Explosive or severe diarrhea is diarrhea in overdrive. The contractions of your bowels that help you pass feces become stronger and more forceful. Your rectum fills with more volume than it can contain. Often, large amounts of gas accompany severe diarrhea. This increases the ejection and loudness of the bowel movement.
Diarrhea is defined as bowel movements of a more liquid consistency, or an increase in the number or volume of bowel movements. The World Health Organization (WHO) is more specific, defining diarrhea as three or more loose or liquid stools a day.
Approximately 75 percent of your stool is made of water. The other 25 percent is a combination of:
- undigested carbohydrates
- intestinal secretions
As feces travel through your digestive system, fluids and electrolytes are added to their content. Normally, your large intestine absorbs the excess fluid.
When you have diarrhea, though, digestion speeds up. Either the large intestine isn’t able to absorb the rush of fluid or more than the usual amount of fluids and electrolytes are secreted during digestion.
Diarrhea is a symptom that occurs with a number of conditions. The most common causes for severe diarrhea include:
Bacterial and viral infection
Bacteria that cause diarrhea-producing infections include salmonella and E. coli. Contaminated food and fluids are common sources of bacterial infections.
Rotavirus, norovirus, and other kinds of viral gastroenteritis, commonly referred to as “stomach flu,” are among the viruses that can cause explosive diarrhea.
Anyone can get these viruses. But they’re especially common among school-age children. And they’re common in hospitals and nursing homes, and on cruise ships.
Parasites like Giardia lamblia and cryptosporidium can cause severe diarrhea, particularly in people with weakened immune systems. As with viral and bacterial causes, these parasites are spread when there’s direct or indirect contact between feces and the mouth.
These parasites are found in contaminated drinking water, recreational waters, and food. Day care centers, where caregivers may not wash their hands well enough after changing diapers, are particularly vulnerable to outbreaks.
Diseases of the bowel
Diarrhea is a common problem for people who have an inflammatory bowel disease (IBD), Crohn’s disease or ulcerative colitis, or celiac disease.
Many medications can cause diarrhea. Antibiotics, certain medications used to treat heartburn and acid reflux, and chemotherapy drugs are frequent culprits.
Allergies or food intolerance
Diarrhea often occurs when you are allergic to, or have an intolerance of, certain foods, like the lactose found in dairy products.
Explosive diarrhea is usually short-lived. But there are complications that require medical care. These include:
Loss of fluids from diarrhea can cause dehydration. This is a particular concern in infants and children, older adults, and people with compromised immune systems.
An infant can become severely dehydrated within 24 hours.
If you have diarrhea for more than four weeks, it’s considered chronic. Your doctor will advise testing to determine the cause of the condition so it can be treated.
Hemolytic uremic syndrome
Hemolytic uremic syndrome (HUS) is a rare complication of E. coli infections. It occurs most often in children, though adults, particularly older adults, can get it, too.
HUS can cause life-threatening kidney failure if not treated promptly. With treatment, most people fully recover from the condition.
Symptoms of HUS include:
- severe diarrhea, and stools that may be bloody
- abdominal pain
- decreased urination
Diarrhea is common. It’s estimated that adults in the United States experience 99 million episodes of diarrhea each year. Some people are at greater risk and include:
- children and adults who are exposed to feces, especially those who are involved in changing diapers
- people who travel to developing countries, particularly in tropical regions
- people taking certain medications, including antibiotics and medications used to treat heartburn
- people who have bowel disease
See a doctor
Diarrhea normally clears up within a few days without treatment. But you should see your doctor if you have the following symptoms:
- diarrhea lasting longer than two days or 24 hours in a child
- signs of dehydration, including excessive thirst, dry mouth, reduced urination, or dizziness
- blood or pus in your stool, or stool that’s black in color
- a fever of 101.5 °F (38.6 °C) or greater in an adult, or 100.4 °F (38 °C) or higher in a child
- severe abdominal or rectal pain
- diarrhea at night
Your doctor will ask questions about your symptoms, including:
- how long you’ve had diarrhea
- if your stools are black and tarry, or contain blood or pus
- other symptoms you’re experiencing
- medications you’re taking
You doctor will also ask about any clues you may have as to the cause of the diarrhea. Clues could be a food or fluid you suspect may have something to do with your illness, travel to a developing country, or a day of swimming in a lake
After providing these details, your doctor may:
- do a physical examination
- test your stool
- order blood tests
In many cases, treatment will involve managing your symptoms while you wait for the diarrhea to pass. The primary treatment for severe diarrhea is to replace fluids and electrolytes. Electrolytes are the minerals in your body fluid that conduct the electricity your body needs to function.
Drink more fluids, like water, and juice, or broths. Oral hydration solutions, such as Pedialyte, are formulated specifically for infants and children, and contain important electrolytes. These solutions are also available for adults.
You can use over-the-counter (OTC) anti-diarrheal medications if your stool isn’t black or bloody, and you don’t have a fever. These symptoms indicate you may have a bacterial infection or parasites, which can be made worse by antidiarrheal medications.
OTC medications should not be given to children under the age of two unless approved by a doctor. If your infection is bacterial, your doctor may prescribe antibiotics.
It’s difficult to completely avoid getting severe diarrhea. But there are steps you can take to protect yourself and your family.
- Sanitation is crucial. Wash your hands with soap and warm water, especially before handling food, after using the toilet, or after changing a diaper.
- If you’re traveling to an area where water purity is a concern, stick with bottled water for drinking and brushing your teeth. And peel raw fruit or vegetables before eating.
If you do get explosive diarrhea, there are some steps you can take to make yourself more comfortable and improve your outlook for a speedy recovery:
- It’s important to rehydrate. Keep sipping water and other fluids. Stick to a diet of clear liquids for a day or two until the diarrhea stops.
- Avoid sugary fruit juices, caffeine, carbonated drinks, dairy products, and food that’s greasy, overly sweet, or high in fiber.
- There’s one exception to avoiding dairy products: Yogurt with live, active cultures may help curb diarrhea.
- Eat a diet of bland, soft foods for a day or two. Starchy foods like cereal, rice, potatoes, and soups made without milk are good choices.
In most people, diarrhea will clear up without requiring treatment or a trip to the doctor. Sometimes, though, you may need medical treatment, especially if your diarrhea leads to dehydration.
Diarrhea is a symptom rather than a condition. The underlying cause of diarrhea varies greatly. People who have signs of complications or chronic diarrhea need to work with their doctor to determine the cause so that it can be treated.