Why do I poo in the morning? A gut expert explains
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No, you’re not imagining it. People really are more likely to poo in the morning, shortly after breakfast. Researchers have actually studied this.
But why mornings? What if you tend to poo later in the day? And is it worth training yourself to be a morning pooper?
To understand what makes us poo when we do, we need to consider a range of factors including our body clock, gut muscles and what we have for breakfast.
Here’s what the science says.
So morning poos are real?
In a UK study from the early 1990s, researchers asked nearly 2,000 men and women in Bristol about their bowel habits.
The most common time to poo was in the early morning. The peak time was 7-8am for men and about an hour later for women. The researchers speculated that the earlier time for men was because they woke up earlier for work.
About a decade later, a Chinese study found a similar pattern. Some 77% of the almost 2,500 participants said they did a poo in the morning.
But why the morning?
There are a few reasons. The first involves our circadian rhythm – our 24-hour internal clock that helps regulate bodily processes, such as digestion.
For healthy people, our internal clock means the muscular contractions in our colon follow a distinct rhythm.
There’s minimal activity in the night. The deeper and more restful our sleep, the fewer of these muscle contractions we have. It’s one reason why we don’t tend to poo in our sleep.
But there’s increasing activity during the day. Contractions in our colon are most active in the morning after waking up and after any meal.
One particular type of colon contraction partly controlled by our internal clock are known as “mass movements”. These are powerful contractions that push poo down to the rectum to prepare for the poo to be expelled from the body, but don’t always result in a bowel movement. In healthy people, these contractions occur a few times a day. They are more frequent in the morning than in the evening, and after meals.
Breakfast is also a trigger for us to poo. When we eat and drink our stomach stretches, which triggers the “gastrocolic reflex”. This reflex stimulates the colon to forcefully contract and can lead you to push existing poo in the colon out of the body. We know the gastrocolic reflex is strongest in the morning. So that explains why breakfast can be such a powerful trigger for a bowel motion.
Then there’s our morning coffee. This is a very powerful stimulant of contractions in the sigmoid colon (the last part of the colon before the rectum) and of the rectum itself. This leads to a bowel motion.
How important are morning poos?
Large international surveys show the vast majority of people will poo between three times a day and three times a week.
This still leaves a lot of people who don’t have regular bowel habits, are regular but poo at different frequencies, or who don’t always poo in the morning.
So if you’re healthy, it’s much more important that your bowel habits are comfortable and regular for you. Bowel motions do not have to occur once a day in the morning.
Morning poos are also not a good thing for everyone. Some people with irritable bowel syndrome feel the urgent need to poo in the morning – often several times after getting up, during and after breakfast. This can be quite distressing. It appears this early-morning rush to poo is due to overstimulation of colon contractions in the morning.
Can you train yourself to be regular?
Yes, for example, to help treat constipation using the gastrocolic reflex. Children and elderly people with constipation can use the toilet immediately after eating breakfast to relieve symptoms. And for adults with constipation, drinking coffee regularly can help stimulate the gut, particularly in the morning.
A disturbed circadian rhythm can also lead to irregular bowel motions and people more likely to poo in the evenings. So better sleep habits can not only help people get a better night’s sleep, it can help them get into a more regular bowel routine.
Regular physical activity and avoiding sitting down a lot are also important in stimulating bowel movements, particularly in people with constipation.
We know stress can contribute to irregular bowel habits. So minimising stress and focusing on relaxation can help bowel habits become more regular.
Fibre from fruits and vegetables also helps make bowel motions more regular.
Finally, ensuring adequate hydration helps minimise the chance of developing constipation, and helps make bowel motions more regular.
Monitoring your bowel habits
Most of us consider pooing in the morning to be regular. But there’s a wide variation in normal so don’t be concerned if your poos don’t follow this pattern. It’s more important your poos are comfortable and regular for you.
If there’s a major change in the regularity of your bowel habits that’s concerning you, see your GP. The reason might be as simple as a change in diet or starting a new medication.
But sometimes this can signify an important change in the health of your gut. So your GP may need to arrange further investigations, which could include blood tests or imaging.
Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Missing Microbes – by Dr. Martin Blaser
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You probably know that antibiotic resistance is a problem, but you might not realize just what a many-headed beast antibiotic overuse is.
