Diarrhea Every Morning

Diarrhea every morning refers to an urgent desire to have a bowel movement after waking up in the morning. Such eliminated stool is usually watery and loose. In some patients, such abnormal urge to pass feces may cause sleep disruption during the early part of mornings.

Diarrhea every morning is not a particular symptom associated with a specific underlying disorder or cause. It is however frequently observed in gastrointestinal conditions that feature diarrhea as a symptom, most often in bowel diseases like IBS/irritable bowel syndrome, or IBD/inflammatory bowel disease.

Causes of diarrhea every morning

Normal bowel activity increases when a person is awake and decreases during sleeping hours. This is because of increased activity of the nerves and hormones that regulate bowel motility as well as due to increased eating and physical activities when awake. The body also tends to deactivate several processes and sensations, such as bowel movements, during the sleep stage.

Individuals with normal sleep patterns and bowel habits tend to experience an urge to pass stool after waking up, or a short while after. This is normal. It is also different from an abnormal, uncontrollable desire to defecate stools that are watery and loose, every morning.

Diarrhea every morning may or may not have an underlying pathological cause. It is more noticeable and severe if it is caused due to an underlying disease.

Some of the non-pathological causes of diarrhea every morning are listed below:

• Alterations in the body’s circadian rhythm during mornings. As per this 24-hour body clock cycle, bowel movements are curbed during late evenings, thereby promoting increased urge to pass stools at around 8 AM. Disruption of this cycle can cause abnormal bowel movements, including diarrhea every morning.
• Increased physical activities can intensify bowel motility.
• Smoking or drinking coffee can promote bowel activities
• Defecation reflexes, i.e. duodenocolic and gastrocolic reflexes, can get stimulated due to intake of breakfast right after awakening, eventually resulting in increased colonic motility of food present in the first section of small intestine or in the stomach.
• After awakening, nerve activities and hormone levels alter so as to increase the alertness and activeness of the body. If such changes are abnormal then it can affect regular bowel motility and cause diarrhea every morning.
• Intake of fruit juice or milk by people with fructose mal-absorption or lactose intolerance, respectively, can lead to diarrhea every morning.
• Increased bacterial actions inside the bowel caused due to low or nil movement of new digestive enzymes with antibacterial properties as well as stagnancy of bowel contents during sleep, can result in abnormal bowel activity every morning.
• Buildup of water and stool inside the colon at night can cause diarrhea every morning.

Some of the pathological causes of diarrhea every morning are listed below:

• IBD/Inflammatory bowel disease: It is a persistent bowel disorder characterized by bowel wall inflammation. It occurs in two forms, i.e. ulcerative colitis and Crohn’s disease. Both types of IBD cause watery and bloody or mucus-filled diarrhea.Diarrhea may deteriorate at times, not specifically in the mornings, and tends to occur as acute bouts. The diarrhea typically begins every morning after a patient wakes up. People with severe IBD may occasionally awaken from sleep, even many times, to defecate.
• IBS/Irritable bowel syndrome: It is one of the most common causes of diarrhea every morning. It is a bowel condition characterized by abnormal contraction of the colon and intestines, slower or faster bowel motility, bloating, and pain in the abdomen. The precise cause is not known. However, changes in the diet is often the main cause. People with diarrhea-predominant IBS are most likely to experience loose and watery stools every morning. The condition can deteriorate after eating certain foods or with elevated stress. Patients may experience diarrhea every morning, or post every meal.
• Substance abuse: Misuse or excessive intake of alcohol, smoking, and illicit drugs can lead to irritation of the bowels. Most of us engage in such excessiveness during parties and social events at night. It is therefore common for such individuals to suffer from diarrhea the next morning. Diarrhea every morning can become a common feature if people engage in nicotine and alcohol abuse every night.
• AAD/Antibiotic-associated diarrhea: It is caused due to disturbances in good bowel bacteria after use of antibiotics. Most instances of AAD disappear after some time, while others may progress to chronic colon inflammation or colitis. AAD-linked diarrhea every morning typically arises due to bowel wall irritation and inertia of colon contents during sleep.
• Pregnancy: Pregnancy can sometimes result in pathologies such as abnormal levels of some hormones of like HCG/human chorionic gonadotropin and estrogen. Elevated levels of these hormones typically cause morning sickness, but it can also lead to diarrhea every morning.Just as vomiting and nausea tend to aggravate during the first trimester and mornings, pregnancy related diarrhea also worsens during these periods.
• Infections/food poisoning: Infection by bacteria or viruses which occur due to intake of contaminated food tend to cause diarrhea and vomiting all through the day. However, minor infections as well as intake of contaminated food just before sleeping can result in diarrhea in the morning.
• Extreme psychosocial stress: Bowel movements can get disrupted with extreme levels of stress. A severely stressed-out person may relive the stress upon awakening and hence experiences diarrhea every morning. Elimination of the causal stressful situations can alleviate and cure such a case of diarrhea every morning.
• Other causes: Use of certain oral contraceptives can cause “pregnancy-related high hormone” type of diarrhea every morning. Inflammation of the large intestine and colon cancer are other causes.

Treatment

Treatment of diarrhea every morning is focused at finding the underlying cause and resolving it. Patients may also be asked to make some lifestyle changes, eat a balanced and healthy diet, decrease stress, and perform some specific exercises.

• Antidiarrheal medications can be used to get temporary relief.
• Normal intestinal flora can be restored via probiotics
• Moderating fiber consumption can help prevent worsening of diarrhea.
• Avoid irritant drinks and foods like spicy foods, dairy products, fruit juices, sweeteners, alcohol, and caffeinated beverages.