Nocturnal Diarrhea: Symptoms, Causes, and Treatment

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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 a 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.

Illustration of a Woman Sitting on a Toilet

Symptoms

Whether you have diarrhea during the day or only at night, the following are symptoms associated with this condition, as reported by the Mayo Clinic1.

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.

Nausea

Feeling nauseous, or experiencing uneasiness in your stomach, is also considered a symptom of nocturnal diarrhea. In some cases, your nausea may escalate to the point that you are vomiting.

Bloating

When you are bloated, you will notice your stomach feels full and tight, and it protrudes out more than usual.

Fever

You may also experience a fever with nighttime diarrhea, which could be a sign of an infection2. If your fever goes above 102 degrees Fahrenheit, though, you’ll want to contact your doctor. Additionally, fevers should be closely monitored in children with diarrhea.

illustration of a woman having hot flashes and night sweats

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 infection3. 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.

Infections

According to the Mayo Clinic, a virus, bacteria, or parasite that infiltrates the body could result in diarrhea1. 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 underdeveloped countries.

Medications

Certain medications, including antibiotics, may lead to persistent diarrhea1. 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.

Animated Image of a Lady Sleeping after Taking Natural Remedies Tea, Oils, Pills

Certain foods

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 breaks1.

Food poisoning occurs when a person consumes contaminated food. Diarrhea is considered a symptom of foodborne illness.

Allergies

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 dairy1. This is because they lack an enzyme called lactase that aids in the digestion of lactose, a primary sugar found in milk.

Stress

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 research4 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.

Find Out More: How Digestion Affects Your Sleep

Sad Woman Laying in Bed Illustration

Surgery

Surgeries in the abdomen or gallbladder removal could also cause diarrhea1. According to the Mayo Clinic, it’s estimated that 20 percent5 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 Nocturnal Diarrhea

Inflammatory bowel disease

Referred to as IBD for short, inflammatory bowel disease6 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.

IBS7 specifically targets the gastrointestinal tract, including the stomach and intestines, and one of the symptoms of this condition is nighttime diarrhea.

Treatments for IBS may include a combination of medications and changes to the patient’s diet.

Microscopic colitis

Microscopic colitis8 is when the colon is inflamed, resulting in diarrhea. The different types of microscopic colitis are collagenous, lymphocytic, and incomplete (a mix of collagenous and lymphocytic).

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 Mellitus

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 complications9 is diarrhea, particularly at night. According to health experts, diarrhea is a symptom that’s more common in those who’ve had diabetes for a long time.

Secretory Diarrhea

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 diarrhea10 can be caused by bacteria, diseases, laxatives, certain drugs, or medical problems.

How to Treat Nocturnal Diarrhea

Try medication

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 medication1.

Stay hydrated

Loose and watery stools can lead to dehydration. To combat this, you should drink plenty of water and beverages containing plenty of electrolytes, such as orange juice11.

Children, the elderly, and those with weakened immune systems are the most vulnerable to dehydration, so if you have someone that fits any of these descriptions, pay close attention to their intake of fluids.

illustration of a Lady Drinking Water Right Before Going to Bed

Adjust your diet

According to the Mayo Clinic, you should avoid foods that may irritate your stomach1. 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

Cutting out your caffeine and alcohol12 intake should also help manage your diarrhea. This is because health experts say that excessive consumption of these substances could worsen or cause diarrhea symptoms.

Get More Info: How Does Caffeine Affect Sleep?

Manage your stress

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 keep 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. Probiotics13 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
  • miso soup
Animated Illustration of Microbes Having Party Inside Mans Gut

Frequently Asked Questions

Can diarrhea at night be linked to cancer?

In some cases, yes, diarrhea may 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 symptoms14:

  • Your diarrhea lasts more than two days without improving
  • Extreme thirst
  • Dry mouth or dry skin
  • Little to no urination
  • Feeling weak or dizzy
  • Dark urine
  • Severe stomach or rectal pain
  • Bloody or black stools

Can nighttime diarrhea happen to adults?

Yes, 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?

Yes. As mentioned earlier, foods contaminated with bacteria or parasites can cause food poisoning. In this case, diarrhea is your body’s defense mechanism for removing these harmful germs by working to flush them out.

