Explosive or severe diarrhea is not an everyday occurrence, so knowing what to expect when it occurs is helpful. In a regular stool, three-quarters are water and the remaining quarter is made up of undigested carbs, fiber, protein, fat, mucus, and intestinal secretions. Your large intestine absorbs the excess fluid so your stool isn’t usually watery. In regular diarrhea, bowel movements have a more liquid consistency and are usually more frequent.
In cases of explosive (severe) diarrhea, the bowel contractions are stronger and more forceful, meaning your rectum is filled beyond its capacity. This type of diarrhea is often accompanied by increased gas activity, which increases the ejection and makes the excretion loud.
Symptoms of explosive diarrhea
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Diarrhea is considered severe when some of the following symptoms are present:
- Very watery stool
- Excessive and loud passing of gas
- Forceful defecation that propels stool
- Hyperactive bowel sounds
- Anal discomfort during and after defecation
- Uncontrollable diarrhea
Depending on the cause of explosive diarrhea, you may also experience abdominal distention, cramps, pain, loss of appetite, nausea, vomiting, or excessive sweating.
What causes explosive diarrhea in adults
Severe diarrhea often occurs as an acute episode of chronic diarrhea, but it can be caused by one of the factors below.
Infectious diarrhea: This is a viral condition more commonly known as the stomach flu. Patients may also experience nausea, vomiting, abdominal cramps, and a fever. Viral gastrointestinal conditions usually affect people living in close quarters, such as hospitals and nursing homes as well as cruise ship passengers and school students. Severe diarrhea can also be brought about by bacterial infections, which are usually triggered by salmonella and E. coli found in contaminated food and drinks.
Food poisoning: When you consume food that contains bacterial toxins, the lining of your bowels gets irritated. Diarrhea is usually the final symptom of food poisoning, preceded by pain, nausea, and severe vomiting. In the case of food poisoning, you can actually avoid diarrhea if all of the contaminated food is expelled before reaching the intestines.
Drugs: Laxatives, antacids containing magnesium, drugs with compounds that act on the bowels, heartburn, and acid reflux medications, chemotherapy drugs, and even antibiotics can wreak havoc on your digestion and cause severe diarrhea.
Malabsorption: This is usually a chronic condition and is mainly associated with food sensitivities such as lactose or gluten intolerance, or sorbitol and fructose malabsorption. The compound in question cannot be fully absorbed by your digestive system, leading to explosive diarrhea. You may also have trouble absorbing certain compounds due to structural abnormalities of the bowel, a lack of certain digestive enzymes, or the effects of medication.
Other less common causes of severe diarrhea include inflammatory bowel disease, irritable bowel syndrome, ulcerative colitis, and overconsumption of irritating foods.
Explosive or severe diarrhea: Risk factors and complications
While diarrhea is a common condition that everybody experiences once in a while, certain groups of people are more likely to suffer from diarrhea than others. These are visitors to developing countries, people on medications that may cause diarrhea (such as antibiotics and heartburn drugs), bowel disease patients, and children and adults exposed to feces.
Explosive diarrhea may be unpleasant, inconvenient, and even painful, but it is usually short-lived. Nevertheless, in some cases, it may lead to complications that require medical attention.
Dehydration: Due to insufficient absorption of liquid in the large intestine, you lose a lot of fluids in your stool. If you’re not rehydrating yourself properly, you may end up dehydrated. Children, elderly, and people with compromised immune systems are particularly susceptible to the dehydrating effects of diarrhea.
Chronic diarrhea: You have a chronic condition if you’ve been suffering from diarrhea for over four weeks. Medical testing may be required for the diagnosis of the cause.
Hemolytic uremic syndrome: This is a rare complication of an infection caused by E. coli. If not treated properly, it may lead to kidney failure. Severe diarrhea and bloody stools, fever, abdominal pain, vomiting, decreased urination, and bruising may be indicative of the syndrome, so it’s important to see the doctor as soon as you recognize some of these symptoms.
When to see your doctor
Even severe diarrhea usually resolves itself in a few days without medical treatment. But in some situations, it’s important to see your doctor to avoid serious complications. The following scenarios should definitely prompt you to seek medical help:
- You are suffering from diarrhea for over two days (over 24 hours in a child)
- You are dehydrated (you experience excessive thirst, dry mouth, reduced urination, or dizziness)
- You have blood or pus in your stool
- Your stool is black
- You have a fever of 38.6 °C or higher
- You experience severe pain in your abdomen or rectum
- You have diarrhea at night.
How to treat explosive diarrhea
As mentioned, unless your diarrhea becomes aggravated and requires medical attention, your condition will resolve on its own. There are, however, a few things you can do to make your experience more bearable and speed up the recovery process.
Over-the-counter anti-diarrheal drugs can reduce the severity of diarrhea for some time. It may be a good idea to consult with your doctor prior to use if your diarrhea is caused by infections or toxins, if you have a fever, or if your stool is black or bloody. If your diarrhea is caused by bacteria, you have to take prescription antibiotics.
To address dehydration and loss of electrolytes caused by diarrhea, you can take oral rehydration solutions and drink more water, juice, or broth.
You may want to switch to bland diets while you’re dealing with your severe diarrhea. A good example is a menu consisting of mashed bananas, rice, grated apple or applesauce, and plain toast.
Probiotics can help restore the irritated bowel flora, but make sure you don’t cause any further harm if you are sensitive to lactose.
Explosive or severe diarrhea: Prevention tips
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Of course, it’s better to avoid severe diarrhea altogether. While you can’t completely prevent it, you can take some steps to protect your health and the health of your family. Wash your hands with soap and warm water before handling food and eating, after using the toilet, and after changing a diaper. When traveling to developing regions, drink bottled water and use it for brushing your teeth. Peel raw fruit and vegetables before eating them as well.
If you end up with explosive diarrhea, keep drinking fluids to stay hydrated. Avoid sugar-loaded juices, caffeinated and carbonated drinks, dairy, as well greasy, sweet, and fiber-rich foods. Stick to a bland diet based on starchy foods and soups. Eat some yogurt to help repopulate your intestine with good bacteria. With proper care and patience, you can safely recover from explosive diarrhea within a day or two.
Related: Bland diet for gastritis, ulcers, diarrhea, and reflux disease