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I need help with a diagnosis, I have young M. ramirezi is sick, it stays in the background and is very fat ... Could this be a bowel obstruction? What is it that I do? Thanks for help
Sounds like bloat. Unfortunately, once small fish like rams have bloated to where it is very obvious it may be too late to save them. There will always be some debate about how to treat bloat in a ram/apisto, but I have had the most success increasing the temperature up to 82-84, treating with metronidazole and doing lots of water changes.
Possibly a protozoan parasite (most likely hexamita), which is why metro is usually effective. Bacterial infection will also be present, but often secondary to damage by the protozoan. Metro is also a mild antibiotic.
Bloating is a symptom, not a specific disease. It indicates that the fish is not able to excrete excess water. Parasites, bacterial infection, improper diet or water conditions, and old age are some of the possible causes.
If your water is very soft and low conductivity (less than 80 uS) then adding a small amount of buffering salts (a mix of Ca, Mg, Na, K, Cl, SO4) might help his recovery, even for soft-water fish like rams. Adding some extra ions in the water will ease the workload on the salt-uptake cells and water-excreting cells in the gills and kidney for a bloated fish.