Nocturnal (Nighttime) Diarrhea

Diarrhea can be unpleasant and worrisome at any time of day. Waking at night with symptoms of diarrhea, however, can make these feelings and frustrations worse, as it disrupts your sleep.

Diarrhea is a condition in which you have urgent, loose, or watery stools. Nocturnal diarrhea is when you experience these symptoms at night, often awakening you from your sleep. Nocturnal diarrhea can have many causes and can last from a day or two to more than a month, depending on the cause.

This article will talk about the symptoms, causes, and treatments for nocturnal diarrhea and when you should speak with your healthcare provider about your symptoms.

Woman has painful stomachache lying in bed at night

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Symptoms of Nocturnal Diarrhea

 Nocturnal diarrhea happens at night and may include the following symptoms:

  • Loose, thin, or watery stools
  • Urgency in bowel movements
  • Bloating 
  • Abdominal pain
  • Nausea
  • Fever or chills
  • Blood or mucus in stool

Types of Diarrhea

Diarrhea is generally categorized into types based on how long it lasts:

  • Acute diarrhea: Lasts two weeks or less
  • Persistent diarrhea: Lasts more than two weeks but less than four weeks 
  • Chronic diarrhea: Lasts four weeks or more

Additionally, diarrhea may be categorized by whether it is infectious or noninfectious. For example, most cases of acute diarrhea are caused by viral infection. Chronic diarrhea often tends to be noninfectious.

Causes of Nocturnal Diarrhea

Some causes of nighttime diarrhea are similar to those that cause mild daytime diarrhea. These cases are usually acute and tend to go away on their own. They include:

  • Infections (viral or bacterial)
  • Food poisoning
  • Food allergies or food intolerances
  • Medications, such as antibiotics

What Medical Conditions Can Cause Nocturnal Diarrhea?

In cases of more persistent or chronic diarrhea, another medical condition may be to blame. Below are some medical conditions that might be a possible cause of diarrhea at night.

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) involves chronic inflammation in all or part of your digestive tract and refers to several conditions, including Crohn's disease (CD), ulcerative colitis (UC), and indeterminate colitis (IC).

The main symptoms of IBD are diarrhea, blood and mucus in the stool, abdominal pain, and unintentional weight loss. Some people with IBD experience nocturnal diarrhea in addition to daytime diarrhea.

People with IBD may experience severe symptoms at times or have periods of remission when they are getting treatment. The exact cause of IBD is unknown, though risk factors include having a family history of inflammatory bowel conditions, being a smoker, and taking certain medications, such as nonsteroidal anti-inflammatory medications (NSAIDs).

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a functional gastrointestinal tract (GI) disorder in which the muscles in the colon (large intestine) are especially sensitive to certain triggers. Symptoms may include abdominal pain, bloating, constipation, and/or diarrhea. The severity of symptoms varies from mild to debilitating. 

Most people with IBS do not experience nocturnal diarrhea, but it can occur. Usually, loose watery stools occur during the day. People with IBS who experience nighttime symptoms, including diarrhea, should contact their healthcare provider for medical attention.

What causes IBS is unclear, however medical experts think causes may include stress, anxiety, or depression, GI bacterial infections, bacterial overgrowth in the small intestines, food intolerances or sensitivities, or genetics.

Microscopic Colitis

Microscopic colitis is a term that includes two similar, but separate conditions: collagenous colitis and lymphocytic colitis. This condition causes inflammation of your large intestine that can only be seen by a microscope.

Symptoms of microscopic colitis may include diarrhea that occurs day or night (even when fasting), fecal incontinence, abdominal pain, unintentional weight loss, and fatigue.

The exact cause of microscopic colitis is unknown, though it is more common in females and in older adults. Other risk factors include having certain immune disorders, being a smoker, or taking certain medications.

Diabetes

Diabetes is a condition in which the body is unable to properly use glucose (sugar), resulting in high blood glucose levels.

Though experts are unsure why it is so common, some people with diabetes may experience diarrhea, including at night, if their blood glucose levels are poorly controlled, and if they depend on insulin. Other medications used to treat diabetes, like Glucophage (metformin) and Precose (acarbose), have been linked to causing diarrhea as a side effect.

Additionally, people with diabetes may be more likely to experience nocturnal diarrhea if they have nerve damage in the GI tract known as diabetic neuropathy.