From growing antibiotic superbugs, to killing the friendly bacteria that normally keep pathogens down to harmless numbers (resulting in death of the host, as the pathogens multiply unopposed), to multiple levels of dangers in antibiotic overuse in the farming of animals, this book is scary enough that you might want to save it for Halloween.
But, Dr. Blaser does not argue against antibiotic use when it’s necessary; many people are alive because of antibiotics—he himself recovered from typhoid because of such.
The style of the book is narrative, but information-dense. It does not succumb to undue sensationalization, but it’s also far from being a dry textbook.
Bottom line: if you’d like to understand the real problems caused by antibiotics, and how we can combat that beyond merely “try not to take them unnecessarily”, this book is very worthy reading.
Click here to check out Missing Microbes, and learn more about yours!
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How to Change – by Katy Milkman
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Sometimes it seems that we know everything we should be doing… We have systems and goals and principles, we know about the importance of habits, and we do our best to live them. Yet, somehow, life has other plans for us and things don’t quite come together they way they did in our genius masterplan.
So, what happened? And more importantly, what are we supposed to do about this? Katy Milkman has answers, right from the start.
Sometimes, it can be as simple as when we try to implement a change. It’s not that there’s a “wrong time” for a good change, so much that there are times that are much more likely to succeed than others… and those times can be identified and used.
Sometimes we’re falling prey to vices—which she explains how to overcome—such as:
- Impulsivity
- Procrastination
- Forgetfulness
- Laziness
We also learn some counterintuitive truths about what can boost or sabotage our confidence along the way!
Milkman writes in a compelling, almost narrative style, that makes for very easy reading. The key ideas, built up to by little (ostensibly true) stories and then revealed, become both clear and memorable. Most importantly, applicable.
Bottom line: this is a great troubleshooting guide for when you know how everything should be working, but somehow, it just doesn’t—and you’d like to fix that.
Click here to check out “How To Change” on Amazon, and get those changes rolling!
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Considering taking Wegovy to lose weight? Here are the risks and benefits – and how it differs from Ozempic
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The weight-loss drug Wegovy is now available in Australia.
Wegovy is administered as a once-weekly injection and is approved specifically for weight management. It’s intended to be used in combination with a reduced-energy diet and increased physical activity.
So how does Wegovy work and how much weight can you expect to lose while taking it? And what are the potential risks – and costs – for those who use it?
Let’s look at what the science says.
Halfpoint/Shutterstock What is Wegovy?
Wegovy is a brand name for the medication semaglutide. Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better.
Normally when you eat, the body releases the GLP-1 hormone which helps signal to your brain that you are full. Semaglutides enhance this effect, leading to a feeling of fullness, even when you haven’t eaten.
Another role of GLP-1 is to stimulate the body to produce more insulin, a hormone which helps lower the level of glucose (sugar) in the blood. That’s why semaglutides have been used for several years to treat type 2 diabetes.
Wegovy is self-injected once a week. S Becker/Shutterstock How does Wegovy differ from Ozempic?
Like Wegovy, Ozempic is a semaglutide. The way Wegovy and Ozempic work in the body are essentially the same. They’re made by the same pharmaceutical company, Novo Nordisk.
But there are two differences:
1) They are approved for two different (but related) reasons.
In Australia (and the United States), Ozempic is approved for use to improve blood glucose levels in adults with type 2 diabetes. By managing blood glucose levels effectively, the medication aims to reduce the risk of major complications, such as heart disease.
Wegovy is approved for use alongside diet and exercise for people with a body mass index (BMI) of 30 or greater, or 27 or greater but with other conditions such as high blood pressure.
Wegovy can also be used in people aged 12 years and older. Like Ozempic, Wegovy aims to reduce the risk of future health complications, including heart disease.
2) They are both injected but come in different strengths.
Ozempic is available in pre-loaded single-dose pens with varying dosages of 0.25 mg, 0.5 mg, 1 mg, or 2 mg per injection. The dose can be slowly increased, up to a maximum of 2 mg per week, if needed.
Wegovy is available in prefilled single-dose pens with doses of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg. The treatment starts with a dose of 0.25 mg once weekly for four weeks, after which the dose is gradually increased until reaching a maintenance dose of 2.4 mg weekly.
While it’s unknown what the impact of Wegovy’s introduction will be on Ozempic’s availability, Ozempic is still anticipated to be in low supply for the remainder of 2024.
Is Wegovy effective for weight loss?
Given Wegovy is a semaglutide, there is very strong evidence it can help people lose weight and maintain this weight loss.
