Most people do not focus on their bowel regularity until a problem arises. Normal bowel habit varies. For some people, going twice daily is normal whereas for others going every second day is acceptable. In terms of a medical perspective, having a bowel movement more than three times in a day or less than three times are considered abnormal.
What are sluggish bowel movements?
The term sluggish bowel movements is a common way to describe constipation. Not only are the bowel movements irregular and occur less than three times a week, but it may also be difficult to pass out the stool. A person strains to defecate and often feels that the bowel movement was incomplete. Most people see these symptoms as an indication of sluggishness in bowel activity.
Constipation is one of the most common bowel conditions. It occurs for a host of reasons which may include diet, lifestyle, diseases and disorders as well occurring for no known cause in some instances. Therefore constipation is not only due to sluggish bowel activity. It can even lead to complications, some of which may be serious although this is rare.
Lazy Bowel Syndrome
Another term that is sometimes used for constipation, particularly constipation due to unknown causes, is lazy bowel syndrome. It is essentially the same as bowel sluggishness. However, the term lazy bowel syndrome is at times also attributed to constipation that occurs after excessive or prolonged laxative use.
Laxatives promote and can even induce bowel movements. People who use laxatives regularly may therefore experience sluggish bowels after stopping laxatives. It may be a short term consequence of laxative cessation. However, it can be an ongoing problem for people who had chronic constipation. This lazy bowel syndrome can worsen the constipation that existed prior to laxatives.
Causes of Sluggish Bowel Movements
There is a host of causes for sluggish bowel movements. It is important to remember that constipation is a symptom. Most of the time the causes of constipation are not serious. However, there are instances where constipation is a symptom of serious and potentially life-threatening diseases.
Dietary factors are one of the leading causes of constipation. Low fiber intake is one of the main reasons. It is a common problem with the modern diet that is rife in low fiber foods that are also heavily processed. Therefore the natural fiber which is abundant in fruit and vegetables is lacking in the diet. Without fiber, stool does not have bulk or the ability to absorb and retain water.
Being inactive is a factor in sluggish bowel movements. This is commonly seen in people who live a sedentary lifestyle. It also correlates with obesity where there is often a lack of physical activity and constipation is commonly reported among obese people.
Movement through the bowels depends on tiny muscles in the bowel wall. These muscles are constantly active to push food and stool through the gut. During a bowel movement, these same muscles contract strongly and force out feces. Various diseases that affect the muscles may therefore cause sluggish bowel movements.
Nerves coordinate the muscles that make movement through the bowels possible. These nerves stimulate the bowel wall muscles to contract and relax to push the food and stool through the bowels as well as to facilitate defecation. When there are nerve diseases or disorders, bowel habit may be affected.
There are many other conditions where constipation is a symptom. This may include:
- Hypothyroidism (underactive thyroid)
- Irritable bowel syndrome (IBS)
- Eating disorders
- Psychological stress
- Medication like certain antidepressants, antacids and painkillers.
- Supplements like calcium and iron.
Treatment of Sluggish Bowels
Contrary to popular belief, laxatives are not the first choice of treatment for sluggish bowels. In fact it can worsen the sluggishness once the laxatives are stopped. It may be helpful in the short term when a person is not passing any stool and there is a risk of complications like fecal impaction. However, it is not a viable option for long term management.
The underlying cause needs to be identified. By treating the causative condition, symptoms like constipation should resolve. For example, thyroid hormone drugs can help relieve symptoms like constipation in people who have an underactive thyroid gland.
Diet and Lifestyle
Simple dietary and lifestyle changes can be effective in treating sluggish bowels and managing it long term if it is a chronic problem.
- Reduce the intake of refined foods. A diet abundant in fresh fruit and vegetables provides the fiber that is needed for a regular bowel habit. It should be part of every meal and the be the largest portion of any food on the plate.
- Consider using fiber supplements if necessary. While dietary fiber from food is a better choice, fiber supplements can be helpful. These supplements should not be used to replace food sources of fiber.
- Increase water intake. An adult should consume at least 2 liters (approximately 64 ounces) of water daily. This should be separated throughout the day. The general rule is to drink 8 glasses of water throughout the day. This should be 250mL (8oz) glasses of water.
- Avoid alcohol, coffee, tea and cola. These beverages are diuretics meaning that it increases water loss from the body. As a result there is less water to keep the stool soft and make it easier to pass out. Any food or beverage with alcohol or caffeine should be avoided or at least minimized.
- Start an exercise program. Physical activity is an important factor in managing constipation but it has to be regular and preferably daily. It does not always have to be a strenuous gym workout. Even a brisk walk for 15 minutes daily may be sufficient.
- Do not restrain bowel movements when there is the urge to defecate. This can be a factor in causing constipation. It is not always possible to pass stool immediately once the urge arises. Therefore bowel training is important whereby a person sits on the toilet and attempts to pass stool at a set time that is convenient on a daily basis.
Read more on remedies for dry and hard stool.