Hi. I have exactly the same issue, but with a normal sim (not a fairy). My sim has several reward traits that completely remove the need for the toilet and other basic needs. Free will is disabled, ...
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I was not having this issue until after I patched to latest patch today & now it is pretty constant. I'm having the issue with and without mods in. I'm on PC; have all but one kit (menswear), all EP's, SP's, & GPs. Fully patched.
My sim was Fairy & is now human. Her motives are full & she has no negative moodlets to indicate she's sick & she's not pregnant. She'll be going about her business and suddenly she grabs her stomach & has the toilet bubble appear above her head.
I clear caches regularly before & after each play session.
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