# Nighttime diarrhea



## dianajune

I've suffered with IBS for over 20 years, and I don't get nighttime diarrhea very often. But tonight it decided to kick in. I was getting ready for bed and around midnight the cramps started and I had gas. I thought that gas was all I was going to have. So at about 12:45 am I took one dicyclomine and hoped for the best.

I was wrong.

Less than 20 minutes after I took that pill, I was heading for the bathroom. I've gone 3-4 times since I took that pill and feel another trip is coming on.

Nighttime diarrhea doesn't normally indicate IBS but something worse from what I heard. However, this has happened to me before. Not very often. Only difference is, this time around I've been having daytime diarrhea off and on since around New Year's. I was in the hospital overnight with cellulitis and they put me on Keflex. I was sent home the next day and my gut hasn't been the same since.

I've had rectal bleeding several times, so to be on the safe side they scheduled a colonoscopy, which will be done next week.

In the meantime, does anyone out there have suggestions as to how to beat nighttime diarrhea? I'm beginning to wonder if my stools will ever get back to normal. I'm sick of having this all the time.

Can a person with IBS-D have constant or chronic diarrhea?


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## SLaurenAlise

Chronic diarrhea is exactly what a person with IBS-D has. Sometimes the attacks of diarrhea are prompted by eating specific foods or too much food, and may be isolated to one or two attacks. Sometimes the attacks are prompted by the very act of eating because your colon has become so sensitive, and people with IBS-D can experience as many as ten to twenty attacks in a day.

Have you had IBS-C for most of your 20 years with IBS? Because if that's so, I've heard of people switching from IBS-C to D, and vice versa, which I suppose could be happening to you. I don't know what the explanation is, though. It's certainly wise to get it checked out and eliminate other possibilities, but if you already have IBS, it's a good bet that this is IBS-D. Especially because of the Keflex...

I don't know much about Keflex, but in looking at the Wikipedia entry (http://en.wikipedia.org/wiki/Cefalexin), I found out that it's an antibiotic -- bingo! Antibiotics eliminate not only the bad bacteria that cause illness, but also the good bacteria (gut flora) in your stomach and intestines that you need to digest food properly. People with IBS are very sensitive to antibiotics. While I don't know much about how IBS-C sufferers typically react to antibiotics, I know from personal experience (I have been IBS-D for 7 years) and from talking with others that IBS-D sufferers react in a major way to antibiotics. I always get sick after taking antibiotics, and in fact, my doctor and I have theorized that the large amount of antibiotics that I was given as a child predisposed me to developing IBS because it altered the makeup of my gut flora so completely.

I've never taken Dicyclomine, so I don't know how effective it is -- I've usually taken Imodium after an attack of diarrhea, in terms of drugs. I have started trying more natural ways to calm my intestines after an attack, though. Here is what I do:


Peppermint tea and/or Peppermint Oil (either in capsule form or from a bottle)
Fennel tea and/or Fennel Capsules (I actually tend to combine a bag of Peppermint Tea and a bag of Fennel tea in one cup)
Lycopodium Clavatum 200c (a homeopathic medicine that provides relief from cramping, and diarrhea to some extent)
Arsenicum Album 30c (another homeopathic medicine)
Aloe Socotrina 200c (another homeopathic medicine for diarrhea)

The best way to fight nighttime diarrhea, though (if it is IBS) is to not simply fight it at night -- but to fight it all day, too. I would suggest drinking more Peppermint and Fennel Tea throughout the day, taking Fennel capsules, carefully monitoring your diet and staying away from all foods that could irritate your intestines (which is different for everyone), and starting a regimen of probiotics (which are found in yogurt and can also be taken in pill form). Probiotics are very important -- you need to replace the good bacteria in your stomach that the antibiotics killed. Be careful, though -- some people react to larger doses of probiotics (myself included), so start out with regular yogurt and an over-the-counter probiotic like acidophilus. Then perhaps graduate to Activia yogurt, which is supplemented with tons of extra probiotics, and consider taking a probiotic pill with more strains of probiotic, such as Probiotic Synergy by Designs for Health (http://www.discountvitamins.pro/ProbioticSynergy60spheresDesignsforHealth.aspx). You probably need to give your system a lot of time to calm down and reset itself.