Other Medical Conditions

Other medical conditions that can cause nocturnal diarrhea include:

  • Hyperthyroidism (increased function of the thyroid gland)
  • Secretory diarrhea (type of diarrhea that occurs when water and electrolytes are increased in the intestinal lumen, resulting in increased secretion and decreased absorption of water and sodium): Causes of secretory diarrhea may include infections, tumors, and inflammatory bowel disease.
  • Surgical resection of small or large bowel resulting in a decrease in the absorptive surface of the bowel: If the resection in the small bowel is long, it can result in a condition called short gut syndrome.

How to Treat Nocturnal Diarrhea

In many cases diarrhea goes away on its own after a few days, usually without any treatment. However, some treatments may be appropriate to help decrease symptoms of mild diarrhea and prevent complications from occurring. These include the following:

Stay Hydrated

As with any type of diarrhea, it’s important to stay hydrated. Drink plenty of fluids at the first signs of diarrhea to prevent dehydration, including water and other beverages that have nutrients and electrolytes (minerals that carry an electric charge), such as  sports drinks, fruit juices, and broth.

Foods and Beverages to Avoid

Research has shown that, in most diarrhea cases, restricting your diet does not help to treat it. Additionally, most experts do not recommend fasting when you have diarrhea. However, avoiding certain types of foods and beverages might help, including:

  • Alcohol
  • Caffeinated beverages and foods
  • Drinks and foods containing fructose
  • High-fat or greasy foods
  • Spicy foods
  • Fruits such as apples, peaches, and pears
  • Foods and beverages containing alternative sweeteners such as sorbitol, mannitol, and xylitol
  • Dairy products containing lactose if you are lactose intolerant or are sensitive to lactose

Medications

Short-term diarrhea usually goes away on its own and does not require any medication. If you are experiencing persistent, chronic diarrhea, talk to your healthcare provider about possible medications to help ease symptoms. 

In some cases, medications such as antidiarrheal drugs or antibiotics may be recommended, while other medications might be more suitable if the cause is due to a medical condition. 

Manage Stress

Managing stress and anxiety may help reduce diarrhea in some cases. Research has shown that symptoms of IBS, including diarrhea, may be made worse by psychological distress.

Practicing relaxation techniques, meditation, or walking are all examples of how someone might manage stress.

Complications Associated With Nocturnal Diarrhea

Bouts of diarrhea can lead to complications:

When to See a Healthcare Provider

Seek medical help if you experience any of the following symptoms associated with nocturnal diarrhea:

  • Signs of dehydration such as decreased urination, dark or amber-colored urine, extreme fatigue or weakness, extreme thirst, or dry mouth
  • Blood or pus in your stool
  • Long-lasting or high-grade fever
  • Significant abdominal pain
  • Diarrhea lasting several weeks

Summary

Nocturnal diarrhea is a condition of loose, watery stools that occurs at night and can disrupt your sleep. It may simply be a bout of mild diarrhea that clears up within a day or two. However, if you experience nocturnal diarrhea on an ongoing basis, you may have a serious medical condition that requires a visit with your healthcare provider.

A Word From Verywell

It can be frustrating and concerning to experience nocturnal diarrhea. However, acute, mild cases can often be safely treated at home and will go away on their own.

If your nighttime diarrhea doesn’t go away and you notice other symptoms, contact your healthcare provider to determine the root cause of your health problems. They can help you find the best solution to ease your symptoms and allow you to get a full night of uninterrupted rest.

Frequently Asked Questions

  • What causes nocturnal diarrhea?

    Acute nocturnal diarrhea may be caused by the same triggers as mild daytime diarrhea, including infections (viral or bacterial), food poisoning, food allergies or intolerances, or certain medications.

    However, sometimes the cause of ongoing nocturnal diarrhea is due to a chronic medical condition, such as irritable bowel syndrome, inflammatory bowel disease, microscopic colitis, or diabetes.

  • Can lactose intolerance cause nocturnal diarrhea?

    Lactose intolerance is characterized by GI symptoms, including diarrhea, brought on by consuming dairy products containing lactose.

    In general, symptoms occur between half an hour to a couple of hours after eating dairy products and tend to coincide with the amount of lactose consumed.

    If consumed in the evening or close to bedtime, symptoms, including diarrhea, can occur during the night.

  • How can I get rid of nocturnal diarrhea?

    Acute (sudden onset) nocturnal diarrhea will usually go away on its own within a day or two. If your nocturnal diarrhea lasts several days to weeks, it’s best to visit with your healthcare provider to determine the exact cause and create an individualized treatment plan to ease or resolve symptoms.

    Treatment may include avoiding certain foods or beverages, taking medication, and managing stress. 

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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