What is Nocturnal Diarrhea?
Diarrhea is defined as a gastrointestinal condition which causes a person to have watery and loose stools. Diarrhea can be both acute and chronic. In acute cases, diarrhea lasts for a couple of days and resolves without much medical intervention. A person with chronic diarrhea will have episodes of loose stools for a period of four weeks or more.[1,2,3]
Persistent diarrhea can have a draining effect on the body. It affects the quality of life of a person and even interferes with normal sleep. Nocturnal Diarrhea occurs when a person has loose watery stools at night. If it is just an one off episode then there is nothing to worry about as it may be caused by a stomach bug or an infection.[1,2,3]
However, if there are persistent episodes of Nocturnal Diarrhea then it may be a sign of something serious like diabetes as a potential cause or a medical condition affecting the GI tract. The treatment of Nocturnal Diarrhea depends on what is actually causing it and the severity of the episodes.[1,2,3]
What Causes Nocturnal Diarrhea?
A common diarrhea can have many causes including food allergies, infection, certain medications, and even stress at times. If these are the cause of Nocturnal Diarrhea then the condition clears up once the causative factor is taken care of. Chronic Nocturnal Diarrhea is often caused by something that may be more than just a stomach bug. It may include.[3]
Secretory Diarrhea: This is one of the primary causes of Nocturnal Diarrhea. It occurs when the body is not able to absorb electrolytes properly. People who binge on alcohol regularly are most at risk for developing secretory Nocturnal Diarrhea. People who have undergone an intestinal surgery or are on certain medications that affect the GI tract can also at times have Secretory Nocturnal Diarrhea.[3]
Irritable Bowel Syndrome: This is yet another cause of chronic Nocturnal Diarrhea. This condition occurs when the gastrointestinal system malfunctions. Primary symptoms of irritable bowel syndrome include gas and bloating, periods of constipation, mucous in stools, and pain in the stomach.[3]
Generally, irritable bowel syndrome does not cause Nocturnal Diarrhea; however, if it occurs then it is termed as a serious symptom which requires immediate medical attention. People with irritable bowel syndrome who develop Nocturnal Diarrhea will also experience bloody stools, severe abdominal pain, and unintentional weight loss.[3]
Microscopic Colitis: This is a condition which is caused as a result of inflammation of the large intestine. Persistent diarrhea is the primary symptom of this condition including Nocturnal Diarrhea. The inflammation is so minute that it can only be observed with a microscope and thus it gets the name. This condition is quite common in the elderly population but any person who has Nocturnal Diarrhea should be checked up for microscopic colitis.[3]
Some of the other symptoms of microscopic colitis include stool incontinence, nausea, severe pain in the stomach, and unintentional weight loss. What exactly causes this inflammation is not yet known but chronic use of NSAIDs is believed to be the most common risk factor for microscopic colitis.[3]
Diabetes: This is perhaps the most common endocrinological disorder which affects the way sugar is absorbed in the body. This results in accumulation of sugar in the blood causing a variety of symptoms and potentially serious complications. People who are not in control of their blood sugars and are dependent on insulin are at risk for developing Nocturnal Diarrhea. This can also occur in people who have nerve damage as a result of diabetes, a condition called diabetic neuropathy.[3]
Additional symptoms for diabetes include vision disturbance, fatigue, polyuria, polydipsia, frequent infections, and unintentional weight loss. Diabetes is of two types, namely type-1 and type-2. The cause of diabetes depends on the type of it. In cases of type-1 diabetes, it is the immune system that is responsible and in cases of type-2 diabetes the cells become resistant to insulin that is naturally produced by the body. Some females develop diabetes as a result of pregnancy. This is termed as gestational diabetes and may also cause Nocturnal Diarrhea.[3]
What are the Symptoms of Nocturnal Diarrhea?
A person with Nocturnal Diarrhea will also experience fever, abdominal bloating, sleep problems, stomach pains, nausea, and frequent urge to pass stools. The symptoms can be mild to severe in intensity. In mild cases however the symptoms tend to fade away within a day or two. In serious causes of Nocturnal Diarrhea, the individual will also experience bloody stools, severe pain, and unintentional weight loss.[3]
If diarrhea persists for a period of more than a month, then it is termed as chronic diarrhea that requires prompt medical attention to get to the bottom of the cause and start treatment for it.[3]
How is Nocturnal Diarrhea Treated?
In mild cases, Nocturnal Diarrhea clears up on its own within a couple of days. During this time, it is imperative that the individual stays hydrated as plenty of fluids and electrolytes are lost during diarrhea. Chronic cases of diarrhea need thorough investigation to get to the bottom of the cause and formulate a treatment plan. Some treatment options for Nocturnal Diarrhea include use of medications to stop diarrhea, avoiding any foods that the person thinks may have triggered an episode. In cases of bacterial infections, the patient will be given a course of antibiotics.[3]
It is also important to eat light and easy to digest food products till the time the GI tract heals after an episode of diarrhea. People with chronic Nocturnal Diarrhea should refrain from excessive consumption of alcohol and nicotine. If irritable bowel disease is believed to be the cause of Nocturnal Diarrhea then treatment is basically symptomatic and supportive as this condition does not have a cure.[3]
The patient will be given medications to include NSAIDs, immune suppressants, and other medications that calm down inflammation. In rare cases, people with irritable bowel disease need to be treated surgically to make a narrow bowel wide or remove any damaged section of the digestive tract.[3]
For cases of Nocturnal Diarrhea caused by microscopic colitis, stopping all medications that may cause inflammation and worsen the symptoms is one of the frontline treatments. Additionally, the patient will be recommended dietary and lifestyle modifications to control the symptoms of microscopic colitis including Nocturnal Diarrhea. NSAIDs and medications that decrease production of bile acids are also quite effective in managing the symptoms of microscopic colitis including Nocturnal Diarrhea.[3]
What Are The Complications Of Nocturnal Diarrhea?
Dehydration is the most common complication of Nocturnal Diarrhea. Passing watery stools frequently results in significant loss of fluids and electrolytes from the body. This makes the body weak. In addition, dehydration due to Nocturnal Diarrhea can also cause muscle weakness, dizziness, renal dysfunction, abnormal heart rhythm, shock, and rarely coma.[3]
In cases if an underlying medical condition is believed to be the cause of Nocturnal Diarrhea then there might be additional complications that may arise like vision loss in cases where diabetes is the cause of Nocturnal Diarrhea.[3]
In conclusion, Nocturnal Diarrhea is a condition in which a person passes watery loose stools frequently in the middle of the night. This affects the sleep patterns and overall quality of life of the person. Nocturnal Diarrhea can be acute or chronic. While the acute form of Nocturnal Diarrhea clears up without much treatment within a couple of days, chronic Nocturnal Diarrhea may persist for a significant period of time and is generally caused due to underlying medical conditions like diabetes, irritable bowel disease, or microscopic colitis.[1, 2, 3]
Thus if a person has frequent episodes of Nocturnal Diarrhea then it is best to consult with a physician to identify a cause for it and start treatment. Prompt diagnosis and treatment is important to prevent any worsening of the condition and avoid any unnecessary complications that may arise.[1, 2, 3]
During an episode of Nocturnal Diarrhea it is imperative for the patient to stay hydrated and eat foods that are easy to digest. Hydration is of paramount importance as with every episode of Nocturnal Diarrhea significant amount of body fluids are lost causing dehydration which is a common complication of Nocturnal Diarrhea.[1, 2, 3]
