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Suggest Treatment For Nocturnal Diarrhea

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Posted on Thu, 16 Apr 2015
Question: I have nocturnal diahrea 2 - 4 times a month. The next day I feel lousy - partly due to lack of sleep. (I'm 72)
doctor
Answered by Dr. Panagiotis Zografakis (6 hours later)
Brief Answer:
Please provide more details

Detailed Answer:
Hello,

If I understood your description, you're having diarrhea 2-4 times a month, at night only and you're probably OK during the rest of the month. Right?
Please answer my questions, so that I can have more data about your case.
- how long has this been going on?
- have you considered the possibility it's related to certain food?
- have you done any tests? If yes, can you provide the results?
- any other medical conditions? Your medical history and drugs? Vascular, intestinal, pancreatic problems?
- does the diarrhea awake you?
- any surgical operations in the past?

Your answers may help a lot with understanding the source of your problem.
Please add any related detail, that you consider important.

I'll be waiting for your answer.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (5 hours later)
This has been going on gor more than a year - it has occurrd more frequently in the past 2 months. Does the fiarrhea wake me? Of course, i have yo get ip and ho yo the bsthroom 4-6 times during the night. So the next day im very tired and sometimes nauseous. So im ok the rest of yhe month after recovering which csn take 1-2 days.
I have not kept a journal, but always think back to what i ate and i dont notice a good pattern.

No tests

I gave my medical hidtory snd drugs when i sent in the question. But here it is again,

I have heart disease with three stents in for no presentstion. I have pre-diabetes. I take synthroid as i have half a thyroid gland removed due to benign lump. Meds: synthroid, crestor, cardedilol, losartan, baby asprin.

I tead that having diarrhea at night is more serious than having it during the day. Is that correct?
doctor
Answered by Dr. Panagiotis Zografakis (1 hour later)
Brief Answer:
I'll present a list of potential diagnosis and best action

Detailed Answer:
Hello,

to answer your question first, nocturnal diarrhea that wakes you in the night means that there is an organic cause and it's not irritable bower syndrome for example.

If the diarrhea cannot be attributed to specific patterns of eating (like after eating legumes or fatty food for example) then we'll have to consider various conditions. I'll make up a short list for you, taking into account the fact that your diarrhea is intermittent.

Inflammatory bowel disease (Crohn's or ulcerative colitis). This is a chronic condition that has exacerbations and remissions. It is usually accompanied by abdominal pain and perhaps also fever and blood test findings (increased white blood cells, erythrocyte sedimentation rate etc).

Microscopic colitis is another entity that may cause intermittent (and nocturnal) diarrhea. This is caused by immunological disorders.

Ischemic colitis which is compatible with your history of heart disease (which by the way was not visible to me). This is usually accompanied by blood in the stool.

Diverticular disease may cause diarrhea and pain. Perhaps even fever (diverticulitis).

Colon cancer does not typically present this way, but it can't be excluded from the differential diagnosis.

All of the above can be diagnosed by colonoscopy. Blood tests may help depending on the cause.

So this is what I would suggest you to do. Contact a gastroenterologist for an endoscopy of your colon.

I hope you find my answer useful.
If you'd like to ask for more details, I'll be glad to provide them for you.

Kind Regards!


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (29 minutes later)
Oh dear - this is really scaring me!! I had a colonoscopy 5 years sho snd woke ip duting the procedure. It was very scary and painful! Should i ho straight yo a gastrenyolodt or go see my regular foctor first? (Sorry gor the typos - amusing an iphone and the print on this app is tiny!)
doctor
Answered by Dr. Panagiotis Zografakis (8 minutes later)
Brief Answer:
I'm afraid it is

Detailed Answer:
Hi,

endoscopy is the best way to assess such conditions. Biopsies taken during endoscopy would clarify many things regarding the cause of your diarrhea. You can ask the gastroenterologist to provide a mild sedation, so that you won't remember what happened. My view is that the worst thing about colonoscopy is the previous day (preparing your bowels) but this a matter of opinion.

Your primary care doctor is a good first step because he will be able to evaluate your symptoms in more detail, examine you and conduct useful tests like a complete blood count and biochemistry panel. The gastroenterologist will probably provide the solution though.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (4 minutes later)
From my colonoscopy 5 years ago, it wasdetermined thst i have diviticila pockets. Does diviticular disease cause noctornal (exclusivrly) diarrhea ?
doctor
Answered by Dr. Panagiotis Zografakis (11 minutes later)
Brief Answer:
It could but not exclusively

Detailed Answer:
Diverticular disease is possible but most patients experience diarrhea regardless of the time of day (or night).
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3809 Questions

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Suggest Treatment For Nocturnal Diarrhea

Brief Answer: Please provide more details Detailed Answer: Hello, If I understood your description, you're having diarrhea 2-4 times a month, at night only and you're probably OK during the rest of the month. Right? Please answer my questions, so that I can have more data about your case. - how long has this been going on? - have you considered the possibility it's related to certain food? - have you done any tests? If yes, can you provide the results? - any other medical conditions? Your medical history and drugs? Vascular, intestinal, pancreatic problems? - does the diarrhea awake you? - any surgical operations in the past? Your answers may help a lot with understanding the source of your problem. Please add any related detail, that you consider important. I'll be waiting for your answer.