Nocturnal Diarrhea

Medically reviewed by Stacy Sampson, DO on December 4, 2017Written by Natalie Silver on December 4, 2017

Overview

Experiencing diarrhea at night can be concerning and unpleasant. Diarrhea is when you have loose, watery bowel movements. Nocturnal diarrhea occurs at night and commonly wakes you from sleep. There are many causes of nocturnal diarrhea.

You may just have a case of mild diarrhea that will pass after a day or two. Or you may have chronic nocturnal diarrhea. Chronic diarrhea lasts for four weeks or more and may be the sign of a serious health condition. You should see your doctor in cases of severe or chronic diarrhea.

Symptoms

Symptoms of nocturnal diarrhea occur at night and include:

  • watery, loose, or thin stool
  • pain in your abdomen
  • the sensation of an upcoming bowel movement
  • nausea
  • bloating
  • fever

Experiencing mild diarrhea involves having some or all of these symptoms and being able to manage the condition for a day or two. You may wake up with these symptoms or have difficulty sleeping with mild diarrhea, but the condition typically will pass in time.

Severe diarrhea may include these symptoms as well as others, such as blood in your stool and severe pain.

Chronic diarrhea is when you experience diarrhea several times a day for a month or longer. Often, chronic diarrhea can occur at night and be a sign of a more serious underlying condition.

Nocturnal diarrhea can be bothersome because it disrupts your sleep patterns. This can be especially problematic with chronic diarrhea.

Causes

Mild to severe diarrhea can be caused by:

  • infections, including those due to viruses or bacteria
  • medications
  • foods
  • allergies

You may find that you experience diarrhea at night due to one of these causes, but it’s unlikely that you will experience the condition for an extended period of time.

Chronic nocturnal diarrhea is likely the sign of a more serious condition. The condition may even help your doctor make a diagnosis. Several gastrointestinal conditions, like irritable bowel syndrome and other functional bowel diseases, do not generally cause nocturnal diarrhea.

It is common for secretory diarrhea to cause nocturnal diarrhea. Secretory diarrhea occurs when your intestine cannot properly absorb or secrete electrolytes and fluid. You may experience secretory diarrhea from an underlying health condition or from an external factor like alcoholism, surgery, or medication use.

Here are a few health conditions that can cause chronic nocturnal diarrhea:

Inflammatory bowel disease

Inflammatory bowel disease can be caused by several different conditions, including ulcerative colitis and Crohn’s disease. It occurs when you experience chronic inflammation within the gastrointestinal (GI) tract. Ulcerative colitis occurs in your large intestine. Crohn’s disease can occur anywhere from your mouth to anus. Both are autoimmune diseases that cause inflammation in the GI tract.

You may experience blood or mucus in your bowel movements in addition to other diarrhea content. Other symptoms of these conditions include pain during bowel movements, fatigue, weight loss, anemia, and chronic abdominal pain. This chronic condition can be severe at times and in remission with therapy for others.

The exact cause of inflammatory bowel disease is not known, but you may be more susceptible to it if you have a family history of it, smoke tobacco, or take nonsteroidal anti-inflammatory medications (NSAIDs).

Microscopic colitis

Microscopic colitis can cause nocturnal diarrhea even if you are fasting. The condition inflames your large intestine at a microscopic level. You are more likely to get this condition as you age. You may experience this condition if you take certain types of medications, such as nonsteroidal anti-inflammatory medications, for a prolonged period of time. It may develop for a separate reason as well.

Diabetes mellitus

Diabetes mellitus may be the cause of nocturnal diarrhea. You may be more susceptible to nocturnal diarrhea if your blood glucose level is poorly controlled and if you depend on insulin. You may be more likely to experience nocturnal diarrhea if you have diabetes with peripheral and autonomic neuropathy. You may experience nocturnal diarrhea frequently or only occasionally.

Treatment

Your nocturnal diarrhea may occur in isolation or it may be the sign of a chronic underlying condition. Treatments vary based on the cause of the nocturnal diarrhea. You should see your doctor before treating persistent diarrhea to receive a specific diagnosis and management plan. Your doctor may prescribe or recommend certain medications to treat chronic diarrhea, including antidiarrheal or antibiotic therapy.

Here are some ways to treat mild diarrhea:

  • Stay hydrated by drinking diluted liquids that have nutritional value like fruit juices, sports drinks, and broth.
  • Eat bland foods that do not contain very much fiber and stay away from heavy, greasy food.
  • Try over-the-counter antidiarrheal medications.
  • Reduce caffeine intake.
  • Avoid drinking alcohol.

Prevention tips

Experiencing mild diarrhea is normal and may occur once or twice a year.

You may be able to prevent nocturnal diarrhea in chronic health conditions by managing the underlying cause.

Inflammatory bowel disease

Avoid triggers that can cause the condition to acutely flare. You cannot cure this condition, but you want to avoid experiencing diarrhea and other undesirable symptoms. You should not smoke tobacco, and make sure to get enough sleep. Your doctor may recommend certain supplements as well, in addition to tailoring a prescription therapy for treating your IBD.

Microscopic colitis

Change your diet to a low-fiber, low-fat, and dairy-free one. Consider going gluten-free. Avoid medications that worsen the condition.

Diabetes mellitus

Manage diabetes mellitus effectively with the help of your doctor to avoid nocturnal diarrhea. Your doctor could recommend various treatment and prevention methods to alleviate nocturnal diarrhea.

Complications and emergency symptoms

Nocturnal diarrhea may be the sign of a serious condition that requires medical treatment. See your doctor if:

  • You suspect dehydration. You need to maintain a certain level of water and salt in your body, and long-lasting or severe diarrhea can cause complications. You should see your doctor if you experience dehydration. Vulnerable populations include young children, the elderly, and those with other medical conditions.
  • You have a long-lasting or high-grade fever.
  • You have blood or mucus in your stool.
  • Your diarrhea lasts for multiple weeks.
  • You recognize symptoms of another, more serious condition.

Outlook

Nocturnal diarrhea is a condition that can wake you up from settled sleep. The condition may pass through as a bout of mild diarrhea that resolves in just a day or two. Or you may experience nocturnal diarrhea on a regular basis. This condition can be the sign of something more serious and requires a doctor’s consultation.

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