The most important thing you can do, though, is to eliminate the possibility of other types of illness (which you are already doing) and then see a doctor who knows a lot about IBS (if it turns out that it's IBS-D that's causing your problem). The doctor should be able to make suggestions similar to mine, but that are more tailored to your particular body chemistry. Everyone with IBS reacts a little bit differently to many foods, supplements and drugs.

Good luck!


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## SLaurenAlise

I forgot in my previous post -- rectal bleeding isn't a sign of IBS, but rather of Colitis (http://en.wikipedia.org/wiki/Colitis) and Crohn's disease (http://en.wikipedia.org/wiki/Crohn%27s_disease). As I have IBS-D, I don't know much about either one of these...


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## Kathleen M.

Generally, most of the time, the colon tends to rest during sleep.

However if you ate something that would give anyone diarrhea, or got a bit of a virus that would give anyone diarrhea, often that does occur at night.

Rectal bleeding has causes other than colitis (depending on amount we are talking) so they will check for fissures and hemorrhoids that can also sometimes cause a surprising amount of bleeding.

If you have diarrhea predominately at night they need to do a colonoscopy with biopsies to look for microscopic colitis, but that usually doesn't cause a lot of bleeding, but generally causes more watery diarrhea than IBS and like I said often it causes symptoms mostly during the sleep hours for some reason.

However if you have one off diarrhea at night as any healthy human can have, that doesn't always mean something much worse than IBS. It could be any acute cause of diarrhea. I wish IBS meant you couldn't possibly ever get a GI virus or a bit of bad food but it doesn't protect you from those things.

FWIW, usually when I have that much diarrhea that short a period of time (day or night) it is a GI virus, or every so often some badly canned tuna as you can get histamine reactions in some foods when improperly handled.

IBS ranges from a few days a week or a couple weeks a month to every single day. Do you use anything to control the diarrhea? Dicyclomine is really for the cramps. Imodium is usually the first drug they use. Just the over the counter stuff. Usually dosing 2X a day is more effective than even the same amount once a day.


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## dianajune

I'd like to thank you both for responding!

The symptoms I listed got worse last night and I ended up having dry heaves early this morning as my stomach was empty. After speaking with someone at my doctor's office, they told me I've got the stomach bug and I agree. I don't normally have diarrhea at night, esp. as bad as that. It kept me up all night.

What really amazes me about this is that there was no bleeding whatsoever. At least not that I could see.

I understand imodium is good for diarrhea, but I don't have any on hand. So, I took the dicyclomine, thinking that might help too. Obviously I was wrong.

My IBS is mixed. I can be constipated and have diarrhea the same day.

I'll have to go to the store to get more yogurt (just ran out of that today) and probiotics and Imodium. I hope I'll be up to going on Friday. I'm staying home tomorrow to be on the safe side. I don't have a car and depend on public transportation. I'd hate to be stuck on the bus during a flareup!

I've got peppermint tea here. Will fix some in the morning. Right now its about 10:30 pm and I'm going to have a tiny bite to eat. Other than that I'll have water. I'm not up to much more than that. If it weren't for my diabetes, I'd be content to fast.

I hope this wont screw up my colonoscopy next week. The prep is a week from today.

Thanks again for listening!


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## dianajune

I'm feeling better this afternoon, but I'm not 100%. I had cereal this morning as I ran out of yogurt and didn't make it to the store. I'm hoping to go tomorrow, depending on how I feel.

Here's one horrid thought: I'm sure that given how fast I'm recovering, I'll feel much better by next Wednesday, which will be prep day for my colonoscopy. Should I have told my g.i. doc about this stomach bug? I only called my primary care md's office.

