Medical News Today: What is explosive diarrhea?

Explosive, or severe, diarrhea causes a person to pass liquid or loose stool more frequently and forcefully than regular diarrhea. Explosive diarrhea occurs when the rectum fills with more liquid and gas than it can hold. Passing the stool is often loud, due to the escaping gas.

The World Health Organization (WHO) define diarrhea as passing three or more liquid or loose stools in a day. However, a person may have diarrhea if they pass more loose stool than usual.

Diarrhea can result from infection, but there are also many noninfectious causes.

Under normal circumstances, the large intestine absorbs excess liquid. When a person has diarrhea, the digestion process moves too fast for the large intestine to absorb the extra liquid present.

In this article, we look at the causes of explosive diarrhea and describe what a person should do if they have it.

Causes

Infection is a common cause of explosive diarrhea, but other factors can be responsible.

Viral infections

Lots of toilet rolls, possibly for explosive diarrhea
Causes of explosive diarrhea can include viral infections, bacterial infections, and food allergies.

The viruses most often responsible for diarrhea include norovirus, rotavirus, or any number of the viruses that cause viral gastroenteritis. This condition is what many people call the “stomach flu.”

All of these viruses tend to spread in areas where people meet in groups, including:

  • schools
  • day care centers
  • hospitals
  • cruise ships
  • nursing homes

Bacterial infections

A person can blame bacteria if their explosive diarrhea occurs after eating or drinking contaminated food or water. A person may mistakenly think that their illness is a result of food poisoning because the symptoms can be severe.

Bacteria that can cause diarrhea include Salmonella, Campylobacter, and Escherichia coli , which is commonly called E. coli.

These bacteria can spread from person-to-person via unwashed hands and surfaces. If someone has diarrhea, they should wash their hands thoroughly after using the bathroom, and take other steps to reduce the risk of passing on the infection.

Parasitic infection

Many types of parasites can cause diarrhea, severe or otherwise. Two of the more common are Giardia lamblia (G. lamblia) and Cryptosporidium enteritis (C. enteritis).

As with bacteria, a person can acquire parasites through unsanitary conditions. A person can become infected with G. lamblia or C. enteritis when their mouth directly or indirectly comes into contact with contaminated fecal matter. These parasites thrive in fresh, untreated water and in certain foods.

In developed countries, hikers, backpackers, and campers are among the most likely groups to come in contact with G. lamblia. The parasites do not survive in chlorinated water.

Medications

Many medications can cause mild diarrhea, or loose stool. Occasionally, they can cause severe diarrhea. Some of these types of medications include:

Antibiotics and other medications that contain magnesium are a particular risk.

Food allergies

Some people have adverse reactions to certain foods, and these reactions can result in diarrhea.

A common cause is lactose intolerance. If a person cannot tolerate lactose, and they eat or drink a dairy-based product, they may experience explosive diarrhea.

Bowel disease

People with some illnesses that affect the bowels often experience diarrhea. Bowel-related conditions that can cause explosive diarrhea include:


Risk factors

plane in flight
Travelling to developing countries can be a risk factor for diarrhea.

Diarrhea is a common condition that affects around 179 million people in the United States every year.

Certain portions of the population are at greater risk of developing diarrhea than others.

These groups include:

  • people with bowel disease, such as irritable bowel syndrome, ulcerative colitis, or Crohn’s disease
  • people who live in or travel to developing countries
  • children and staff at day care centers
  • people taking antibiotics or medications that contain magnesium

Treatment and home remedies

Treatment for any form of diarrhea often involves staying hydrated and maintaining levels of electrolytes.

In many cases, the person will just need to wait for their diarrhea to pass. An individual can consume fluids and electrolytes in:

  • broth
  • vitamin water
  • low-sugar sports drinks

When experiencing diarrhea, a person should avoid:

  • sugary foods and drinks
  • most dairy products
  • overly greasy or fatty foods

Some people choose to take over-the-counter (OTC) medications that are anti-diarrheal.

A person should not take OTC medications if they have a fever or blood in their stool. A person with either symptom likely has a bacterial or parasitic infection, which could get worse with the introduction of medication.

Children under the age of 2 should not take OTC medications unless instructed by a healthcare provider.

In severe cases, people should speak to their healthcare providers about additional treatment options.

An individual may need treatment for serious infections or other underlying conditions, or they may require intravenous fluids to stay hydrated.

Prevention tips

Taking the following steps can help a person to avoid getting explosive diarrhea:

  • Always wash the hands thoroughly after using the bathroom, handling diapers, and handling food.
  • When traveling to underdeveloped countries, drink only filtered water, and thoroughly cook local produce and other types of food.


When to seek medical attention

woman in bed with high fever and oral thermometer
If a person has a fever higher than 102°F and diarrhea, they should seek immediate medical attention.

Many cases of diarrhea will clear up within a few days. Usually, people require no medication.

However, if diarrhea does not go away within 2 days or the person feels dehydrated, they should see a healthcare provider.

Seek immediate medical attention if any of the following symptoms occur:

  • severe pain in the rectum or abdomen
  • a fever higher than 102°F
  • blood in the stool
  • frequent vomiting
  • passing loose stool six or more times in 1 day
  • signs of dehydration, including dry mouth, extreme thirst, and dizziness

A healthcare provider will review a person’s symptoms. They will often ask about medications and trips to other countries, and they may request stool and blood tests.

Complications

A few complications may develop due to explosive diarrhea.

A common complication is dehydration, which occurs because the body cannot readily replace the fluids and electrolytes lost through diarrhea. It is important that a person keeps taking in fluids throughout their illness.

Another complication of diarrhea is malabsorption, which involves the body failing to take in sufficient nutrients from food. Malabsorption can also result from some conditions that cause diarrhea, including infections and food allergies.

Some people experience diarrhea for longer periods. When diarrhea lasts for 4 or more weeks, the medical community considers it to be chronic.


Outlook

Most cases of explosive diarrhea are short-lived, and many people require no medical treatment.

Take in as much fluid as possible throughout the duration of diarrhea. Staying well hydrated helps fight off infection and replenish electrolytes. It also supports other bodily functions.

If other symptoms accompany diarrhea, or it lasts for more than 2 days, a person should seek medical care.

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