Is diarrhea at night a sign of COVID-19?

Not necessarily, but it’s a symptom. Researchers have found that diarrhea is a symptom of the COVID-19 virus. According to the 2020 study15, up to 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-19. The best thing to do is monitor your symptoms and get tested if you notice no improvements.

References:

  1. “Diarrhea”. Mayo Clinic. Last modified August 18, 2021. https://www.mayoclinic.org/diseases-conditions/diarrhea/symptoms-causes/syc-2035224
  2. “Fever”. Mayo Clinic. Last modified May 7, 2022. https://www.mayoclinic.org/diseases-conditions/fever/symptoms-causes/syc-20352759#:~:text=A%20fever%20is%20a%20temporary,a%20fever%20may%20be%20uncomfortable.
  3. Rajan MD, Elizabeth. “Mucus in stool: A concern?”. Mayo Clinic. Last modified March 5, 2022. https://www.mayoclinic.org/mucus-in-stool/expert-answers/faq-20058262#:~:text=Larger%20amounts%20of%20mucus%20in,ulcerative%20colitis%20and%20even%20cancer.
  4. Taché, Yvette., Larauche, Muriel., Yuan, Pu-Qing., Million, Mulugeta. “Brain and Gut CRF Signaling: Biological Actions and Role in the Gastrointestinal Tract”. Current Molecular Pharmacology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8091865/#!po=1.08696. 2018.
  5. Picco MD, Michael F. “Chronic diarrhea: A concern after gallbladder removal?”. Mayo Clinic. Last modified September 29, 2021. https://www.mayoclinic.org/tests-procedures/cholecystectomy/expert-answers/gallbladder-removal/faq-20058481.
  6. “Inflammatory bowel disease (IBD)”. Mayo Clinic. Last modified September 3, 2022. https://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/symptoms-causes/syc-20353315.
  7. “Irritable bowel syndrome”. Mayo Clinic. Last modified November 2, 2022. https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016.
  8. “Microscopic colitis”. Mayo Clinic. Last modified January 20, 2021. https://www.mayoclinic.org/diseases-conditions/microscopic-colitis/diagnosis-treatment/drc-20351483.
  9. “Diabetes-Related Diarrhea”. Cleveland Clinic. Last modified April 25, 2022. https://my.clevelandclinic.org/health/symptoms/22843-diabetic-diarrhea#:~:text=Diarrhea%20is%20a%20common%20symptom,diabetes%20affects%20the%20anal%20sphincter.
  10. Schiller, LR. “Secretory diarrhea”. National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/10980977/. 1999.
  11. Takahama, Elise S. “Electrolyte Showdown: Sports Drinks vs. Fruit Juices”. California Science and Engineering Fair. https://csef.usc.edu/History/2011/Projects/J0622.pdf. 2011.
  12. “When you have diarrhea”. Mount Sinai. Webpage accessed January 7, 2023. https://www.mountsinai.org/health-library/selfcare-instructions/when-you-have-diarrhea.
  13. “Probiotics”. Cleveland Clinic. Last modified March 9, 2020. https://my.clevelandclinic.org/health/articles/14598-probiotics.
  14. “Diarrhea Symptoms: When to see a doctor”. Mayo Clinic. Last modified July 14, 2021. https://www.mayoclinic.org/symptoms/diarrhea/basics/when-to-see-doctor/sym-20050926#:~:text=Diarrhea%20lasts%20more%20than%20two,Bloody%20or%20black%20stools.
  15. D'Amico, Ferdinando., Baumgart, Daniel C., Danese, Silvio., Peyrin-Biroulet, Laurent. “Diarrhea During COVID-19 Infection: Pathogenesis, Epidemiology, Prevention, and Management”. National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/32278065/. 2020.
Content Writer

Rachael is a content writer for Sleep Advisor who loves combining her enthusiasm for writing and wellness. She’s had a passion for writing since she was a kid when she wrote awful poetry. She’s honed her craft quite a bit since then and considers herself a lucky duck to get paid to do what she loves.

Embracing the remote work life, she occasionally takes her work on the road and lives out her travel writer pipe dream.

In her free time, she attempts to meditate regularly, rides her bike to Trader Joe’s, and enjoys trying every type of food that she can get her hands on.

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