# IBS and night symptoms



## john maher (Oct 23, 2003)

Hello,Are there any fellow sufferers who have night cramps and diarrhea at night? I suffer from both and the bouts usually start at 2 or 3 AM. I am curios as I have recently been diagnosed with IBSD, however I note that night cramps and D are not typical of IBS, so it makes me question the dagnosis.Remus


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## Meredith974 (Dec 7, 2003)

Hi!I suffer from a similar problem- I am often woken from sleep with stomach cramps and D. This is not typical IBS but so far no other answers have presented themselves despite much investigation and testing. I find that eating an early dinner helps ameliorate the symptoms as it gives you time to process and have D before you get comfy in bed!Good luck


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## Kathleen M. (Nov 16, 1999)

Usually IBSers tend to have symptoms most of the time during those times when the colon is normally at it's most active (after you get up in the morning and after meals). The colon is normally at rest when you are at rest, so for MOST but not ALL IBSers night time is relief time.When you have a GI infection, or other inflamatory process going on that TENDS to be less dependant on the colon's natural rhythm.But it is not 100% one way or the other.IBSers who have pain/diarrha that wakes them from sleep at night generally need more testing than IBSers who do not, but there are people who have no other symptoms/signs of inflamatory problems that seem to only have IBS that have night symptoms (it is just much rarer).So if you take 100 people with Crohns a lot of them have symptoms when asleep, but out of 100 IBSers you would find very few who do. This is why it is a red flag that something else may be going on. MAY BE, not ALWAYS is...So with this symptom you definitely need to have the blood screened for sedimentation rate, and you may be much more likely to need to be scoped before they decide what you have.K.PS and occasional symptoms like this may be due to GI infections that IBSers get just like anyone else (that is usually how I can tell IBS from GI infection stuff...the timing of the bouts).


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## LNAPE (Feb 9, 1999)

You may consider what meds even over the counter things like vitamins you take at night. This could very well be a cause for the 3 am wake up call.Linda


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## BackFire44 (Nov 19, 2003)

After I started Levsin, there were a few nights when I was woken up the middle of the night with bad cramps and D. I did two things to help this, and I haven't had a problem since:1) On each of the nights I had had something to eat roughly thirty minutes before bed. Now, I try to get a full hour in after I eat anything at all before going to bed. 2) On the worst night in question, I had worked out, then eaten a bit, and then gone to be about twenty minutes later. I think my system wasn't shut down yet from working out and the food plus the exercise combined to give me problems. I make sure now that I have at least an hour after working out before going to bed.Make sure you get tested by your doctor for other problems besides IBS, though. If you are someone who eats or workouts close to bed, try changing that. Also, maybe if you are extra careful at dinner with what you eat, it may get better.


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## Jeffrey Roberts (Apr 15, 1987)

Just an FYI:There was a study done by Dr. Sperber out of Israel that was presented at Digestive Disease Week in 2002 which kind of blew away the myth that night time symptoms of IBS are atypical.Sometimes it can raise a red flag if there are other symptoms associated with night time waking with D such as fever, blood in your stool or rapid unusual onset, in which case it does require further investigation.Jeff


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## LaurieJ (Sep 3, 2002)

Textbook GallBladder pain usually occurs in the early morning hours and wakes people up from sleep. However I am unsure if D associated with gallbladder problems would do the same. Just thought I would mention this possibility as a consideration.


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## loulou (Jan 18, 2001)

I believe you'll need every GI test to be given to you if you have night time symptoms. Night time D highly increases your odds you've got the wrong diagnosis. I personally think night time symptoms is never IBS, but it is possible there is that one except. However, too many doctor's poopoo this red flag and will barely cover the minimum for GI testing. It took nine years to discover that I have microscopic colitis and I had daily symptoms which began in the wee hours of the morning. I didn't get serious about my illness until I had to stop working. Problem is most doctors don't care about patients with the diagnosis IBS.


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## john maher (Oct 23, 2003)

First of all I'd like to thank everyone who replied to my posting. This was my first posting and it is very comforting to know there is a caring community out there, as IBS is a lonely affliction. Thank you.I have been thoroughly tested including gastroscopy, upper GI, small bowel series, barium enema, colonoscopy and various blood screens. From the comments given by Kmottus I may just be an exception. One question, what is blood sedimentation and what significance does it play in determining ibs versus non ibs diagnois?Also to loulou, how did you finally find out you had miscroscopic colitis? Finally to Backfire44, did Levsin alleviate the urgency of the bowel movements as I am finding the complete lack of control a huge challenge, where can I find out more about it?Once again thanks to all. Remus


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## candywithaholeinthemiddle (Dec 9, 2003)

