Explosive Diarrhea

Diarrhea refers to abnormal bowel movements with increased volume, frequency, and liquid content.

Explosive diarrhea is a severe type of diarrhea with extremely high urgency to pass stool. Patients may want to use the rest room again, even if they have used it just a few minutes ago. It’s as if patients have lost control of their bowel movements. As compared to normal diarrhea, explosive diarrheal bowel movements of watery stool tend to be more loud, smelly, and violent as it occurs along with increased levels of gas. Additional symptoms include fever, nausea, stomach cramps, chills, and severe dehydration.

Explosive diarrhea is often caused due to chronic digestive tract problems, overuse of certain medicines, and intake of contaminated food, etc. It often resolves on its own, but patients with persistent and prolonged episodes need to seek medical attention.

What happens during explosive diarrhea?

Explosive diarrhea occurs in the following manner:

• There is increased buildup of gas leading to flatulence that is higher than normal levels of flatus
• Rectum and colon contractions when passing stool are abnormally strong
• Stool tends to be very loose and watery
• The sphincters fail to open completely and provide resistance to elimination of gas and watery feces

Symptoms of explosive diarrhea

Some of the common signs and symptoms of explosive diarrhea are listed below:

• Forceful bowel movements wherein the stool may be propelled out, thereby causing the buttocks to soil and/or stool splatter on toilet bowl.
• Stool is excessively watery
• Very loud and increased flatulence or passing gas
• Increased rumbling or gurgling in stomach along with hyperactive defecation sounds
• Diarrhea cannot be controlled by patients
• Anal discomfort or distress during and after passing stool
• Depending on underlying causative condition/factors of explosive diarrhea, patients may also suffer from abdominal cramping, distention, and/or pain; vomiting and nausea; loss of appetite; and excessive perspiration.

Causes of explosive diarrhea

A few common causes of explosive diarrhea are discussed below:

• Eating contaminated food: Intake of water or food contaminated with pathogens like bacteria (Clostridium difficile, E. coli, and Campylobacter), parasites (Giardia duodenalis), and viruses (rotavirus) can cause explosive diarrhea, especially in young children and infants. Improperly or undercooked food, poor hygiene at eating places, and bad food handling and storage practices are known causes of food-borne ailments that cause explosive diarrhea.
• Increased fiber intake: Sudden and excessive increase in intake of fiber rich foods like bran cereal, veggies, fruits, or whole grains puts more than normal fiber into the intestines which then cannot be fully digested, thereby causing softer stools, faster passage of waste matter across the gut, elevated gas, and explosive diarrhea. Intake of large amounts of food with poorly digestible sugars and starches (like green smoothies, etc.) can also cause bloating and increased gas.
• Malabsorption: It refers to inability of body to effectively absorb adequate nutrients from consumed food. Malabsorption can trigger explosive diarrhea for 1 or 2 weeks or more. In this case, the stool is smellier than other instances of explosive diarrhea. Malabsorption can occur due to lactose intolerance, celiac disease, some types of cancers, and chronic malfunction of liver.
• Medications: Prolonged and/or frequent use of certain medicines can trigger explosive diarrhea.
  • Antibiotics are known destroy harmful bacteria, but they also kill the good bacteria in gut. Reduction in good bacteria allows proliferation of bad bacteria, which then produce excessive toxins and cause explosive diarrhea and stomach cramps. Antibiotics used for treatment of conditions like rosacea, acne, and UTIs are known to cause explosive watery bowel movements.
  • Excessive use of laxatives may lead to explosive diarrhea
  • Proton-pump inhibitors, used for stomach ulcers treatment, works by reducing stomach acids. Stomach acids help control bad bacteria levels in gut. Hence, low levels of stomach acids increase bad bacteria and trigger explosive diarrhea. Magnesium-having antacids, used for heartburn, also reduce stomach acids and cause explosive diarrhea.
• Food Intolerance: Intolerance to certain foods like dairy (lactose intolerance), gluten, fructose, mannitol, sorbitol, etc., is marked by inability to digest such foods. Lack of proper digestion of such foods can lead to explosive diarrhea.
• Amyloidosis: It is an uncommon disease characterized by protein buildup in different body tissues. The disease is associated with rapid passage of food via the digestive tract, which is what causes explosive diarrhea. Other symptoms experienced by patients include edema, tingling in feet or hands, substantial weight loss, extreme fatigue, and breathing issues.
• Intestinal disorders: Explosive diarrhea may also occur as a symptom of chronic intestinal inflammatory disorders like Crohn’s disease, IBS/inflammatory bowel syndrome, or ulcerative colitis.
• Other causes: Resection of a section of diseased bowels or stomach and/or bariatric surgery for loss of weight can also trigger explosive diarrhea.

Treatment of explosive diarrhea

Explosive diarrhea is usually a short-lived condition that disappears in a few days on its own. Patients however need to consult a doctor if explosive diarrhea continues for than 2 to 3 days as it can be an indication of some severe underlying illness.

Medical treatment of explosive diarrhea is dependent on the causative condition. A few treatment options and self-care measures are listed below:

• Drink lots of water, broths, and juices to prevent dehydration. Doctors may also suggest oral rehydration solutions to minimize electrolyte loss and dehydration.
• Consume foods that promote good bacteria. Probiotics are given for restoration of normal levels of gut flora
• Antidiarrheal medicines may be prescribed for short term relief from diarrhea
• Bacterial infections are treated with antibiotics