Experiencing diarrhea is frustrating as is, but when it’s at night and interferes with your sleep, that’s even more problematic.
The stomach growling and sleep interruptions combined with concerns about an embarrassing accident make nighttime diarrhea a real-life nightmare.
While some cases are temporary, chronic or frequent instances could be the sign of an underlying problem.
In this article, we’ll discuss what causes nocturnal diarrhea and what you can do to help prevent it from happening in the future. We’ll also review what other serious health conditions may be linked to this condition.
What Is Nocturnal Diarrhea?
As the name suggests, nocturnal diarrhea is loose and watery bowel movements that happen repeatedly and almost uncontrollably at night.
While most cases only last for a few days, experts warn that experiencing diarrhea for weeks could mean you have another underlying health issue.
Whether you have diarrhea during the day or only at night, the following are symptoms associated with this condition, as reported by the Mayo Clinic.
Watery, Loose, or Thin Stool
Instead of a solid formation, you may experience stools that are loose and watery.
Abdominal Pain or Cramps
You may find yourself woken up with diarrhea after experiencing pain or cramps in your stomach.
The Feeling of an Urgent Bowel Movement
The need to go can be intense and come without warning. Sometimes, your stomach will settle down, and you’ll feel like everything is back to normal, and then, without warning, you’re sprinting to the toilet.
Feeling nauseous is also considered a symptom of diarrhea.
When you are bloated, you will notice your stomach feels fulls, tight, and protrudes out more than usual.
You may also experience a fever with nighttime diarrhea. This could be a sign of an infection. The average temperature is around 98.6 degrees Fahrenheit or 37 degrees Celsius. Experts stress that even a slight fever in infants should be closely monitored.
Blood or Mucus in Stool
You should be mindful of any blood, mucus, or a combination of the two in your bowel movements. Large amounts of mucus may result from an intestinal infection. Bloody mucus or mucus-filled stool and stomach pain could signify Crohn's disease, ulcerative colitis, or cancer.
Nighttime Diarrhea Causes
These symptoms can feel highly uncomfortable and stressful, which is why understanding what causes diarrhea at night can help you find the right treatment plan to feel better.
According to the Mayo Clinic, a virus, bacteria, or parasite that infiltrates the body could result in diarrhea. The germs can lead to a gastrointestinal infection, and diarrhea is the body’s natural way of flushing them out.
For example, travelers may experience diarrhea after being exposed to bacteria or parasites in food or water, especially in under-developed countries.
Certain medications, including antibiotics, may lead to persistent diarrhea. Antibiotics are designed to remove both good and bad bacteria, which can throw off this balance in your intestines, resulting in loose stool. Medications for cancer and antacids that contain magnesium may also cause diarrhea.
Certain foods or drinks may cause loose bowel movements in the middle of the night. For example, the Mayo Clinic reports that products containing artificial sweeteners may cause frequent bathroom breaks.
Food poisoning occurs when a person consumes contaminated food. Diarrhea is considered a symptom of foodborne illness.
An intolerance or allergy to a particular food or substance could also trigger an episode.
The culprit is often an enzyme that’s lacking in the digestive system. For example, people who are lactose-intolerant will often have bouts of stomach problems after eating dairy. This is because they lack an enzyme called lactase that aids in the digestion of lactose, a primary sugar found in milk.
For those who’ve experienced a traumatic event or are dealing with high-stress levels, this could cause you to wake up during the night with diarrhea.
Emerging research suggests that the nervous and gastrointestinal systems are linked. Experts say that brain chemicals emitted under stress, such as corticotropin-releasing factor (CRF), can bind to receptors that affect your bowels. This could lead to faster bowel movements like diarrhea or slower ones that result in constipation.
Find Out More: How Digestion Affects Your Sleep
Surgeries in the abdomen or gallbladder removal could also cause diarrhea. According to the Mayo Clinic, it’s estimated that 20 percent of gallbladder surgery patients experience diarrhea afterward.
In the case of gallbladder surgery, experts say that it’s unclear as to why this occurs, but add that it usually stops after a few days. Some people may experience this side effect for years, but this is considered rare.
Health Conditions that Cause Diarrhea While You Sleep
Inflammatory Bowel Disease
Referred to as IBD for short, Inflammatory Bowel Disease is characterized by the inflammation or destruction of the bowel wall. This can cause your intestines to become narrow, and you may develop sores in them as well.
Two of the primary causes are Crohn’s Disease and ulcerative colitis. The majority of IBD cases are genetic.
IBD is a chronic condition that would require long-term management. This may include antibiotics, antidiarrheal drugs, lifestyle changes, or surgery.
Irritable Bowel Syndrome
Irritable Bowel Syndrome, on the other hand, is a different condition than IBD.
IBS specifically targets the lower gastrointestinal area, including the small and large intestines and the colon. According to Cedar Sinai, patients with IBS may experience chronic diarrhea, constipation, or both. A blood test can help determine whether or not you have this condition.
Treatments for IBS may include antibiotics, other medications to ease constipation or diarrhea, and changes to the patient’s diet.
An inflamed colon is referred to as colitis, but when the affected tissue can only be observed under a microscope, it’s labeled as microscopic colitis. There are two main types: Collagenous colitis and Lymphocytic colitis.
With Collagenous colitis, a layer of collagen forms on the colon tissue. Lymphocytic colitis occurs when lymphocytes (white blood cells) grow in the colon tissue. In some cases, a person may experience both types.
Microscopic colitis may clear up on its own. However, if you have diarrhea for longer than a few days, you should consult with your physician.
