IBS and Shift Work: How to Support Your Gut Despite an Irregular Routine

Are you a shift worker struggling with IBS? You’re not alone — and we’ve got some helpful insights for you.

Shift workers are an essential part of our workforce. First responders, medical professionals, and transportation workers allow our society and its essential services to function properly and keep systems moving. However, we know from extensive research alongside anecdotal reports, that shift work (both in small doses and long term) can contribute to sleep issues, negative health impacts and more. Further, there is a strong link between Irritable Bowel Syndrome (IBS) and shift work. 

If you’re a shift worker with IBS (and potentially following a low FODMAP diet) and want to better support your digestion and health while engaging in your work responsibilities, this article is for you!

What is Shift Work?

The term ‘shift work’ refers to any work schedule that falls outside the typical workday hours of 7 am and 6 pm. This can include both evening, night and early morning shifts as well as rotating (ie. changing week to week) or fixed schedules. 

Jobs that commonly have shift schedules include (1):

• Industrial work
• Customs  and immigration
• Mines
• Hospitality:hotels, food service
• Healthcare 
• First responders:paramedical, firefighters, police
• Transportation services:trucking, airlines

You probably know that shift work can be incredibly taxing on your body, considering it requires sleeping and waking on a schedule that is not “natural”. We’ve known for a long time that shift work can contribute to various health conditions including gastrointestinal conditions, heart disease, sleep disorders and potentially cancer (1). This is due to the dysregulation of circadian rhythms, and the bodily processes they play an important role in. 

Circadian Rhythms 

Many human physical functions follow a 24-hour cycle. These cycles are called ‘circadian rhythms’, which include physical, mental and behavioral changes. While most people use the term ‘circadian rhythm’ (singular) – as humans we have more than one. Sleeping, digestion, secretion of adrenaline and cortisol, body temperature, blood pressure, heart rate and many other functions of our human body are regulated by these 24-hour cycles (1). 

As we discussed in our article on Chrononutrition, the body uses cues from our day to day environment including light and dark cycles, clock time and eating times to keep these rhythms on track. However, our rhythms can get out of sync if these factors are disrupted as in the case of shift work. This disorientation can lead to feelings of fatigue and feeling “out of it”, also known as “jet lag” (1). 

We’re not exactly sure how quickly circadian rhythms adapt to a change in time zone or routine. Some may take 2-3 days, while others may take much longer. 

Chrononutrition: The Study of Eating Times, Circadian Rhythms and Health

Chrononutrition is an emerging field that explores how the timing of our meals affects our circadian rhythms and overall metabolic health. Increasing research suggests that eating in alignment with the body’s natural daily rhythms, when our systems are most efficient at processing food, can positively impact factors like weight, body composition, blood sugar levels, and more. This perspective may also help explain why shift work, which disrupts normal sleep and eating patterns, can negatively affect metabolic health.

You may also want to read: Chrono-nutrition, Circadian Rhythms & Irritable Bowel Syndrome.

The Connection Between Shift Work & IBS 

So, what’s the connection between IBS and shift work? Research shows there’s a strong link. A study published in 2022 looked at how shift work might be related to both IBS and functional dyspepsia (a type of recurring indigestion). It reviewed data from eight studies done in countries like the U.S., China, and Singapore.

The findings? People who work shifts were 81% more likely to have IBS compared to those who don’t. The researchers also noted that the results were consistent across the different studies, which strengthens the reliability of the findings.

Why would this be the case? Let’s discuss reasons why shift work may be a risk factor for IBS. 

How Circadian Rhythms Impact Digestive Processes

It’s clear that there is an important connection between our circadian rhythms and digestive processes. There are a few ways that circadian rhythms may regulate our gastrointestinal functions: 

Intestinal Barrier: The intestinal barrier acts like a defensive mechanism between the contents of our gastrointestinal tract, and our bloodstream (3). It lets essential nutrients in, but blocks entrance to pathogens, viruses and other compounds that have no place in our bloodstream. If there is weakening of the intestinal barrier, we may have what’s known as ‘leaky gut’ or in medical terms, intestinal hyperpermeability. Studies have shown that there are ‘diurnal’ (aka daytime) changes in the intestinal barrier integrity (strength). Due to this, a shift or change in our light-dark cycles can negatively impact the intestinal barrier integrity and may increase the risk of “leaky gut” (4). Leaky gut is considered to be a common driver for the symptoms of IBS. 

