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4:30 am wakeup call: can I retrain my bowel?

4K views 26 replies 6 participants last post by  Mike NoLomotil 
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#1 ·
My gut wakes me up every morning at 4:30. I wake up, have a lot of gas, and eventually the diarrhea comes (usually by 6 am sometimes even by 5 am). I am really tired of waking up at 4:30!! --it just makes me so tired! And with the switch to daylight savings time looming (I've never lived somewhere with DST before, when exactly does the time switch?), I'll be waking at 3:30 am!! --I am nothing if not regular.Whether I am normal or IBSing, I have my bowel movements at the same time of the day. Little Miss Regularity, I am. And I do appreciate the predictibility of that. But man, I wish it weren't SO EARLY. Is there any way to retrain my bowel to wake up LATER??? even 6 am would be fine! Thanks for any input
 
#3 ·
EARLY RISER SKOOZ,Yes, you could try to retrain your bowel to wake up later and you will get lots of advice about that BUT this is not the way your bowel should be waking up...with diarrheaic episodes. There is more going on here than behavioral modification is going to benefit. It is better to get to the bottom of why you are getting this diarrheic episode every day. Before I say anything about what causes this in the absence of known infection, dysbiosis, or even IBD, have you seen a board certified gatsroenterologist and had a compete differential diagnosis done and all that goes with that?If not that should be your first step before you start thinking about any of the remedies we will toss about in the community.If you have underlying pathology and we toss some masking symptomatic treatment at it, that would be a gross disservice to you.I cannot hang out today but I would like to know what the situation is with your diagnostic work etc as asked, and then I feel we can give better advice. Will revisit tomorrow if there is any way I can provide some input after you reply.Eat well. Think well. Be well.MNL_______________ www.leapallergy.com
 
#2 ·
EARLY RISER SKOOZ,Yes, you could try to retrain your bowel to wake up later and you will get lots of advice about that BUT this is not the way your bowel should be waking up...with diarrheaic episodes. There is more going on here than behavioral modification is going to benefit. It is better to get to the bottom of why you are getting this diarrheic episode every day. Before I say anything about what causes this in the absence of known infection, dysbiosis, or even IBD, have you seen a board certified gatsroenterologist and had a compete differential diagnosis done and all that goes with that?If not that should be your first step before you start thinking about any of the remedies we will toss about in the community.If you have underlying pathology and we toss some masking symptomatic treatment at it, that would be a gross disservice to you.I cannot hang out today but I would like to know what the situation is with your diagnostic work etc as asked, and then I feel we can give better advice. Will revisit tomorrow if there is any way I can provide some input after you reply.Eat well. Think well. Be well.MNL_______________ www.leapallergy.com
 
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#4 ·
Hmmm. When I had my workup done and got my diagnosis, here is what the GI did:1. stool culture (obviously!)2. stool for O&P3. sigmoidoscopy (still not sure WHY!)4. barium upper and lower5. colonoscopy.Everything was normal! That's when they said "it's IBS" --and it resolved shortly after that, so I never investigated further. The only truly unusual thing was that after the barium, they take films every 45 minutes till you've passed the barium through. They said "it usually takes 4 to 6 hours" --well, when they took my FIRST film at 45 minutes, the barium was already GONE! The techs commented that they'd never seen anything run through somebody so fast in their life!I've wondered how you identify food triggers. . for instance, I had a "bad" morning this morning. Was it something I ate yesterday? Or the day before? --how do you know? I've never been able to associate my diarrhea with something that I eat because when I'm NOT IBSing for months on end, I eat what I eat, and when I AM IBSing for months on end, I'm eating the same stuff! So I've assumed it was all anxiety and not food triggers. However, I am very open to admitting my ignorance and looking into the food thing.
 
G
#5 ·
Hmmm. When I had my workup done and got my diagnosis, here is what the GI did:1. stool culture (obviously!)2. stool for O&P3. sigmoidoscopy (still not sure WHY!)4. barium upper and lower5. colonoscopy.Everything was normal! That's when they said "it's IBS" --and it resolved shortly after that, so I never investigated further. The only truly unusual thing was that after the barium, they take films every 45 minutes till you've passed the barium through. They said "it usually takes 4 to 6 hours" --well, when they took my FIRST film at 45 minutes, the barium was already GONE! The techs commented that they'd never seen anything run through somebody so fast in their life!I've wondered how you identify food triggers. . for instance, I had a "bad" morning this morning. Was it something I ate yesterday? Or the day before? --how do you know? I've never been able to associate my diarrhea with something that I eat because when I'm NOT IBSing for months on end, I eat what I eat, and when I AM IBSing for months on end, I'm eating the same stuff! So I've assumed it was all anxiety and not food triggers. However, I am very open to admitting my ignorance and looking into the food thing.
 
