Nocturnal diarrhea is loose, watery, and frequent stool that wakes someone from sleep. Sometimes, the disruption in sleep can further aggravate diarrhea, especially in people who have been diagnosed with conditions such as irritable bowel syndrome (IBS).
There are those who suffer from something called osmotic diarrhea. This is diarrhea that happens when there is too much water drawn into the bowels. When a person drinks too much sugar or salt, it draws water from the body into the bowel and can cause osmotic diarrhea. This could also be diarrhea in the middle of the night.
Having an occasional bout of diarrhea is not unusual, but chronic diarrhea can be a sign of a serious health problem. Chronic diarrhea is defined as diarrhea that lasts for one month or longer.
What are the causes of nocturnal diarrhea?
Diarrhea, including nighttime diarrhea, can occur if a person has an infection due to a virus or bacteria; has consumed certain foods; or has certain allergies. It is likely that diarrhea will only last a short time. Chronic or ongoing nocturnal diarrhea causes are usually more serious. Here we look at various causes of nighttime diarrhea.
Secretory diarrhea:
This is diarrhea that occurs at night because a person’s intestine can’t properly absorb or secrete electrolytes and fluid. Secretory diarrhea has been linked to health conditions such as alcoholism, surgery, and use of medications.
Inflammatory bowel disease:
Conditions such as ulcerative colitis and Crohn’s disease are autoimmune diseases that cause inflammation in the gastrointestinal tract and can lead to diarrhea. Some people who suffer from these conditions don’t experience nighttime diarrhea while others do. People who suffer from inflammatory bowel disease experience many other symptoms aside from diarrhea, including pain during bowel movements, bleeding during bowel movements, and fatigue.
Irritable bowel syndrome (IBS):
This can’t be discounted when discussing causes of nocturnal diarrhea. Nighttime washroom breaks are frequent among those who suffer from IBS. Although the exact cause is not known, many in the medical field believe psychological factors make symptoms worse.
Microscopic colitis:
Even if a person is fasting, microscopic colitis can occur. Microscopic colitis is when the large intestine becomes inflamed at a microscopic level. It is more likely to happen in older individuals and in those who have taken nonsteroidal anti-inflammatory medications for a long period of time.
Diabetes mellitus:
Research shows that if your glucose level is poorly controlled and you are depending on insulin, you are at a higher risk of experiencing nocturnal diarrhea diabetes. You are also more likely to have nighttime diarrhea if you have diabetes with peripheral and autonomic neuropathy.
Psychological factors:
Nighttime diarrhea causes can also be attributed to psychological stress. If a person has a gastrointestinal issue and then has nighttime stress or nightmares, it can lead to diarrhea. Some experts suggest that sleep disorders may also contribute to diarrhea.
Foods and drinks before bedtime:
This is one of the most common causes of nighttime diarrhea. Foods and beverages consumed shortly before bedtime can trigger diarrhea at night. Some people have difficulty with dairy within hours of consuming it. These people may be lactose intolerant.
What are the symptoms of nighttime diarrhea?
Depending on the underlying cause, nocturnal diarrhea symptoms will vary from person to person; however, the following list covers the most common signs and symptoms reported to doctors:
- Watery, loose, or thin stools
- Abdominal pain
- Sensation of bowel movement
- Nausea
- Bloating
- Fever
- Blood in stool
There can be complications and what we call “emergency symptoms” associated with nocturnal diarrhea. Let’s take a look at those complications and symptoms.
- Dehydration: It is important to maintain a certain level of water and salt in the body. Chronic, severe diarrhea can lead to dehydration. Young children and the elderly tend to be especially vulnerable to dehydration.
- Fevers: If you have diarrhea along with a long-lasting or high-grade fever, you need to seek medical attention.
- Blood or mucus: Having blood and/or mucus in the stool is something that should be reported to your doctor.
- Other symptoms: If you notice symptoms that do not fit the nocturnal diarrhea description, you could have another more serious condition as well.
How to treat diarrhea at night
Nocturnal diarrhea treatment focuses on the cause. Sometimes, the condition is already being treated, so it is a matter of adjusting medications. Drugs that may cause diarrhea in some people can be changed, but this should be done under the supervision of a doctor. In some cases, antidiarrheals will be prescribed. They are usually used for a short period of time while the underlying cause is being addressed.