Intestinal Microbiota: The intestinal microbiome is the collection of micro-organisms that live in the intestinal tract including but not limited to bacteria, fungi, protozoa, and viruses. Emerging data suggests that day to day fluctuations in the intestinal microbiome are related to circadian rhythms. Animal studies have shown that circadian disruptions in the host (ie. viewing bright lights at nighttime) can contribute to dysbiosis (an imbalance in the gut microbiome profile) (5). We also know that dysbiosis contributes to the development and severity of IBS symptoms. 

Motility: Our body works on a diurnal rhythm, meaning we are awake and have more metabolic activity during the daytime. Both small intestine and colonic (large bowel) activity are higher during the day, and less so at night – suggesting that our body is likely better at breaking down and digesting foods during the daytime, versus into the night (6). While more research is needed, it appears that disruption of human circadian rhythms may negatively affect GI motility and contribute to disorders where dysmotility is a feature such as irritable bowel syndrome (7,8). 

In Simple Terms…

• Your gut has a protective barrier that lets in nutrients but keeps harmful stuff out — and this barrier is stronger during the day. Disrupting your sleep-wake cycle (like with shift work) may weaken this barrier, leading to what’s sometimes called “leaky gut,” which is linked to IBS.
• Your gut is full of helpful microbes (the microbiome), and these microbes follow a daily rhythm too. Messing with your natural light-dark schedule can throw them off balance, which may make IBS symptoms worse.
• Your digestion works best during the day. Your intestines are more active when you’re awake and less active at night — so eating and digesting at odd hours (like during night shifts) might lead to digestive issues, including IBS symptoms.

Other Aspects of Shift Work that May Contribute to IBS

From a nutrition and eating habit perspective, shift workers may be more likely to partake in habits that can contribute to worsened digestive symptoms and gut health (impaired microbiome, intestinal health). This includes:

• Eating meals and snacks in irregular patterns (i.e. various times through the day), and perhaps large meals before bedtime
• Opting for convenience foods like packaged and processed snacks, takeout and fast food that are lacking in nutrients 
• Snacking on quick-digesting carbs for “energy” like sugary drinks and sweets, chocolates 

Sound familiar? These habits could be due to not having proper breaks, rotating shift schedules, access to food and other factors. 

While there are downsides to shift work, those of you reading this likely work shift schedules and so this is not meant to cause you additional stress. It should be noted that there are positives to shift work – including easier commute times (less traffic), better wages and a better schedule for night owls or early risers. As you may choose to take on a shift work role, let’s discuss how you can take on that role while trying to support your digestive system as best as possible! 

Strategies to Manage Shift Work When You Have IBS

Here are some key ways you can support your health and manage IBS if you have shift work. 

Create a Schedule

Consistency, consistency, consistency! While your work schedule may be atypical, that doesn’t mean your day to day needs to be completely irregular. Aim to set eating times and stick to them each day to provide your body a sense of regularity and support circadian rhythms. For example, a nurse who works overnight shifts may use the following eating plan:

Work 11pm – 7am: 

• Meal 1: 5:30pm 
• Meal 2: 9:30pm
• Snack: 12:30/1am 
• Meal 3: 4/5am 
• Bedtime snack: 6am 

Sleep 8:30 am – 4:30pm:

Be sure to avoid eating large meals at least 3-hours away from sleep as this can impact your sleep and digestion.

Prioritize Protein & Blood Sugar Balanced Meals

Avoid relying on those “quick energy” foods like candies and chips when you feel energy crashing. Instead, aim to have balanced, regular meals with protein, fibre (fruits, vegetables, whole grains) and healthy fats. This will support stable energy and prevent crashes due to drops in your blood sugar levels. 

Here are some low FODMAP meal examples:

• Rolled oatmeal with ½ cup lactose-free cottage cheese, ⅓ cup raspberries and 1 medium unripe banana

• 4-ounces chicken with 2-ounces avocado, brown rice, steamed carrot, oyster mushrooms and ¼ cup lentils 

Planning ahead will be key to consistency – meal prep on your days off and/or consider a low FODMAP meal delivery service to help you out. Modify Health is a low FODMAP option in the US, or Gut Feelings in Canada. 

If you need help with meal planning and navigating IBS and a low FODMAP diet, be sure to reach out to a Registered Dietitian for support. 

