of lazy bowel syndrome include dry stools, infrequent bowel movements, the need to strain excessively or take a long time to evacuate, the sensation of incomplete evacuation or failure to defecate.  Below, however, we list some of the most commonly observed symptoms of this condition

Adults are considered constipated when they:

• Report hardened stools during defecation.
• Complain of a bowel movement frequency of less than three times a week.
• Describe a sensation of “incomplete emptying” of the rectum.

Another area of concern involves hardened and broken stools.

difficult to eliminate.1 In such cases, even if the frequency of evacuation is seen as “normal”, the symptoms indicate intestinal dysfunction and/ or constipation.

What are the causes?

Lazy bowel is primarily a symptom rather than a pathology, often related to difficulties in fecal evacuation, commonly referred to as “essential constipation” or “primary constipation.”

Typically, over 85% of cases are triggered by a diet low in liquids and plant fiber. Additional contributing factors may include a lack of regular exercise, a sedentary lifestyle, depression, anxiety, delaying bathroom visits, and side effects from certain medications, which can exacerbate constipation.

What are the symptoms of lazy bowel?

Constipation is one of the main gastrointestinal disorders diagnosed in clinical practice in Western countries.2 The worldwide prevalence is estimated between 12% and 19% .

Some of the most notable symptoms of lazy bowel syndrome include dry stools, infrequent bowel movements, the need to strain excessively or take a long time to evacuate, the sensation of incomplete evacuation or failure to defecate. ³ Below, however, we list some of the most commonly observed symptoms of this condition.

Difficulties in defecation

Difficulty in evacuating is such an essential criterion in the diagnosis of constipation (or lazy bowel) that it is included in the medical protocol to establish the presence or absence of this condition in the patient. ² In fact, it is imperative to mention that the symptoms must last for at least three months.

According to the Rome criteria (a set of clinical guidelines developed to aid in the diagnosis and classification of functional gastrointestinal disorders), to characterize constipation , the person must:

• straining during more than a quarter of bowel movements (one in every four bowel movements, for example);
• have irregular or hard stools in more than a quarter of bowel movements;
• having the sensation of incomplete evacuation in more than a quarter of defecations;
• have a sensation of anorectal obstruction/blockage in more than a quarter of bowel movements;
• perform manual maneuvers to facilitate evacuation in more than a quarter of defecations;
• have less than three spontaneous bowel movements per week;
• have loose stools only with the use of laxatives .

Discomfort in the abdominal region

As a consequence, obstruction resulting from difficulty in evacuating often leads to discomfort and abdominal distension.

Negative psychological impacts

Although they are common, chronic cases of constipation — or lazy bowel — have a considerable impact on quality of life, causing both physical and psychological effects , such as frustration and irritability, which, from this perspective, can also be considered symptoms of the condition.

Individuals affected by the problem often report that constipation interferes with their daily routine, especially by restricting their productivity and even the regularity of their social activities.

Pain in the anal area

Constipation can result in the formation of hemorrhoids and anal fissures. These conditions are usually caused by straining during bowel movements.  It is also worth explaining that hemorrhoids are basically veins located around the anal region or rectum that become inflamed or dilated .

During a bowel movement, these veins dilate and contract, usually returning to their original size. However, continued straining to have a bowel movement, caused by constipation or hard stools, can compromise blood drainage and lead to the development of hemorrhoids.

Does a lazy bowel make you fat?

No. In fact, intestinal disorders — including lazy bowel — trigger, among the main symptoms, pain and/or discomfort in the abdominal region, changes in daily bowel habits and distension in the abdominal area, which often creates the impression of bloating in people affected by the condition. 

Individuals who live with functional bowel disorders regularly complain of pain and a feeling of bloating in the abdominal area, usually caused by Irritable Bowel Syndrome (IBS). Some patients also describe visible distension in the region, to the point where it is necessary to “loosen” their clothes.

So, yes, there may be the perception that a lazy bowel makes you gain weight, but the swelling can appear abruptly and be caused, in reality, by the combination of the reflex contraction of the diaphragm and the relaxation of the abdominal muscles.

Another point worth highlighting involves the fact that, although distension and flatulence sometimes affect the same person at the same time, bloating is generally a reflection of a sensory or perceptive phenomenon. In other words, it is important to take into account that distension indicates a noticeable change in the diameter of the abdominal wall.

In fact, recent objective measurements have confirmed that this abdominal perimeter normally increases slightly throughout the day, decreasing when the individual lies down to sleep and increasing again when getting up in the morning.

What is the relationship between lazy bowel and slow metabolism?

Secondary causes linked to lazy bowel syndrome can be associated with various identifiable disorders, including metabolic conditions. The condition is multifactorial, meaning primary causes can coexist with additional issues like altered bile acid metabolism, neuropathies, and immune dysfunction.

Organic or secondary constipation may arise from factors not solely within the digestive system and can relate to metabolic conditions such as thyroid disease and diabetes. In these cases, imaging and functional laboratory tests are necessary to rule out metabolic causes associated with lazy bowel.

• X-ray; 
• tomography of the abdominal region; 
• colonoscopy; 
• barium enema; 
• blood count, blood glucose, calcium, potassium and thyroid hormones. 
• Anorectal manometry;
• Colonic emptying time.

What are the treatments for lazy bowel?

Constipation — another name given to “lazy bowels,” as we have seen — tends to have its main symptoms alleviated, when it is not linked to an underlying pathology, by adopting a different lifestyle and implementing changes in the regular diet.  Even so, in some circumstances, the administration of medication regimens for faster relief may be necessary.