A recent study found that over four years, participants taking Wevovy as indicated experienced an average weight loss of 10.2% body weight and a reduction in waist circumference of 7.7cm.
For those who stop taking the medication, analyses have shown that about two-thirds of weight lost is regained.
Wegovy can help people lose weight and maintain their weight loss – while they take the drug. Mladen Mitrinovic/Shutterstock What are the side effects of Wegovy?
The most common side effects are nausea and vomiting.
However, other serious side effects are also possible because of the whole-of-body impact of the medication. Thyroid tumours and cancer have been detected as a risk in animal studies, yet are rarely seen in human scientific literature.
In the four-year Wegovy trial, 16.6% of participants who received Wegovy (1,461 people) experienced an adverse event that led to them permanently discontinuing their use of the medication. This was higher than the 8.2% of participants (718 people) who received the placebo (with no active ingredient).
Side effects included gastrointestinal disorders (including nausea and vomiting), which affected 10% of people who used Wegovy compared to 2% of people who used the placebo.
Gallbladder-related disorders occurred in 2.8% of people who used Wegovy, and 2.3% of people who received the placebo.
Recently, concerns about suicidal thoughts and behaviours have been raised, after a global analysis reviewed more than 36 million reports of adverse events from semaglutide (Ozempic or Wegovy) since 2000.
There were 107 reports of suicidal thoughts and self-harm among people taking semaglutide, sadly including six actual deaths. When people stopped the medication, 62.5% found the thoughts went away. What we don’t know is whether dose, weight loss, or previous mental health status or use of antidepressants had a role to play.
Finally, concerns are growing about the negative effect of semaglutides on our social and emotional connection with food. Anecdotal and scientific evidence suggests people who use semaglutides significantly reduce their daily dietary intake (as anticipated) by skipping meals and avoiding social occasions – not very enjoyable for people and their loved ones.
How can people access Wegovy?
Wegovy is available for purchase at pharmacists with a prescription from a doctor.
But there is a hefty price tag. Wegovy is not currently subsidised through the Pharmaceutical Benefits Scheme, leaving patients to cover the cost. The current cost is estimated at around A$460 per month dose.
If you’re considering Wegovy, make an appointment with your doctor for individual advice.
Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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What is Ryeqo, the recently approved medicine for endometriosis?
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For women diagnosed with endometriosis it is often a long sentence of chronic pain and cramping that impacts their daily life. It is a condition that is both difficult to diagnose and treat, with many women needing either surgery or regular medication.
A medicine called Ryeqo has just been approved for marketing specifically for endometriosis, although it was already available in Australia to treat a different condition.
Women who want the drug will need to consult their local doctor and, as it is not yet on the Pharmaceutical Benefits Scheme, they will need to pay the full cost of the script.
What does Ryeqo do?
Endometriosis affects 14% of women of reproductive age. While we don’t have a full understanding of the cause, the evidence suggests it’s due to body tissue that is similar to the lining of the uterus (called the endometrium) growing outside the uterus. This causes pain and inflammation, which reduces quality of life and can also affect fertility.
Ryeqo is a tablet containing three different active ingredients: relugolix, estradiol and norethisterone.
Relugolix is a drug that blocks a particular peptide from releasing other hormones. It is also used in the treatment of prostate cancer. Estradiol is a naturally occurring oestrogen hormone in women that helps regulate the menstrual cycle and is used in menopausal hormone therapy. Norethisterone is a synthetic hormone commonly used in birth control medications and to delay menstruation and help with heavy menstrual bleeding.
All three components work together to regulate the levels of oestrogen and progesterone in the body that contribute to endometriosis, alleviating its symptoms.
Relugolix reduces the overall levels of oestrogen and progesterone in the body. The estradiol compensates for the loss of oestrogen because low oestrogen levels can cause hot flushes (also called hot flashes) and bone density loss. And norethisterone blocks the effects of estradiol on the uterus (where too much tissue growth is unwanted).
Is it really new?
The maker of Ryeqo claims it is the first new drug for endometriosis in Australia in 13 years.
But individually, all three active ingredients in Ryeqo have been in use since 2019 or earlier.
Ryeqo has been available in Australia since 2022, but until now was not specifically indicated for endometriosis. It was originally approved for the treatment of uterine fibroids, which share some common symptoms with endometriosis and have related causes.