Check out our Global Registered Dietitian Directory here. 

Using a low FODMAP meal planner can help take the stress out of ensuring you have the right fuel for your day. Be sure to check out our low FODMAP meal planner over on Real Plans. 

Mindful Snacking 

Bring your own snacks so you have something nutritious on hand when hunger strikes, instead of relying on crisps, chocolate bars, or baked goods at work that may not be the healthiest choices.

Some easy low FODMAP snack options include: 

• Homemade trail mix: mix 5 almonds, 5 walnuts, 5 pecans, 1 tbsp dark chocolate chips, and 1 tbsp raisins
• Plain rice cakes with 1-2 tbsp peanut butter & 10 raspberries
• Carrot sticks + 2 tbsps tahini
• Hard-boiled egg + ½ cup sliced cucumber
• 1 orange + ½ cup edamame beans

Leave these at work and/or prep on your days off so they are easy to grab and go. 

Don’t Eat 24/7

Some daily fasting time, or time off of eating, allows our intestinal tract to reset and the function of our Migrating Motor Complex (MMC) to activate (9). Have you heard of the MMC? The MMC acts like a cleansing wave, to sweep out debris and bacteria in our intestinal tract and keep things healthy. Allowing some fasting time each day, around 12-14 hours helps this process work effectively. This pattern is more common in those who are awake during the daytime and sleep at night. However, if you have a different schedule, try to maintain some fasted time in your day. Instead of eating around the clock, try to keep your eating to within roughly a 12-hour window and some fasted time during your personal “nighttime”. 

Stay Hydrated

No surprise that keeping hydrated helps support your digestion and energy levels. Be sure to drink plenty of flat water – bring a water bottle with you on your shift and fill it up regularly. Consider herbal teas such as ginger or peppermint to help support motility (ie. movement of food through our gut) and reduce bloating. 

Sleep Hygiene 

When you do sleep make it count as much as possible. While there’s no shortage of sleep support tips online and you’ve probably heard many of them, they do help! 

Some key ones to keep in mind include:

• Keep your bedroom completely dark – remove all sources of light or use an eye mask 
• Cold is best – approx.18 degrees celsius/64 degrees fahrenheit 
• Avoid caffeine at least 6-8 hours before bed (more on that below)
• Avoid looking at stimulating content at least 1 hour before bed: news, social media, certain TV shows
• Take a hot shower or warm bath before bed, this has been shown to improve sleep quality and relaxation

It should be noted that sleep schedule should remain the same as well – even if you have days off, keeping the same schedule on these days can prevent fatigue. 

You may also want to read: How Does Sleep Impact IBS?

Non-Sleep Deep Rest

Think that if you miss a night of good sleep, there’s no undoing it? Well – a technique called NSDR also known as Yoga Nidra may be as beneficial as getting those extra Zs. . Essentially, NSDR is an umbrella term for relaxation techniques that help a person enter deep relaxation. You aren’t actually sleeping, but puts your mind in a very restorative but alert state of mind for a short period of time. It’s intended to help you feel more calm and focused, and can also help with sleep anxiety. 

You can learn more about Non Sleep Deep Rest in this article by the Sleep Foundation, as well as links to resources to try it yourself. 

Mental Health Support

A lot of shift work is also mentally tough work. Further, we know that unmanaged stress can negatively impact your digestion and IBS symptoms. Seeking therapy from a licensed psychotherapist can be a gamechanger for your mental health. Try a Google search, ask a trusted healthcare team member for a referral, or a database like Psychology Today to find a good fit for you. 

For day to day support, consider activities that help reset your nervous system and vagus nerve like yoga, breathwork, journaling and meditation. 

Mindful Caffeine Consumption

Improper timing or overdoing those caffeinated drinks can contribute to poor sleep, as well as worsening anxiety. This can contribute to IBS symptoms. Avoid caffeinated drinks and products like coffee, black or green tea, caffeinated energy gels and bars at least 6-8 hours before your planned sleep time. 

You may also want to read: IBS, The Low FODMAP Diet, Coffee & Coffee Drinks

If you have rotating shiftsthis can exacerbate the issues that come with shift work. If you know your upcoming schedule, consider adjusting your bedtime and mealtimes by 1-2 hours a few days ahead to  get your body used to the change. If your changing shifts are wearing you down, consider speaking to your supervisor about adopting a more consistent shift schedule if possible. 

