Explosive diarrhea is a serious kind of diarrhea marked by extreme urge for frequent bowel movements. Patients keep using the toilet after every few minutes. They keep going in and out of the rest room as if they have no control of the bowel movements.

Explosive diarrhea is different from usual diarrhea; the stool tends to be smellier and bowel movements are more violet and loud with excessive expulsion of gas. Patients may also suffer from nausea, fever, chills, intense dehydration, and abdominal cramping.

Most instances of explosive diarrhea are caused by persistent gastro-intestinal tract conditions, eating contaminated food, and overuse of certain medications, etc.

Explosive diarrhea usually resolves without medical treatment. Prolonged or chronic cases however need to be treated by a doctor.

Symptoms of explosive diarrhea

The process of explosive diarrhea involves excessive gas buildup which triggers higher than normal flatulence, extremely strong contractions of the colon and rectum, watery and abnormally loose feces, and failure of the sphincters to open fully and resist removal of watery stool and gas.

Common signs and symptoms of explosive diarrhea are as follows:

• Very watery and loose stools
• Abnormal bowel movements marked by forceful removal of stool which causing feces to get sprayed across the toilet bowl and/or soil the patient’s buttocks
• Excessive and very loud passage of gas
• Loss of control over diarrheal bowel movements
• Excessive gurgling and rumbling sound in the abdomen. Bowel movement sounds may also be abnormally loud
• Distress or discomfort in the anus after passage of feces
• As per the underlying cause, explosive diarrhea may also occur along with cramps, pain, distention of abdomen; nausea and/or vomiting; increased sweating; and appetite loss.

Causes of explosive diarrhea

Explosive diarrhea may occur due to below listed factors/conditions:

• Fiber is abundant in whole grains, fruits, vegetables, and bran cereal, etc. Sudden, increased intake of fiber in diet causes increased levels of fiber in the gut which then cannot be fully digested, thus causing faster transit of food across the tract, excess gas, and explosive diarrhea. Flatulence, explosive diarrhea, and bloating may also occur due to eating heavy meals with poor-digestible starches and sugars.
• Explosive diarrhea may occur due to eating food or drinking water contaminated by bacteria like E. coli, Clostridium difficile, and Campylobacter; viruses like rotavirus; or parasites like Giardia duodenalis. Infants and young children are most prone to effects of food contamination. Undercooking or improperly cooking food and unhygienic food handing and cooking places can cause food contamination.
• Explosive diarrhea may be caused by frequent and chronic use of certain medications like
  • Laxatives
  • Antibiotics are used for treating bacterial infections, but they tend to destroy good bacteria in gut along with bad bacteria. Decrease in good bacteria causes bad bacteria to thrive, released increased toxins, and cause abdominal cramps and watery bowel movements. Antibiotics used of treating acne, rosacea, and urinary tract infections may trigger explosive diarrhea.
  • Proton-pump inhibitors decrease stomach acids and help cure peptic ulcers. Stomach acids prevent proliferation of bad bacteria and hence decrease in its levels causes multiplication of bad bacteria and subsequent case of explosive diarrhea. Antacids with magnesium also lower stomach acids and cause watery bowel movements.
• Explosive diarrhea can occur due to malabsorption, i.e., inability of body to absorb sufficient nutrients from food. The diarrhea may continue for 1-2 weeks or more and the fecal matter is smellier than other explosive diarrhea instances. Some causes of malabsorption include conditions like celiac disease, lactose intolerance, chronic liver malfunction, and certain malignancies.
• People with intolerance to certain kinds of foods like gluten, dairy, mannitol, fructose, sorbitol, etc., may not be able to digest them. Poor digestion then triggers explosive diarrhea
• Prolonged intestinal inflammatory conditions like inflammatory bowel syndrome, Crohn’s disease, and/or ulcerative colitis may cause explosive diarrhea
• Amyloidosis is a condition of excessive protein in varied tissues of body. It causes rapid food transit in digestive tract, which triggers explosive loose watery stools. Patients may additionally experience symptoms like tingling in limbs, edema, significant loss of weight, breathing difficulties, and heightened fatigue.
• Other causes include bariatric surgery for weight loss and resection of a diseased part of stomach or bowels, etc.

Treatment of explosive diarrhea

Treatment options for severe and persistent cases of explosive diarrhea are listed below:

• Antidiarrheal drugs may provide temporary relief from the symptoms
• Doctors may prescribe probiotics to restore gut flora levels to normalcy
• Eat foods that enhance good bacteria levels in the gut
• Bacterial infections, caused by intake of contaminated food, etc., are treated with antibiotics and other medicines
• Explosive diarrhea causes severe dehydration. Hence patients need to keep the body hydrated by drinks lots of water and other fluids like juices, broths, etc. Oral rehydration solutions may also be given by doctors to reduce loss of electrolytes.