In addition to Ryeqo, current medical guidance lists other drugs that are suitable for endometriosis and some reformulations of these have also only been recently approved.
The oral medicine Dienogest was approved in 2021, and there have been a number of injectable drugs for endometriosis recently approved, such as Sayana Press which was approved in a smaller dose form for self-injection in 2023.
You can’t take the contraceptive pill with Ryeqo but the endometriosis drug could replace it.
ShutterstockHow to take it and what not to do
Ryeqo is a once-a-day tablet. You can take it with, or without food, but it should be taken about the same time each day.
It is recommended you start taking Ryeqo within the first five days after the start of your next period. If you start at another time during your period, you may experience initial irregular or heavier bleeding.
Because it contains both synthetic and natural hormones, you can’t use the contraceptive pill and Ryeqo together. However, because Ryeqo does contain norethisterone it can be used as your contraception, although it will take at least one month of use to be effective. So, if you are on Ryeqo, you should use a non-hormonal contraceptive – such as condoms – for a month when starting the medicine.
Ryeqo may be incompatible with other medicines. It might not be suitable for you if you take medicines for epilepsy, HIV and AIDS, hepatitis C, fungal or bacterial infections, high blood pressure, irregular heartbeat, angina (chest pain), or organ rejection. You should also not take Ryeqo if you have a liver tumour or liver disease.
The possible side effects of Ryeqo are similar to those of oral contraceptives. Blood clots are a risk with any medicine that contains an oestrogen or a progestogen, which Ryeqo does. Other potential side effects include bone loss, a reduction in menstrual blood loss or loss of your period.
It’s costly for now
Ryeqo can now be prescribed in Australia, so you should discuss whether Ryeqo is right for you with the doctor you usually consult for your endometriosis.
While the maker has made a submission to the Pharmaceutical Benefits Advisory Committee, it is not yet subsidised by the Australian government. This means that rather than paying the normal PBS price of up to A$31.60, it has been reported it may cost as much as $135 for a one-month supply. The committee will make a decision on whether to subsidise Ryeqo at its meeting next month.
Correction: this article has been updated to clarify the recent approval of specific formulations of drugs for endometriosis.
Nial Wheate, Associate Professor of the School of Pharmacy, University of Sydney and Jasmine Lee, Pharmacist and PhD Candidate, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Reclaiming Body Trust – by Hilary Kinavey & Dana Sturtevant
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Authored by a therapist and a dietician, this book draws from both of their extensive professional clinical experiences, to explore how we can (often early in our lives) be led into disordered thinking when it comes to food and our bodies, and how we can “take back that which has been stolen from us”.
More prosaically: the presented goal here is for us to each figure out where we are with our own body, and how we might build our relationship with same going forwards, in the way that will work the best for us.
The style is relaxed and conversational, while taking care to cover topics that are often tricky with no less seriousness. Chapter headings such as “Your coping is rooted in wisdom”, “What does grief have to do with it?” and “Allowing for pleasure and satisfaction” give an idea of the flavors at hand here.
Bottom line: if you think your relationship with food and your body could be better, not only are you probably right, but also, this book can help.
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Rest For The Restless (Legs)
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Any tips for dealing with restless legs syndrome?❞
As a neurological disorder (Willis-Ekbom Disease, as it is also called
by almost nobody outside of academia), there’s a lot that’s not known about its pathology, but we do know that looking after one’s nerves can help a lot.This means:
- Avoid alcohol, as this is bad for everything, including nerves
- See also: How To Reduce Or Quit Alcohol
- Don’t smoke, as this is bad for everything, including nerves
- Do exercise those restless legs! It may sound funny, but in seriousness, movement promotes nerve health
- See also: Walking… Better.
- Take care of your blood sugars, because diabetic neuropathy can also cause this
- See also: 10 Ways To Balance Blood Sugars
- Massage your legs, and enjoy a hot bath/shower
You can also take into account the measures recommended for dealing with peripheral neuropathy, e.g:
Peripheral Neuropathy: How To Avoid It, Manage It, Treat It
There are also medication options for RLS; most of them are dopamine agonists, so if you want to try something yourself before going the pharmaceutical route, then things that improve your dopamine levels will probably be a worth checking out. In the category of supplements, you might enjoy:
NALT: The Dopamine Precursor And More
Take care! And… Want something answered here? Send us your questions!
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- Avoid alcohol, as this is bad for everything, including nerves