G
#6 ·
OH, and btw, when I am normal, I always wake up in the morning and have a BM first thing. The only difference when I'm IBSing is that it is diarrhea instead of a normal BM, and it is much much earlier (instead of my more reasonable 7:30 am!).
 
G
#7 ·
OH, and btw, when I am normal, I always wake up in the morning and have a BM first thing. The only difference when I'm IBSing is that it is diarrhea instead of a normal BM, and it is much much earlier (instead of my more reasonable 7:30 am!).
 
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#9 ·
I have had to threaten my husband with bodily harm if he continues to wake me early in the morning. Once I am awake, I have to go. My G.I. doc did say that retraining your bowel is possible sometimes.I might suggest that you dont eat food too late in the day, and take some Calcium and or Immodium before you go to bed. IF you are waiting for test results then you could discuss a plan of action with your doctor.------------------Brenda S, R.N.This too shall pass !Although I am a nurse, nothing I say here should be taken as medical advice, its only personal experience. See your own doctor for any medical questions & answers.
 
G
#8 ·
I have had to threaten my husband with bodily harm if he continues to wake me early in the morning. Once I am awake, I have to go. My G.I. doc did say that retraining your bowel is possible sometimes.I might suggest that you dont eat food too late in the day, and take some Calcium and or Immodium before you go to bed. IF you are waiting for test results then you could discuss a plan of action with your doctor.------------------Brenda S, R.N.This too shall pass !Although I am a nurse, nothing I say here should be taken as medical advice, its only personal experience. See your own doctor for any medical questions & answers.
 
#11 ·
I've had IBS for 8.5 years now. I've gone through cycles of weeks of waking at 4:30 with the same things you're experiencing. Then, for several weeks I might not have that happen only to have it return later. It has been a long, tiring rollercoaster ride. I've accepted that the ride probably won't be over until I am.I wish I knew why there are some periods of time I go through without these early morning seranades from below. My best guess is that it has little to do with the bowel itself and everything to do with changes in your sleep habits in general...room temperature, exercise, and other factors that affect your ability to sleep. As one post put it "as soon as I'm awake, I have to go." For me, it is more like 15-30 minutes after I wake-up I have to go, but my point is...if you study sleep, you'll learn that even normal people cycle through 4-5 stages of sleep many times during a night. On any given night, the quanitity and quality of those stages can vary tremendously.My best guess is that those variations in sleep patterns in general have more to do with the undesirable wake-up calls than anything else. Of course, it is sort of a chicken-and-the-egg question, isn't it?Try doing whatever you can to make sure your sleep situation is as ideal as possible before you assume that anything can be done about your bowel itself. Make sure the room is cool enough. Make sure you go to bed fully relaxed. Perhaps engage in some vigorous exercise to get yourself uhh...pooped-out (sorry).Peaceful dreams,Steve
 
#10 ·
I've had IBS for 8.5 years now. I've gone through cycles of weeks of waking at 4:30 with the same things you're experiencing. Then, for several weeks I might not have that happen only to have it return later. It has been a long, tiring rollercoaster ride. I've accepted that the ride probably won't be over until I am.I wish I knew why there are some periods of time I go through without these early morning seranades from below. My best guess is that it has little to do with the bowel itself and everything to do with changes in your sleep habits in general...room temperature, exercise, and other factors that affect your ability to sleep. As one post put it "as soon as I'm awake, I have to go." For me, it is more like 15-30 minutes after I wake-up I have to go, but my point is...if you study sleep, you'll learn that even normal people cycle through 4-5 stages of sleep many times during a night. On any given night, the quanitity and quality of those stages can vary tremendously.My best guess is that those variations in sleep patterns in general have more to do with the undesirable wake-up calls than anything else. Of course, it is sort of a chicken-and-the-egg question, isn't it?Try doing whatever you can to make sure your sleep situation is as ideal as possible before you assume that anything can be done about your bowel itself. Make sure the room is cool enough. Make sure you go to bed fully relaxed. Perhaps engage in some vigorous exercise to get yourself uhh...pooped-out (sorry).Peaceful dreams,Steve
 
