Why Are My IBS Symptoms Worse in the Morning?

Why in the morning?

Your IBS may tend to flare up in the morning for several reasons.

Circadian rhythm

Your circadian rhythm regulates your sleep-wake cycle and the motility of your large intestine.

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

The review also found that 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 an expected automatic response that increases motility.

The reflex is most active after eating and in the morning, which may explain why IBS symptoms tend to flare at that time of day.

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

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 and is involved in intestinal motility.

Human and animal research suggests psychological stress disrupts the connection between the brain and the 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.

Prevention

To prevent or manage IBS flare-ups, try to:

• 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 triggering IBS symptoms.
• Avoid high fat foods: High fat foods, like fried foods, overstimulate digestion. Try to limit or avoid these foods.
• Eat slowly: Eating quickly may contribute to IBS. Try to 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, stretching, and meditation, can help relieve 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 sleep 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 (IBS-D), your doctor might recommend over-the-counter (OTC) or prescription anti-diarrheal drugs. These drugs, however, might cause constipation, nausea, or blackened stools.
• Laxatives or stool softeners: If you have IBS with constipation (IBS-C), you can take OTC or prescription laxatives or stool softeners to simulate movement. Possible side effects include bloating, nausea, and diarrhea.
• Anti-spasm drugs: Antispasmodic 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 beneficial bacteria that may help your gut. Your doctor may 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
• you 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 takeaway

Your irritable bowel syndrome (IBS) may tend 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.

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