Diet and lifestyle adjustments can also be a big part of treatment for nighttime diarrhea. The following list includes helpful tips for those suffering from nocturnal diarrhea:
- Avoid eating at least two to three hours before bedtime
- Limit spicy, greasy, and heavy meals
- Avoid triggers like alcohol and caffeinated beverages
- Try to have a bowel movement before bed to train your bowel to empty at this time every day
- Exercise in the morning or during the day if night workouts seem to be followed by diarrhea
Home remedies for nocturnal diarrhea
Having diarrhea during the day or night can be frustrating. For those who are looking for relief, there are home remedies that some people report they have used with success. The list below covers some of the home remedies diarrhea sufferers turn to regularly.
Chamomile tea:
This is known to reduce inflammation and is a natural sleep aid. If you suffer from nocturnal diarrhea, you can try sipping on a cup of chamomile tea about an hour before going to bed.
Relaxation:
Those who are suffering from intestinal problems are told to use relaxation techniques daily. As we mentioned earlier, stress can make nocturnal diarrhea worse, so using relaxation techniques such as deep breathing and meditation for 10 to 15 minutes before bed can be a good option.
Sleep close to the bathroom:
It may be hard to avoid having to get up in the middle of the night and go to the bathroom. Try to sleep as close to the washroom as possible to make it less of a hassle. Many people find that the security of knowing the bathroom is close makes it easier for them to actually sleep.
Stay hydrated:
A lot of water and electrolytes are lost when a person suffers from diarrhea. It is easy to become dehydrated so make sure you drink enough fluids throughout the day. This can include water, juice, and broth. If you think you are having issues with hydration, consult a doctor.
Avoid caffeine:
Food and drinks that are caffeinated can keep you up at night and stimulate the bowels. Coffee, black and green teas, sodas, energy drinks, and chocolate are all examples of beverages and food that contain caffeine.
Avoid heavy supper:
Heavy foods that are hard to digest are more likely to make diarrhea worse. Avoid foods that are greasy or fat. Foods such as fries, donuts, pizza, and breaded meats should be excluded. Also eliminate spicy foods, high-fiber foods and consider cutting down on milk products.
Consume bland foods:
Eating bland foods can help calm the stomach when you are suffering from diarrhea. It can also prevent diarrhea from getting worse. Some good foods to include when you have nighttime diarrhea include bananas, white rice without sauce or seasoning, boiled potatoes, boiled carrots, baked chicken with the fat and skin removed, crackers, plain toast, and eggs.
Replenish gut bacteria:
Having healthy gut bacteria is important for good digestion and has been known to help reduce diarrhea. Many people who experience diarrhea as a result of taking antibiotic medications do well by replenishing their gut bacteria.
You can replenish gut bacteria by eating live culture yogurt. This is yogurt that contains bacteria that aids digestion. You can also take probiotics, which are available in supplement form and contain bacteria that are found in a healthy digestive tract. These bacteria help break down food.
Prevention of nocturnal diarrhea
Preventing nocturnal diarrhea is really all about managing the underlying cause. In the case of inflammatory bowel disease, avoiding triggers that can cause symptoms to flare up is a simple way to look at prevention. While it is true that you can’t cure the condition, you may be able to avoid some of the uncomfortable symptoms. Avoiding tobacco and getting a good night’s sleep can also be really helpful.
If a person has received a diagnosis of microscopic colitis, a low-fiber, low fat, and dairy-free diet may be recommended. Some people also find that going gluten-free helps too. Avoiding any medications that may make the condition worse is something that has to be taken into consideration with microscopic colitis as well.
Your doctor should be consulted if you have diabetes mellitus and diarrhea. There are a variety of different prevention methods that he/she could suggest.
Having the odd bout of diarrhea is not alarming, but chronic diarrhea and diarrhea that keeps you up at night can be concerning. If you have nocturnal diarrhea, don’t let it go on without consulting with a medical professional. The sooner you get a proper diagnosis, the sooner you can begin treating diarrhea and get back to feeling yourself again.
Related: Morning diarrhea: Causes, treatment, and prevention