#13 ·
There are a number of things that effect circadian rhythms, but I'm not sure what in particular will reset you. Some people are more set than others.I know caffiene tends to effect it, but coffee before bedtime to reset you a couple hours ahead (it's part of why it wakes you up in the morning....your now at 8 am instead of 6 am) might not be conducive to getting a good night sleep.The colon normally gets 3X more active when you awaken. I wonder if doing some things to make your sleep better may help. It may be your sleep lightens up enough at that time of day that your body thinks you got up.Sometimes the signals needed to keep the circadian rythm can be be farily subtle. In one experiment where they wanted people to free cycle they put the room near the time clock and the clicks at the same time every day was enough to keep some people entrained on 24 hours. Light and social cues are some of the most potent for people.For good sleep hygeine.Get up at the same time every morningDo not nap during the day. (if you must you can have a 20 minute power nap but no more than that)Make sure the room is the right temperature, darkness and quietness.Do things about 1 hour before bedtime that tend to set up the sleep cycle. Dim the lights, no strenous mental or physical activity. Take a hot bath or shower (the body temp drops as a signal to sleep so sometimes artificially warming yourself up so you then have an artificial drop helps).Melatonin sometimes helps as it is also a natural signal for the start of sleep (many people use it for jet lag).Exercise during the day can help you sleep more regularly at night.The other thing to think about is try taking Imodium at bedtime. It may slow things down so it won't wake you up.I find that if I have things that wake me up, I will almost always need to use the bathroom for one thing or another, If I can sleep through the night and stay asleep I usually have fewer nighttime bathroom visits.Signals for time to wake up that I use to get myself up when it is dark outside. A dim light that goes on 30-45 minutes before getting up. (you can get alarm clocks that are light based and they start dim and slowly get brighter over the course of about 1/2 an hour...I just have a light on a timer). Setting the programable thermostat so it heat kicks on about 30 minutes before I get up. For me sometimes doing the morning thing helps entrain the whole system so that I then get a good nights sleep the following night.If you snore loudly you may want to be evaluated. When you stop breathing at night that will wake you up and sometimes in the "what woke me up" scan one of the focuses is bowel/bladder.K.------------------ kmottus###aol.com�When I despair, I remember that all through history the way of truth and love has always won. There have been tyrants and murderers and for a time they seem invincible but in the end, they always fall�Think of it, ALWAYS. �Mahatma GandhiMy story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html
 
#12 ·
There are a number of things that effect circadian rhythms, but I'm not sure what in particular will reset you. Some people are more set than others.I know caffiene tends to effect it, but coffee before bedtime to reset you a couple hours ahead (it's part of why it wakes you up in the morning....your now at 8 am instead of 6 am) might not be conducive to getting a good night sleep.The colon normally gets 3X more active when you awaken. I wonder if doing some things to make your sleep better may help. It may be your sleep lightens up enough at that time of day that your body thinks you got up.Sometimes the signals needed to keep the circadian rythm can be be farily subtle. In one experiment where they wanted people to free cycle they put the room near the time clock and the clicks at the same time every day was enough to keep some people entrained on 24 hours. Light and social cues are some of the most potent for people.For good sleep hygeine.Get up at the same time every morningDo not nap during the day. (if you must you can have a 20 minute power nap but no more than that)Make sure the room is the right temperature, darkness and quietness.Do things about 1 hour before bedtime that tend to set up the sleep cycle. Dim the lights, no strenous mental or physical activity. Take a hot bath or shower (the body temp drops as a signal to sleep so sometimes artificially warming yourself up so you then have an artificial drop helps).Melatonin sometimes helps as it is also a natural signal for the start of sleep (many people use it for jet lag).Exercise during the day can help you sleep more regularly at night.The other thing to think about is try taking Imodium at bedtime. It may slow things down so it won't wake you up.I find that if I have things that wake me up, I will almost always need to use the bathroom for one thing or another, If I can sleep through the night and stay asleep I usually have fewer nighttime bathroom visits.Signals for time to wake up that I use to get myself up when it is dark outside. A dim light that goes on 30-45 minutes before getting up. (you can get alarm clocks that are light based and they start dim and slowly get brighter over the course of about 1/2 an hour...I just have a light on a timer). Setting the programable thermostat so it heat kicks on about 30 minutes before I get up. For me sometimes doing the morning thing helps entrain the whole system so that I then get a good nights sleep the following night.If you snore loudly you may want to be evaluated. When you stop breathing at night that will wake you up and sometimes in the "what woke me up" scan one of the focuses is bowel/bladder.K.------------------ kmottus###aol.com�When I despair, I remember that all through history the way of truth and love has always won. There have been tyrants and murderers and for a time they seem invincible but in the end, they always fall�Think of it, ALWAYS. �Mahatma GandhiMy story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html
 
