Why are My IBS Symptoms Worse in The Morning?

Irritable bowel syndrome (IBS) is a gastrointestinal condition that can involve the large intestine, also called the colon. It doesn’t cause permanent damage, but it can trigger uncomfortable symptoms.

It’s common for IBS symptoms to get worse in the morning. This is due to the way the large intestine functions. Stress can also play a role.

Possible morning IBS symptoms include:

  • diarrhea
  • constipation
  • bloating
  • stomach cramping

The symptoms can vary from day to day. They might even go away for a few days, only to come back again.

Read on to learn why IBS gets worse in the morning, plus ways to prevent IBS.

Why in the morning?

There are several reasons why IBS tends to flare up in the morning. Possible explanations include:

Circadian rhythm

Your circadian rhythm is your body’s internal clock. It regulates your sleep- wake cycle, as well as the motility of your large intestine.

According to a 2020 review, colonic motility decreases during sleep. Its activity increases when you wake up. This could trigger IBS symptoms in some people.

Plus, according the review, having a disrupted circadian rhythm is linked to IBS. Potential causes of impaired circadian rhythm include:

  • jet lag
  • shift work
  • irregular sleep-wake rhythm
  • delayed sleep phase disorder
  • advanced sleep phase disorder
Overactive gastrocolic reflex

The gastrocolic reflex is your large intestine’s response to food. It’s a normal, automatic response that increases motility. The reflex is most active after you eat.

In IBS, the gastrocolic reflex overreacts after eating. That’s because IBS involves high visceral sensitivity, or increased sensitivity to the usual activity of organs. This overreaction causes IBS symptoms like diarrhea and cramping.

The gastrocolic reflex is also most active in the morning. This may explain why IBS symptoms tend to flare at that time of day.

Stress

Stress and IBS are closely related. This is due to the gut-brain axis, or the neural connection between your gut and brain.

Your central nervous system regulates your brain, while the enteric nervous system regulates the gut. The latter is involved in intestinal motility.

According to a 2014 review, psychological stress disrupts the connection between the brain and gut. This can affect gut function, contributing to the development of IBS or worsening of symptoms.

If you’re experiencing high levels of stress, you might feel tense or anxious upon waking up, which could then trigger your IBS symptoms.

Symptoms

The symptoms of IBS can vary from one flare-up to the next. They can also come and go.

Common symptoms include:

Loose stools

IBS can cause loose stools, or stools that don’t form together. They can be small in size and come out quickly.

Diarrhea

Diarrhea is watery, loose stools. It can involve increased frequency or a sudden urge to pass stool.

Constipation

Constipation occurs when you strain to pass a bowel movement. When you do pass stool, it will be hard and dry. You might still have a feeling of fullness afterward. This can cause pain and discomfort.

IBS can cause both diarrhea and constipation.

Bloating

Bloating occurs when your stomach feels very full. It can be uncomfortable and get worse during the day.

Stomach pain

Stomach pain is another common symptom. The pain may be continuous or come and go.

Often, IBS pain also:

  • gets better after having a bowel movement
  • happens when the frequency of your stools change
  • happens when the appearance of your stools change
Cramping

Typically, cramping occurs below the belly button. The cramping is often worse after eating and goes away after you pass stool.

Nausea

IBS can also make you feel sick, a sensation known as nausea.

Prevention

To prevent or manage IBS, here’s what you can do:

  • Avoid trigger foods. Avoid eating foods that trigger IBS, like coffee, beans, spicy foods, or dairy. Triggers are different for everyone, so take note of what causes your symptoms.
  • Eat smaller meals. Large meals stimulate the intestines, potentially causing IBS.
  • Avoid high-fat foods. High fat foods, like fried foods, also overstimulate digestion. It’s best to limit or avoid these foods.
  • Eat slowly. Eating quickly may contribute to IBS. Take your time and practice mindful eating.
  • Exercise regularly. Exercise is thought to improve the gut- brain axis, thus helping IBS.
  • Reduce stress. Since stress can worsen IBS, try to focus on stress relief. Exercise, along with stretching and meditation, can help reduce stress.
  • Get enough sleep. Poor sleep can disrupt your circadian rhythm and worsen IBS. Try to practice good sleeping habits, and if you have a sleeping disorder, talk with a healthcare professional.

Treatments

There’s no cure for IBS. Generally, medical professionals will recommend trying lifestyle changes first.

If you still have symptoms, they may recommend treatments to manage IBS:

  • Anti-diarrheal medications. If you have IBS with diarrhea, your doctor might recommend over-the-counter (OTC) or prescription anti-diarrheal drugs. However, depending on the type, these drugs might cause constipation, nausea, or blackened stools.
  • Laxatives or stool softeners. If you have IBS with constipation, you can take OTC or prescription laxative or stool softeners to simulate movement. Possible side effects include bloating, nausea, and diarrhea.
  • Anti-spasm drugs. These drugs are used to ease pain and cramping.
  • Peppermint oil. Peppermint oil capsules may reduce bloating, cramps, and gas. However, peppermint oil may cause heartburn or nausea in some people.
  • Probiotics. Probiotics are live beneficial bacteria that may help your gut. Your doctor might recommend probiotics to manage IBS symptoms.
  • Mental health therapies. Mental health therapy, like cognitive behavioral therapy, can manage IBS by reducing stress. This may help if you don’t want to take medication.

When to seek care

IBS can almost be considered a diagnosis of exclusion because many of its symptoms can be present in other diseases. That’s why it’s important to see a doctor to get an official diagnosis.

Talk with a healthcare professional if:

  • you think you have IBS
  • notice any changes in your bathroom habits
  • you’re not sure if you have IBS or something else
  • your IBS fails to improve with lifestyle changes
  • you have to avoid many foods to feel better
  • your IBS symptoms interfere with your daily life

At your appointment, don’t hesitate to discuss your symptoms in detail. The more specific you are, the more your a medical professional can help.

The bottom line

IBS tends to be worse in the morning. When you wake up, the motility of your large intestines increases. This can lead to IBS. Stress, which affects your gut motility, might also play a factor.

Common IBS symptoms include:

  • diarrhea
  • constipation
  • bloating
  • cramping

If you think you have IBS, talk with a medical professional. They can suggest the best treatment for your specific symptoms.

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