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Hard, knotty bowels are often caused by constipation, which can result from a low-fiber diet, inadequate fluid intake, or a sedentary lifestyle. Other factors include certain medications, stress, and underlying health conditions such as irritable bowel syndrome (IBS) or hypothyroidism. Dehydration and not responding to the urge to have a bowel movement can also contribute to this issue. Regular physical activity and a balanced diet rich in fiber can help alleviate these symptoms.

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