#15 ·
Didn't know your colon is 3 times more active in the morning..That tell me something because sometimes that is the worst part of the day for me....I dont even have to eat anything to get it going------------------"If you always do what you have always did, You'll always get what you always got "
 
#14 ·
Didn't know your colon is 3 times more active in the morning..That tell me something because sometimes that is the worst part of the day for me....I dont even have to eat anything to get it going------------------"If you always do what you have always did, You'll always get what you always got "
 
#17 ·
My main problem apart from having bowel movements is that I have to empty my bladder through the night.At first I was waking up at least five times during the night. This has all changed since I started exercising on a regular basis.I`v found that after a good workout at the gym, my sleep is extremely deep. Therefore I might wake up once or twice and sometomes I just sleep till my alarm wakes me up around 8am. My sleep is definately better since I started exercising.Hope this helps.Courage
 
#16 ·
My main problem apart from having bowel movements is that I have to empty my bladder through the night.At first I was waking up at least five times during the night. This has all changed since I started exercising on a regular basis.I`v found that after a good workout at the gym, my sleep is extremely deep. Therefore I might wake up once or twice and sometomes I just sleep till my alarm wakes me up around 8am. My sleep is definately better since I started exercising.Hope this helps.Courage
 
#18 ·
ohnometo.They did measurements in normal people 24/7 that was published not too long ago.The colon right after you get up is typically 3X over the activity in the middle of the night (lowest activity) and 2X more active after meals.If you read the board awhile it seems that there are many people with morning issues and post meal issues and this tends to mesh well with those patterns and with the idea that the nervous system that would be regulating those patterns may be mucked up. For instance with me that post meal signal either overreacts, or is over-responded to and when the IBS was bad as soon as I eat enough to fill the stomach even a bit I'd be in pain and in the bathroom.K.------------------ kmottus###aol.com�When I despair, I remember that all through history the way of truth and love has always won. There have been tyrants and murderers and for a time they seem invincible but in the end, they always fall�Think of it, ALWAYS. �Mahatma GandhiMy story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html
 
#19 ·
ohnometo.They did measurements in normal people 24/7 that was published not too long ago.The colon right after you get up is typically 3X over the activity in the middle of the night (lowest activity) and 2X more active after meals.If you read the board awhile it seems that there are many people with morning issues and post meal issues and this tends to mesh well with those patterns and with the idea that the nervous system that would be regulating those patterns may be mucked up. For instance with me that post meal signal either overreacts, or is over-responded to and when the IBS was bad as soon as I eat enough to fill the stomach even a bit I'd be in pain and in the bathroom.K.------------------ kmottus###aol.com�When I despair, I remember that all through history the way of truth and love has always won. There have been tyrants and murderers and for a time they seem invincible but in the end, they always fall�Think of it, ALWAYS. �Mahatma GandhiMy story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html
 
#20 ·
You may have read my prior posts about caffeine consumption.I had a very regular schedule of abdominal pain that was timing in right around 12-18 hours after drinking caffeine, in the form of hot tea for breakfast.At night, starting from 10 pm to 1 am, the pain would kick in, then ramp up to an unbearable level and wake me up.But it didn't happen every night. I believe there was a threshhold effect on the amount of caffeine consumed. In other words, maybe one cup of tea would not produce a problem, but two cups would, or perhaps one cup would if it were brewed stronger.I could kick myself now for suffering with this problem as long as I did, given how easily it was solved by removing caffeine from the diet. My case was seasonally worse in the winter, as my diet changes somewhat in cold weather, and I tended to drink considerably more caffeine in the winter months.Of course, your case may be completely different, but it is common for people to have regular habits of consuming certain foods at certain times of the day.
 
#21 ·
You may have read my prior posts about caffeine consumption.I had a very regular schedule of abdominal pain that was timing in right around 12-18 hours after drinking caffeine, in the form of hot tea for breakfast.At night, starting from 10 pm to 1 am, the pain would kick in, then ramp up to an unbearable level and wake me up.But it didn't happen every night. I believe there was a threshhold effect on the amount of caffeine consumed. In other words, maybe one cup of tea would not produce a problem, but two cups would, or perhaps one cup would if it were brewed stronger.I could kick myself now for suffering with this problem as long as I did, given how easily it was solved by removing caffeine from the diet. My case was seasonally worse in the winter, as my diet changes somewhat in cold weather, and I tended to drink considerably more caffeine in the winter months.Of course, your case may be completely different, but it is common for people to have regular habits of consuming certain foods at certain times of the day.
 
