Bladder & Bowel Changes
Urinary (pee/wee) changes
Surgery, treatments or medication for cancer can all lead to changes in wanting to go for a pee, which can disturb a good night’s sleep. This can include needing to pee more often, incontinence (leaking), urgency (needing to pee immediately), difficulty starting a pee or difficulty peeing all together.
A urostomy (urine exit with bag) or nephrostomy (kidney drain) can sometimes interfere with sleep, particularly due to concerns about leakage, night-time drainage, or discomfort from the bag or tubing. Frequently waking up to check or empty the bag can also disrupt rest.
Ways to manage bladder changes
- Speak to your cancer team or GP; discuss whether a referral to a continence service would be helpful.
- Limit fluid intake in the evening, especially caffeine and alcohol. Ensure you still drink the recommended 2 litres or 6 to 8 cups of fluid per day, unless you are told by your clinical team to restrict your fluid intake.
- Empty your bladder (go for a wee) before bedtime
- Make it easy to go to the toilet at night, with simple nightwear. Ensure there are no obstacles that you could trip over
- Consider a pee bottle, bedpan or incontinence products (pads or waterproof mattress covers) to limit sleep disturbance
- Diuretics or medications which make you pee may be prescribed by your medical team for a number of different reasons such as kidney problems or heart problems. It is important you continue to take these as directed. Diuretics can sometimes continue to make you need to go to the toilet during the night if you take them too late in the day. Try to take diuretics in the morning and try not to have them after 2pm if possible. Effects of these medications should have then worn off by the time you go to bed.
- Caffeine also has a natural diuretic effect (make you pee more), so try to reduce caffeine intake after lunch time if you can by trying caffeine free alternatives.
To support better sleep with a urostomy, nephrostomy or Catheter:
- Empty or check the drainage system before going to bed and ensure all tubing is secure and untangled to prevent pulling or leakage.
- Using a larger overnight drainage bag may reduce the need for interruptions.
- It’s also important to position the bag below the level of the stoma (opening) or kidney to allow proper drainage while lying down.
- Wearing comfortable, loose-fitting nightwear and creating a relaxing bedtime routine may also contribute to more restful sleep.
- Speak to your stoma or urology nurse and for useful advice contact the Urostomy Association or Bladder & Bowel UK
Bowel (Poo) Changes
Bowel changes, such as diarrhoea or constipation, are common during cancer treatment and can significantly interfere with sleep. Frequent nighttime trips to the bathroom can disrupt sleep cycles, while constipation may cause pain or discomfort that makes it hard to rest.
An ileostomy or colostomy (surgical openings that allow poo to drain into a bag) can affect sleep for a variety of reasons. Concerns about leakage, the need to empty the bag during the night, or general discomfort from the stoma (opening) can make it harder to fall or stay asleep. It’s also common to experience anxiety about managing the bag while sleeping.
Ways to manage bowel changes
- It’s important to report any changes in going to the bathroom or pooing to your healthcare team, as medications or treatment adjustments may help.
- Making changes to your diet, such as increasing or adjusting fluid and food intake, can help to improve bowel symptoms.
- Setting up your bedroom for easy access to the bathroom, by using nightlights or keeping pathways clear, can reduce disruption and help you get back to sleep more easily.
To support better sleep with an ileostomy or colostomy (surgical openings that allow poo to drain into a bag):
- Empty the bag before bedtime to reduce the chance of nighttime disruption.
- Wearing secure, comfortable bags designed for overnight wear can also provide reassurance.
- Some people find it helpful to sleep in slightly elevated positions or on their back to minimise pressure on the stoma area.
- Speak to your stoma nurse or healthcare team about nighttime concerns. You can also contact Colostomy UK or Ileostomy and Internal Pouch Association for further advice