Remus,I'm also new here and certainly don't have as much knowledge as some of the other members, but I do know what I experience.I too suffer from night symptoms - usually just cramping and 'gurgling noises' (which hurt), tension in the belly etc... but sometimes also D. I find this can often stop me from falling asleep. Once I get to sleep though, I'm fine unless something or someone wakes me up -- if I'm woken up in the middle of the night or early morning, I still have the cramping going on. It's like the whole mess in my stomach was still going on while I slept, I just managed somehow to sleep through it. Do you experience the same sort of thing? There has only been one time where the symptoms actually woke me up. Sometimes I agree that the night symptoms are b/c I ate too close to bed-time...but other times there seems to be no rhyme or reason at all.Just so you know -- even if this type of thing is 'rare' (which the moderator of this board debates), there are other people out there going through the same thing. Wish I could tell you what has worked for me in the past, but I haven't found any consistent help yet. Take care~


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## california123 (Jun 8, 2003)

Hello Remus,I also had middle of the night D on some occasions, along with daily multiple D--mainly in the morning--for six months straight. I tried all OTC remedies--I went to GI who did basic testing and said I had IBS. He gave me prescriptions for anti-spasmodics etc which also made no difference. Finally, out of desperation, I took a Xanax for my anxiety. (I am responsible for two elderly parents with dementia so I'm under chronic stress.) The D stopped in 48 hours! Started seeing a psychiatrist who added Effexor XR--combo anti-anxiety/depressant--and lowered the Xanax slightly. It turns out I had anxiety-induced D which is not uncommon. And if that is the case, an anxiety attack can happen at anytime of the night or day and cause the D to occur. Just something to consider. Take care.


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## LaurieJ (Sep 3, 2002)

An ESR (aka sed rate, sedimentation rate, erythrocyte sedimentation rate) is one indicator for inflammation in your system. It is generally ordered in conjunction with a CRP test (C reactive protein). Theoretically it is a way to monitor inflammatory processes. For example, someone with a flare of RA or lupus, or an infection or tissue injury will have high levels. There are limitations though, with using these tests for measuring bowel inflammation. Because of the localized nature of inflammation in the bowel, you can have significant inflammatory reactions going on that are not detected by the tests (a colleague explained it to me as the GI tract being a hollow tube that the rest of your body is wrapped around - in effect it is an entity of itself). So, if you have high values on these tests and other sources of inflammation have been ruled out, then they may indicated IBD (or something similar) but if the tests come back negative, you cannot completely rule out IBD (although there is a greater likelihood that it is not IBD but rather IBS). And of course, there are all sorts of environmental factors that can influence the results of the lab tests that are beyond your control. Such as: is your blood lipemic and / or hemolyzed when the tests were run....Is the lab too hot or too cold? are there vibrations from construction affecting the blood (which, don't laugh, is common because in many hospitals ongoing construction and remodeling is the norm)? That is why it is recommended that you do these tests at least two different times, preferably when you are feeling your worse. But of course, there are always exceptions to everything so just use this information as a very generalized, simplistic explanation.Laurie


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## loulou (Jan 18, 2001)

To rule out microscopic colitis one needs to have a biopsy of their colon read for MC. My biopsy was taken at the very end of my colon but my believes my whole colon is affected by the MC.


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## john maher (Oct 23, 2003)

Once again thanks to all who have replied and joined this topic. Laurie J, I will look back at my blood tests to study the results closer, though it is likely this test was done, thank you sincerely for the information.loulou, I did have a biopsy with my colonsocopy. They did find inflammation but not associated with damaged tissue or macroscopic evidence of IBD so thus my IBS diagnosis. However I am not sure they checked for microscopic colitis, again I will check.To those of you who share the night symptoms, mine are calming down. I have upped my intake of a herbal theraputic food call Ultrainflavogen (recommended by my Naturopath) and am taking more Omega 3 supplements (Flax oil and EPA capsules) both of which are anti-inflammatories. Also I am on a fish and chicken (white meat only) diet as well as avoiding caffene and alcohol. Slowly I am gaining ground and beginning to sleep through the night again.







I have tried a whole host of prescription medicines with no results. But if my D does not abate I may be forced to try again. the suggestion of antidepressants is one I have heard before but not tried. What are the side effects? Thanks again for all your help. Remus


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## Irene (2 mo ago)

Jeffrey Roberts said:


> Just an FYI:There was a study done by Dr. Sperber out of Israel that was presented at Digestive Disease Week in 2002 which kind of blew away the myth that night time symptoms of IBS are atypical.Sometimes it can raise a red flag if there are other symptoms associated with night time waking with D such as fever, blood in your stool or rapid unusual onset, in which case it does require further investigation.Jeff


I am relieved to hear that


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