IBS & Shift Work: Simple Checklist

• Make a Daily Schedule: Try to eat meals and keep a sleep schedule at the same times every day—even on workdays and days off.
• Eat Balanced Meals: Choose meals with protein, fiber, and healthy fats to keep your energy steady. 
• Plan & Prep Ahead: Prepare meals or snacks on your days off so you’re not stuck without healthy, IBS friendly options. 
• Pack Healthy Snacks: Bring your own snacks with protein (eggs, nuts, greek yogurt) & fibre (fruits, veggies) to avoid eating sugary or greasy foods at work.
• Don’t Eat All Day: Try to give your body a 12-hour break from food each day to support digestion.
• Stay Hydrated: Drink water throughout your shift, and try herbal teas like peppermint or ginger to prevent bloating.
• Sleep Smart: Keep your sleep space dark, cool, and tech-free to get better rest.
• Try Non Sleep Deep Rest (NSDR) to help your body rest if you get less sleep than you’d like.
• Support Your Mental Health: Do calming activities like journaling, breathwork, and/or talk to a licensed therapist if needed.
• Watch Your Caffeine: Avoid caffeine (green tea, black tea, coffee, energy drinks) at least 6–8 hours before bedtime so it doesn’t mess with your sleep.
• Adjust to Rotating Shifts: Slowly shift your sleep and meal times a few days before your schedule changes.

The Takeaway  

In conclusion, shift work is an essential part of our society and is integral to many professions like healthcare, first responder and transportation services. However, there’s no denying that this type of work comes with many challenges, especially for those of you managing IBS and a low FODMAP diet. Sleep, meal and light/dark changes can all impact your circadian rhythms and the associated bodily processes including digestive functions. That said, through planning regular, balanced meals, supporting sleep hygiene, utilizing tools like NSDR and taking time to support mental health, you can take back control of your digestion and make improvements in how you feel while navigating your career.

We hope you enjoyed today’s article! If you have questions about IBS and shift work drop them below. If you know a shift worker who would benefit from these strategies, please share this article with them! 

References:

1. Canadian Centre for Occupational Health and Safety. (n.d.). Shift work. https://www.ccohs.ca/oshanswers/ergonomics/shiftwrk.html

2. Farsi, M., Qadri, S., AlKuwaiti, A., & Al-Muwalid, A. (2022). Impact of shift work on irritable bowel syndrome. Medicine, 101(24), e29489. https://doi.org/10.1097/MD.0000000000029489

3. Camilleri, M. (2019). Leaky gut: Mechanisms, measurement and clinical implications in humans. Gut, 68(8), 1516–1526. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104804/

4. Voigt, R. M., Forsyth, C. B., Green, S. J., Mutlu, E., & Keshavarzian, A. (2019). Circadian rhythms: A regulator of gastrointestinal health and dysfunction. Expert Review of Gastroenterology & Hepatology, 13(5), 411–424. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6533073/

5. Turek, F. W., Joshu, C., Kohsaka, A., Lin, E., Ivanova, G., McDearmon, E., Laposky, A., Losee-Olson, S., Easton, A., Jensen, D. R., Eckel, R. H., Takahashi, J. S., & Bass, J. (2005). Obesity and metabolic syndrome in circadian Clock mutant mice. Science, 308(5724), 1043–1045. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4029760/

6. Knutsson, A. (2003). Health disorders of shift workers. Occupational Medicine, 53(2), 103–108. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4977829/

7. Galgani, J. E., & Ravussin, E. (2008). Energy metabolism, fuel selection and body weight regulation. International Journal of Obesity, 32(Suppl 7), S109–S119. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7147411/

8. Scheer, F. A. J. L., Hilton, M. F., Mantzoros, C. S., & Shea, S. A. (2009). Adverse metabolic and cardiovascular consequences of circadian misalignment. Proceedings of the National Academy of Sciences, 106(11), 4453–4458. https://pubmed.ncbi.nlm.nih.gov/19255424/

9. Sleep.com Editors. (n.d.). What is non-sleep deep rest (NSDR)? Sleep.com. https://www.sleep.com/sleep-health/non-sleep-deep-rest

10. Sleep Foundation. (n.d.). What is non-sleep deep rest (NSDR)? https://www.sleepfoundation.org/meditation-for-sleep/what-is-non-sleep-deep-rest