It is not uncommon for some people with IBS to experience worse symptoms in the morning. There are 4 prevalent reasons why this may be happening to you.
1.Overactive gastrocolic reflex
The gastro-colic reflex is a physiological reflex that occurs in response to stretching of the stomach after eating a meal and the arrival of this partially digested meal into the small intestine. This reflex is responsible for signalling to large bowel to make room for the meal on the way or in other words it’s why you can have the urge to open your bowels following a meal. The process normally takes approximately 20 – 30 minutes, and as it’s more active in the morning, for many people this results in the urge to move their bowels approx. 30 minutes after breakfast.
However, some people with IBS have an over-exaggerated gastrocolic reflex due to suffering with hypersensitivity of the nerves in the gut. So after eating breakfast, the risk of experiencing IBS symptoms such as diarrhoea and pain can be more intense and unfortunately much faster than that of someone without IBS.
Stress and IBS are intimately linked. This is due to the gut-brain axis or bidirectional nerve connections between your gut and brain as stress can disturb the connection between the brain and gut. For example, stress and anxiety can activate the central nervous system, which in turn releases hormones that affect digestive processes and motility in your gut and leading to an array of unwanted IBS symptoms.
If you’re experiencing high levels of stress, this can negatively impact your IBS symptoms upon waking up. You may also have conditioned IBS fear, where the stress of the anticipation of having symptoms could trigger more symptoms. You can’t underestimate the power of the link!
Your circadian rhythm is your body’s internal clock. It regulates your sleep-wake cycle, as well as the motility of your large intestine. Normally your bowel activity decreases during sleep and increases when you wake up. But for some people with IBS, there is the potential of having a disrupted circadian rhythm. This can be caused by for example, night shift work, light at night, late evening food, late sleep or late physical exercise, as well as irregular meal schedules and jet lag, and this can increase the risk of IBS symptoms in the morning.
A breakfast high in fat or caffeine or fruit juice, the previous days meals which were possibly too high in FODMAPs, or a few alcoholic beverages can all be playing a role in increasing IBS symptoms in the morning.
Keeping a food and symptom diary and working with a dietitian can be a good place to start to try and manage these risks. In fact, considering joining the Diet-Hypno programme can help you target and regulate many of the above risk of morning IBS symptoms!
As always, don’t let the embarrassment of discussing digestive problems, stomach pain after eating, frequent or explosive diarrhoea, or other possible symptoms of IBS keep you from discussing your problems