Lazy bowel syndrome, also known as slow transit constipation (STC), is a condition characterized by the slow movement of waste through the digestive system, primarily due to reduced motility of the large intestine. It is a type of functional constipation without a clear cause. Other types of functional constipation include normal transit constipation and defecating disorder.
Normal transit constipation occurs when the digestive system usually operates and waste moves at an average speed; however, stool may be difficult to pass. Defecating disorder is defined as the inability to evacuate contents from the rectum despite excessive straining.
The large intestine moves waste from the small intestine to the rectum through a process called peristalsis, which is characterized by rhythmic, muscular contractions of the intestinal walls, controlled by nerves of the enteric nervous system.
Lazy bowel syndrome may be caused by several factors, which can be categorized into conditions that directly cause lazy bowel syndrome and those that indirectly cause lazy bowel syndrome.
Abnormalities of the enteric nervous system may lead to reduced or blocked peristalsis, which can be a direct cause of lazy bowel syndrome. A relatively rare cause of lazy bowel syndrome is a congenital (that is present at birth) condition called Hirschsprung's disease, which is a condition that causes blockages in parts or all of the large intestines due to a lack of nerve cells that are needed for normal peristaltic muscle movement. Additionally, intestinal blockage (such as a tumor), damage to anal muscles, and unhealthy bowel habits (such as delaying bowel movements) may also directly impact intestinal health, leading to lazy bowel syndrome.
Certain medical conditions that indirectly cause lazy bowel syndrome are:
eating disorders, such as anorexia or bulimiahypothyroidismirritable bowel syndromedementia
Other less common causes of lazy bowel syndrome include pelvic floor dysfunction and use of medications, such as opioids and prolonged use of stimulant laxatives (Example: senna and bisacodyl). Stimulant laxatives encourage peristalsis in order to stimulate a bowel movement. With prolonged use, the body can become dependent on this stimulation, resulting in impaired peristalsis without them.
Lazy bowel syndrome is commonly characterized by symptoms of constipation, which is defined as having a bowel movement fewer than three times per week. Individuals with sluggish bowel syndrome may also have hard stools that are difficult to pass, resulting in straining, painful bowel movements and hemorrhoids, which are swollen veins in the lowest part of the rectum and anus.
Other symptoms of lazy bowel syndrome include:
abdominal bloating and/or painnauseainability to control bowel movements, resulting in uncontrollable soilingpoor appetitebloody stooldiarrhea
Lazy bowel syndrome is typically diagnosed by a medical professional after investigating an individual’s signs, symptoms, and medical history. Although there is no cure for lazy bowel syndrome, symptoms may be managed effectively depending on the severity of symptoms and underlying cause.