#23 ·
HI SKOOZI did not forget to reply..I just worked my way down here finally and now I have a 9:30 am meeting. Since it is my meeting I guess I should be there
You have some good information above but some questions you asked are still unanswered. I will be back as soon as I can and answer the remaining questions you asked to the best of my ability.Stand by duty callsMNL______________ www.leapallergy.com
 
#22 ·
HI SKOOZI did not forget to reply..I just worked my way down here finally and now I have a 9:30 am meeting. Since it is my meeting I guess I should be there
You have some good information above but some questions you asked are still unanswered. I will be back as soon as I can and answer the remaining questions you asked to the best of my ability.Stand by duty callsMNL______________ www.leapallergy.com
 
G
#25 ·
thanks for all replies, including those pending! For the record I am a caffeine-free sorta girl, have been since July (formerly a caffeine addict!). Sometimes I have to laugh because when I WAS ingesting a lot of caffeine I did NOT have this problem! haha.I appreciate the workout advice too. I am a fairly regular exerciser but last night I did a vigorous workout later in the day than usual (it was 8 pm, actually) to see if that would help me sleep (late workouts usually do). I woke at 4 instead of 4:30 this morning so I can't say it helped. But nonetheless, it was a good idea! Anything is worth a try. And Kmottus, thanks for the sleep hygiene tips. I will double-check through those and make sure I'm not sabotaging myself in any way.I really do think, though, that when my gut wakes up, I wake up, whether I'm IBSing or not. My dad is the same way, we always joke about how we never get to sleep in our Saturdays because our bowels move us. ha.
 
G
#24 ·
thanks for all replies, including those pending! For the record I am a caffeine-free sorta girl, have been since July (formerly a caffeine addict!). Sometimes I have to laugh because when I WAS ingesting a lot of caffeine I did NOT have this problem! haha.I appreciate the workout advice too. I am a fairly regular exerciser but last night I did a vigorous workout later in the day than usual (it was 8 pm, actually) to see if that would help me sleep (late workouts usually do). I woke at 4 instead of 4:30 this morning so I can't say it helped. But nonetheless, it was a good idea! Anything is worth a try. And Kmottus, thanks for the sleep hygiene tips. I will double-check through those and make sure I'm not sabotaging myself in any way.I really do think, though, that when my gut wakes up, I wake up, whether I'm IBSing or not. My dad is the same way, we always joke about how we never get to sleep in our Saturdays because our bowels move us. ha.
 
#27 ·
SKOOZ:I read this in the context of some of your other posts which contain different details of your symptom sets:"I've wondered how you identify food triggers. . for instance, I had a "bad" morning this morning. Was it something I ate yesterday? Or the day before? --how do you know? I've never been able to associate my diarrhea with something that I eat because when I'm NOT IBSing for months on end, I eat what I eat, and when I AM IBSing for months on end, I'm eating the same stuff! So I've assumed it was all anxiety and not food triggers. However, I am very open to admitting my ignorance and looking into the food thing. "Hey, skip the self-deprecation vis a vis ignorant about IBS and such. that is the one thing we all truly have in common here. Some are just less ignorant than others...nobody has THE HANDLE yet.That being said, while your questions about food triggers and delayed reactions, and such all reflect a basic understanding of the underlying truths, I don't know if this is where to focus for you yet based on integrating everything you write.One of the most misunderstood subjects is how the normal bacterial flora of the GI tract and the GI tracts immune system have "learned" to work together as your body grew up.[No I am not bypassing your rapid-transit time or that "never saw such a thing" remark of the technicians....if they saw my barium studies years ago they would have opned up a $2 betting window and had me swallow radio-opaque objects
.It has been suggested that a substantial subpopulation of IBS-d types and cyclics sufer varying degrees and weird patterns of loss of oral tolerance secondary to disruption of the normal flora (antibiotics, inflammatory events) and/or from the effects of overuse of NSAIDS.Now, saying "stool culture normal" can mean different hings to different people. Do you recall more clearly exactly what they reported...vis a vis just looked for obviosu pathogens....or ???Did I miss anywhere a big bad course of broad specturm abtibiotics anywhere in your history?Also, ahve you ever taken a good live-multi culture probiotic (not just lactobacillus...which is of limited benefit?)Just snooping around some ideas.later....MNL_____________ www.leapallergy.com
 
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