Why Do I Need to Poop Twice After Waking Up? Your Digestive Health

Q: Why Do I Need to Poop Twice After Waking Up? Your Digestive Health

Hello： 1. <br>This situation is quite common, primarily because the feces in the upper segment tends to accumulate in the rectum. <br>After the first bowel movement, the softer stool can flow down through the curved sigmoid colon when standing up, leading to a renewed urge to def

Having two bowel movements consecutively after waking up?

Hello, doctor.
For a long time, I have noticed that when I wake up and feel the urge to have a bowel movement, I usually pass a significant amount.
However, what troubles me is that after I have a bowel movement upon waking—regardless of how much I pass or how smoothly it goes—I am certain that I have completely emptied my bowels.
Yet, I experience a renewed urge to defecate about 15 to 20 minutes later, during which I can pass an additional one-third to one-half of the initial amount.
If I have time, it’s manageable, but sometimes when I’m in a hurry to leave, this persistent urge from my colon can delay me.
I rarely hear of others experiencing a similar situation, but this has been my reality for many years.
Could you explain why I cannot fully empty my bowels in one go and instead have to do it in two stages? Is this phenomenon normal? Is there a possibility of having colitis or irritable bowel syndrome? PS: My BMI is normal, and my bowel movements are regular, but my mother had stage III colon cancer.

great, 20~29 year old female. Ask Date: 2017/12/01

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: 1.
This situation is quite common, primarily because the feces in the upper segment tends to accumulate in the rectum.
After the first bowel movement, the softer stool can flow down through the curved sigmoid colon when standing up, leading to a renewed urge to defecate.
Additionally, the second bowel movement usually contains a higher water content, which is considered a normal phenomenon.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2017/12/01

More Info

It's not uncommon for individuals to experience the need to have multiple bowel movements shortly after waking up. This phenomenon can be attributed to several factors related to your digestive health and the body's natural rhythms.

Firstly, the body's digestive system operates on a cycle influenced by various factors, including diet, hydration, physical activity, and even stress levels. Upon waking, your body transitions from a resting state to an active one, which can stimulate the digestive system. This is often referred to as the "gastrocolic reflex," a physiological response where the stomach's activity stimulates bowel movements. When you eat or drink, your stomach stretches, sending signals to the colon to make room for the incoming food, which can lead to a bowel movement.

In your case, it seems that the initial bowel movement upon waking is substantial, but shortly after, you feel the urge to go again. This could be due to several reasons:
1. Incomplete Evacuation: Sometimes, the first bowel movement may not fully empty the bowels. This can happen if the stool is not fully formed or if there is still stool in the rectum that wasn't expelled during the first attempt.

2. Timing and Relaxation: After your first bowel movement, your body may still be in the process of fully waking up. The relaxation of the anal sphincter and the colon's continued peristalsis (the wave-like muscle contractions that move food through the digestive tract) can lead to a second urge shortly after.

3. Dietary Factors: The type of food you consume, particularly fiber-rich foods, can influence bowel habits. If you have a diet high in fiber, it can lead to more frequent bowel movements. Additionally, if you consume a large meal the night before, it may take longer for your body to process that food, leading to multiple bowel movements in the morning.

4. Hydration: Adequate hydration is crucial for healthy bowel movements. If you're well-hydrated, your stool will be softer and easier to pass, potentially leading to more frequent urges.

5. Stress and Anxiety: Psychological factors can also play a role in bowel habits. If you're experiencing stress or anxiety, it can affect your digestive system, leading to changes in bowel movement patterns.

Regarding your concerns about conditions like colitis or irritable bowel syndrome (IBS), it's important to note that while your symptoms may seem unusual, they do not necessarily indicate a serious condition, especially since you report normal bowel movements and a healthy BMI. However, given your family history of colon cancer, it is wise to remain vigilant about your digestive health. Regular screenings and consultations with a healthcare provider are recommended, particularly if you notice any changes in your bowel habits, such as blood in your stool, significant changes in frequency, or persistent discomfort.

In conclusion, while having two bowel movements shortly after waking can be a normal variation in digestive health, it's always best to consult with a healthcare professional if you have concerns. They can provide personalized advice and may recommend further evaluation if necessary. Maintaining a balanced diet, staying hydrated, and managing stress can all contribute to a healthier digestive system.

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