Would they postpone my test? I hope not. I want it over with asap.


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## dianajune

I called my g.i. doc's office because my diarrhea came back this afternoon. I don't know if it's the usual "stuff" or if it's because I'm still recovering from the stomach bug. It was watery with bits and pieces (sorry about the tmi) and had an orange hue. When I looked in the bowl I could have sworn it looked like it had blood in it, but there was no blood on the tp.

It looked like the diarrhea I had the same day I last had blood in my stool - probably one or two bm's before the bloody one. Does orange-brown stool indicate there could be blood mixed in?

I've been reading up on microscopic colitis and am wondering if this is what I have (besides the stomach bug). Is this considered an "inflammatory" bowel disorder? If I have this, does it mean I'm more likely to develop colon cancer in the future?

They said I can go ahead and have the colonoscopy next week, but to see my stool look like that startled me. I so don't need any more surprises. Could it be that my attempt at eating a normal diet before I"m over this have caused the diarrhea to come back? This morning it looked like it stopped, or was trying to.

What causes orange-brown stool? It almost looks like my stool when I'm on Citrucel.

Btw, I've had "minor" weight loss w/o trying. It seems as though I lose an average of 5 pounds every other month or so. Is that too much?

Help!


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## amazinggracie

I would definitely ask to have a stool test done for c difficicle. This sounds exactly like when I had c diff.


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## Kathleen M.

Blood can be from a GI infections, it does not have to be Ulcerative Colitis and Cancer in 10 years. But it certainly means you should probably get a stool test, and the colonoscopy probably is a good idea as well.

Microscopic colitis usually doesn't have as many complications of UC or crohn's.


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## windemere

I've had bouts of diarrhea at night. It was the worst. Sometimes I could pinpoint a food that set it off, other times I couldn't. Lately my diarrhea has been waking me up in the morning and that's just as pleasant as staying awake with diarrhea. I haven't had orange hue bms but have had reddish looking ones lately. I've been scheduled for a colonoscopy myself. Mine isn't until July 1st unfortunately. My gi doctor has yet to figure out what could be causing it. He mentioned colitis. My mother was diagnosed with colitis around my age. Not sure if that's genetic or not. If the blood you see is red I wouldn't worry too much. That's normally irritation from pooing too much or hemmorhoids. Dark, black looking blood is usually indication of something wrong. I, my cousin who has celiacs, and my mom all have had blood in our bms at some point in time. I think it comes with the bowel disorder territory. Let us know how the colonoscopy goes. And hopefully you get to feeling better soon.


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## dianajune

windemere said:


> I've had bouts of diarrhea at night. It was the worst. Sometimes I could pinpoint a food that set it off, other times I couldn't. Lately my diarrhea has been waking me up in the morning and that's just as pleasant as staying awake with diarrhea. I haven't had orange hue bms but have had reddish looking ones lately. I've been scheduled for a colonoscopy myself. Mine isn't until July 1st unfortunately. My gi doctor has yet to figure out what could be causing it. He mentioned colitis. My mother was diagnosed with colitis around my age. Not sure if that's genetic or not. If the blood you see is red I wouldn't worry too much. That's normally irritation from pooing too much or hemmorhoids. Dark, black looking blood is usually indication of something wrong. I, my cousin who has celiacs, and my mom all have had blood in our bms at some point in time. I think it comes with the bowel disorder territory. Let us know how the colonoscopy goes. And hopefully you get to feeling better soon.


I had diarrhea again last night but it was short-lived, thank God. I managed to get a few hours of sleep and had a regular "poo" this morning (sorry about the tmi). I'm getting nervous as heck about the colonoscopy. They're doing the upper scope too and I hope that both will turn out ok,

Tomorrow is prep day. They gave me "Suprep" and I hope it's not as nauseating as other preps I had in the past.


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