Waking up in the morning and urgently needing to get to the loo is not uncommon. Or maybe there’s a little less urgency but your first bowel movement is always loose and unformed, watery even. Many of my clients come to see me because morning diarrhoea is perplexing them. They can’t understand why this happens or prevent it.
If you wake with cramping, urgency or loose stools, read on to understand the different mechanisms and possible causes behind this.
Why do diarrhoea or loose stools occur in the morning?
Every body has a circadian rhythm, this is our natural internal clock and first thing in the morning, your body starts to get moving. Cortisol starts to rise, which gets your gut going too. This is part of a healthy process called the gastrocolic reflex. However, when your gut is inflamed or sensitive that reflex can become overenthusiastic. Instead of a normal bowel movement, it turns into cramping, urgency or full-blown diarrhoea.
There are several reasons this can happen and what’s causing morning diarrhoea in you might be different to someone else. But here are the most common things I see.
IBS
Morning diarrhoea is often a feature of IBS, you may have a diagnosis or suspect you have it. This can mean your gut is extra sensitive or reactive to stress, hormones or food. This sensitivity can be heightened in the early part of the day. IBS is an umbrella term that covers a variety of symptoms, all with digestive dysfunction and likely gut dysbiosis as a common cause. Working with a practitioner on these areas can significantly improve or eliminate your symptoms. This, in turn, will get rid of morning urgency. Waking up feeling stressed or anxious can be an indication of higher than usual morning cortisol levels. Combined with a sensitive gut, this leads to an overactive bowel response.
Food Sensitivities
The foods you had the day or night before can contribute to gut irritation which then leads to morning diarrhoea. It’s best to identify your specific triggers as they can be varied. You can work with a practitioner who can help with this or run a food sensitivity test. Food sensitivities develop when the gut is irritated or dysfunctional. Common problem foods that irritate the gut include processed foods, coffee, fatty foods and alcohol.
Small Intestinal Bacterial Overgrowth (SIBO)
If bacteria have overgrown in the small intestine (SIBO), they ferment foods and cause gas, bloating and a gurgling noise in the stomach along with altered bowel movements. This can be worse after meals and in the morning. You can. test for the presence of bacteria in the small intestine. SIBO can co-exist with IBS or it can develop after a course of antibiotics, gall bladder surgery, or gall bladder issues or after a period of stress.
Inflammatory Bowel Disease (IBD)
If there’s ongoing inflammation in the gut like with Crohn’s or ulcerative colitis morning diarrhoea may be one of the first symptoms. These conditions usually also include things like fatigue, weight changes, or blood in the stool. If you’re seeing red flags like that, do speak with your GP or practitioner. If you already have a diagnosis of IBD, consider working with a practitioner to investigate triggers, support gut and immune health and lower inflammation. A stool test can give some useful insights with IBD.
Bile acid malabsorption
Bile acids help you digest fats but if they’re not reabsorbed properly they can irritate the colon and trigger diarrhoea, often first thing in the morning. This can happen if your last meal contained fatty foods and bile is released but not properly reabsorbed. it can also occur when there have been gall bladder issues, like sluggish bile or gall stones.
There are a number of reasons urgency in the morning can occur. If you are able to identify a potential culprit like last night’s take away of glass of wine then you can find a way to work with that.
However, if the situation is chronic and you are struggling to identify a specific trigger, feel free to book a consultation where we can take the time to discuss your current symptoms and health history and help you move forward from this. You don’t have to live with the discomfort, unpredictability or embarrassment that comes with morning diarrhoea.
