Irritable Bowel Syndrome (IBS) is a gastrointestinal condition that reportedly affects around 10-15% of the global population. While the exact cause is unknown, a combination of factors, including gut hypersensitivity, abnormal brain-gut communication, and potentially gut bacteria imbalances or food sensitivities, are said to trigger the condition. There are other potential factors, like stress, past infections, family history, and hormonal changes, that can contribute to IBS.
Unfortunately, some people complain of worsening IBS symptoms in the morning. To know whether there is any truth behind it or not and to find some answers, the OnlyMyHealth team spoke to Dr Ronak Tate, Consultant Gastroenterologist, Fortis Hiranandani Hospital, Vashi.
Also Read: IBS Can Be Triggered By THESE Things! Expert Warns To Stay Cautious
Symptoms Of IBS
IBS affects the stomach and intestines, also called the gastrointestinal tract. And therefore, someone with the condition can identify it by the following symptoms:
- Abdominal pain and cramping
- Changes in bowel habits, like diarrhoea or constipation or alternating diarrhoea and constipation
- Feeling of fullness or swelling in the abdomen
- Excessive gas
- Urgent need to move bowels.
- Mucus in stool
- Fatigue
- Nausea
- Heartburn
- Sleep disturbances
- Anxiety or depression
- Migraine headaches
- Food intolerance/sensitivity
Are IBS Symptoms Worse In The Morning?
According to Dr Tate, IBS flare-ups can in fact be more common in the morning, and this could be due to various factors.
“In the morning cortisol (stress hormone) levels are high, which can increase sensitivity in the digestive system, making it more reactive to stimuli or irritation,” he said.
“The gastrocolic reflex is a natural bodily response where eating or even waking up and thinking about food triggers contractions in the colon. In people with IBS, this reflex can be exaggerated, leading to urgent bowel movements and discomfort soon after waking up, especially if you eat breakfast shortly after getting out of bed.
Additionally, your circadian rhythm regulates your sleep-wake cycle and the motility of your large intestine. Colonic motility decreases during sleep and increases when you wake up. This could trigger IBS symptoms in some people, the doctor further explains. A one-month 1993 study published in the journal Digestive Diseases and Sciences found that poor sleep worsened morning symptoms and, to a lesser extent, evening symptoms.
According to a 2020 review, circadian rhythms help manage digestion by regulating certain genes and hormones. The digestive system follows a 24-hour cycle, with more bowel activity during the day, especially after waking up or eating, and less at night. Factors like environment can change these rhythms. When disrupted, they may cause digestive problems like constipation and IBS.
Also Read: How Do Probiotics Benefit IBS Patients: Gastroenterologist Shares Insights
Dietary Changes That Can Help Minimise Morning IBS Flare-Ups
For people with IBS, identifying your food triggers and ensuring a balanced diet is extremely crucial. Some of the useful dietary changes that you can incorporate into your routine include:
- Avoid eating foods that trigger IBS, like coffee, beans, spicy foods, or dairy.
- 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 practise mindful eating.
Morning Habits That Reduce Risk
Dr Tate recommended a gentle morning walk, a balanced, IBS-friendly breakfast, and mindful stress management techniques like deep breathing or meditation.
He also emphasised a low FODMAP diet (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), adequate hydration the previous night, and good fibre intake.
Conclusion
While IBS is not curable, it is fairly common and can be managed effectively. However, if you have severe abdominal pain, rectal bleeding, weight loss, vomiting, fever, fatigue, nocturnal symptoms, low haemoglobin, or if you are non-responsive to home remedies or Over-The-Counter medications, it is crucial to see a doctor immediately, Dr Tate noted.