In more complex cases, when the pelvic floor muscles — which support the rectal region — lose their previous strength, therapy may be necessary.

Below, we will list some of the main treatments for lazy bowel syndrome. Take a look and, if applicable, discuss the alternatives with your healthcare professional!

Changes in diet and lifestyle adopted

As we have seen, water and fiber intake in the diet significantly influences the symptoms of constipation. In addition, it is essential to maintain a regular exercise routine, which contributes to intestinal health by stimulating bowel movements and facilitating evacuation.

Fiber is a type of carbohydrate that the human body does not fully digest. It helps speed up intestinal transit and, by absorbing water, increases the size and volume of feces.

The recommended daily fiber intake is 25g for women and 38g for men, while for children it varies between 19g and 25g. However, it is important to be cautious, as consumption above 50g daily can lead to increased gas production and abdominal bloating.

Additionally, it is important to be careful with water intake. Adequate hydration enhances the laxative effect of fiber. However, increasing fiber intake without consuming enough fluids can result in impacted stools and cause obstruction. 

It is important to note that the fiber found in foods is superior to that found in supplements, as specific characteristics of dietary fiber aid in the action of digestive enzymes. Additionally, certain foods contain valuable substances such as polyphenols and sorbitol, which work together to enhance health benefits.

Some alternatives that can relieve constipation are:

• kiwi;
• pears;
• apples;
• plums;
• broccoli;
• bean;
• lentils;
• whole grain bran;
• flax seed 

You can meet your recommended daily fiber intake by eating four to five servings of fruits and vegetables, and eating raw foods instead of cooked ones. The cooking process can alter beneficial nutrients and even degrade fiber. 

Furthermore, of course, one should not ignore the need to go to the bathroom, as this can gradually decrease the stimulus to evacuate.

What are the risk factors?

However, it is also important to note that lazy bowel syndrome can be a symptomatic manifestation of more serious diseases.

In combination with other symptoms—such as cramps, weight loss, decreased appetite, bleeding, anemia, and pain associated with a palpable abdominal mass—lazy bowel syndrome can serve as a “warning sign,” indicating the need for medical evaluation.

Here are some possible risk factors in more detail:

Emotional factors

It is not uncommon for individuals with constipation to also suffer from anxiety, stress, trauma or depression. Additionally, some feel embarrassed to use public restrooms and end up holding in their stool, which can result in more serious problems.

When you don’t have a bowel movement, your body can reabsorb water from your stool, making it harder and harder to pass. This can result in you losing the desire to go to the bathroom regularly.

Low water and fiber intake

In cases of functional constipation , an excellent option involves increasing the amount of fiber and water you consume every day.

Genetic predisposition

Family history is one factor to consider. While it’s unclear whether the condition is caused by a specific gene, having a family history of lazy bowel syndrome may increase your risk of developing the condition as well.

Age and gender

In the elderly, common causes of lazy bowel syndrome are generally associated with medication use, physical inactivity and an inadequate diet.

Women are also more susceptible to this condition than men, particularly during pregnancy. Between 11% and 38% of pregnant women suffer from constipation, due to the changes in the digestive system that occur during this phase.

For example, progesterone, a hormone that increases in levels during pregnancy, can slow bowel movements and make stools harder. Additionally, dietary changes and the use of iron and calcium supplements, which are common among pregnant women, can aggravate this condition. As an additional factor, it is natural for women to decrease their regular physical activity during this period.

How Lazy bowel is diagnosed ?

Lazy bowel diagnosis typically begins with a patient’s medical history. A healthcare professional may conduct a physical examination, including a rectal exam to assess the presence, amount, and consistency of feces.

Stool analysis for occult blood is common. A detailed history and careful examination usually confirm a diagnosis of constipation or lazy bowel and help identify possible causes.

If the cause is unclear, various tests may be performed, including sigmoidoscopy or colonoscopy to examine the lower or entire large intestine, especially if constipation occurs suddenly or if there is hidden blood in the stool.

Additional tests, such as abdominal X-rays, may be necessary to identify underlying issues like bowel obstruction.

How to activate lazy bowel?

In some situations, laxatives and other medications for primary constipation can serve as complementary treatments. Ideally, this approach should be combined with behavioral and dietary changes.

After all, it is important to emphasize that, taken alone, laxatives do not have a curative effect. ¹ In other words, sometimes these products even underestimate the cause of lazy bowels and make long-term, truly effective treatments difficult.

What type of medicine can help?

Medication can be an alternative for many patients, often becoming necessary over time. For long-term treatment, fiber supplements (such as psyllium and methylcellulose) and osmotic laxatives are generally well tolerated.

Fiber supplements, known as bulk-forming laxatives, absorb water to increase fecal bulk, stimulating bowel movements.

For pregnant women who do not experience results with non-pharmacological methods, these laxatives are typically recommended due to their safety.

However, they may not have an immediate effect and may cause gas, cramps and bloating.

Osmotic and saline laxatives , in turn, “pull fluids into the intestine which increases the amount of fluids and electrolytes in the stool, making it bulkier and less consistent. This can cause gas and bloating.

Conclusion: symptoms of a lazy bowel

Understanding the symptoms of a lazy bowel is essential for early detection and effective management of constipation. Symptoms such as infrequent bowel movements, difficulty in evacuation, and sensations of incomplete emptying can significantly impact quality of life. Recognizing these signs can prompt individuals to seek medical advice, ensuring appropriate interventions and lifestyle changes are implemented to improve bowel health.

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