Diabetes is a chronic condition resulting from the body’s inability to regulate healthy glucose levels in the blood. When this happens to the body, one of the possible complications is diarrhea that may last for weeks or months.
This type of diarrhea occurs when the intestine doesn’t properly absorb liquid and electrolytes, which then pass through the digestive tract rapidly, causing watery and loose stools. Secretory diarrhea can be caused by bacteria, diseases, laxatives, certain drugs, or medical problems.
Treatments for Chronic Diarrhea
For patients who’ve contracted diarrhea from a bacteria or parasite infection, your doctor may prescribe antibiotics. However, if the antibiotics you’re already taking are the cause of your frequent bathroom breaks, your doctor may adjust your medications.
You can also look into over-the-counter meds to alleviate diarrhea. However, health experts with the Mayo Clinic add that you should check with a doctor before taking any type of anti-diarrheal medication.
Loose and watery stools can lead to dehydration. To combat this, you should drink plenty of water and beverages containing electrolytes such as juices.
Children and the elderly are the most susceptible to dehydration, so if you have a young person or senior citizen under your care, pay close attention to their intake of fluids.
Adjust Your Diet
According to the Mayo Clinic, you should avoid foods that may irritate your stomach. These include dairy products, foods high in fiber or fat, and foods with a lot of seasoning. Furthermore, you should gradually add solid and low-fiber foods back into your diet as you continue to feel better.
You may also want to consider keeping a food journal, so when diarrhea occurs, you might be able to track it back to something you ate. In the event you notice this frequently happens when you eat certain foods, your doctor may have you test for a food allergy.
Avoid Caffeine and Alcohol
For those experiencing loose stool brought about by stress, it’s crucial to find ways to manage your concerns. Exercise and meditation are popular stress-relieving activities, or you may take up more creative endeavors such as painting or writing. Find something that works for you and stick with it.
Replenish Gut Bacteria
There are both good and bad bacteria in the digestive system. The harmful bacteria can cause bowel issues, while the beneficial gut bacteria keeps our immune system in tip-top shape. A variety of factors can harm this balance in the digestive system, including antibiotics.
Therefore, you may want to supplement with a high-quality probiotic. Probiotics work to bring good bacteria back to the body to help maintain a healthy balance. You can naturally access probiotics in yogurt, sourdough bread, cottage cheese, fermented pickles, kombucha, and miso soup.
Frequently Asked Questions
Can diarrhea at night be linked to cancer?
Cancer treatments, infections due to a weakened immune system, and the disease itself may cause diarrhea.
Additionally, other symptoms could be a sign of a more serious underlying condition, including cancer. You should consult with your doctor if your diarrhea also includes the following symptoms:
- Six or more loose bowel movements a day for more than two days
- Blood in your stool or rectal area
- Weight loss from diarrhea
- A fever of 100.5 degrees Fahrenheit (38 degrees Celsius) or higher
- Inability to control your bowel movements
- Diarrhea or abdominal cramps that last for more than a day
Can it happen to adults?
Nocturnal diarrhea can affect people of all ages. However, babies and the elderly are especially vulnerable, so their symptoms should be observed more closely.
Can nocturnal bowel movements be caused by food poisoning?
As mentioned earlier, foods contaminated with bacteria or parasites can cause food poisoning. In this case, diarrhea is your body’s defense mechanism at removing these harmful germs by working to flush them out.
Is diarrhea at night a sign of COVID-19?
Researchers have found that diarrhea is a symptom of the COVID-19 virus. In an April 2020 study, the scientists found that half of the patients in the research group who tested positive for the coronavirus had diarrhea as the main gastrointestinal system.
As we covered in this article, though, diarrhea can result from multiple factors, so experiencing loose bowel movements doesn’t mean you have contracted Covid. The best thing to do is monitor your symptoms and get tested if you notice no improvements.
Sources and References:
-  “Diarrhea“, Mayo Clinic, June 16, 2020
-  “Fever“, Mayo Clinic, May 13, 2020
-  “Mucus in Stool: A Concern?“, Mayo Clinic, July 8, 2020
-  “Diarrhea Causes, Treatment, and Symptoms“, University of Pittsburgh Medical Center, 2015
-  “Food Poisoning“, Mayo Clinic, June 26, 2020
-  “Food Allergy“, Mayo Clinic, November 2, 2019
-  “Can Stress or Anxiety Cause Diarrhea?“, Cary Gastro, 2020
-  “Chronic Diarrhea: A Concern after Gallbladder Removal?“, Mayo Clinic, December 10, 2019
-  “Is It IBS or IBD?“, Cedars Sinai, 2018
-  “Microscopic Colitis“, Mayo Clinic, January 20, 2021
-  Satoshi Murao MD PHD, Hitoshi Hosokawa MD PHD, “Serotonin 5-HT3 Receptor Antagonist for Treatment of Severe Diabetic Diarrhea”, Diabetes Journals, 2010
-  LR. Schiller, “Secretory Diarrhea”, National Center for Biotechnology Information, 1999
-  “Common Causes of Chronic Diarrhea“, International Foundation for Gastrointestinal Disorders
-  “Probiotics“, Cleveland Clinic, March 9, 2020
-  “Diarrhea: Cancer-related Causes and How to Cope“, Mayo Clinic, April 21, 2020
-  Timothée Klopfenstein, N’dri Juliette Kadiane-Oussou, Pierre-Yves Royer, Lynda Toko, Vincent Gendrin, Souheil Zayet, “Diarrhea: An Underestimated Symptom in Coronavirus Disease 2019”, National Center for Biotechnology Information