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.

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

Viral infections

According to the National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK), viruses 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

Bacteria can cause explosive diarrhea to occur after eating or drinking contaminated food or water.

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 more common parasites that can cause diarrhea 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 or their ingredients, 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. Gluten sensitivity, whether or not related to Celiac disease, can also lead to significant diarrhea.

Bowel disease

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

Anything that damages the lining of the intestines or causes malabsorption, whether it be viral, parasitic, bacterial, or other can cause explosive diarrhea after eating.

  • Campylobacter
  • Escherichia coli (E. coli)
  • Salmonella
  • Shigella

This happens due to injury to the gut epithelium, which are cells in the intestinal tract that usually help the body absorb substances such as water and electrolytes. Damage can make them unable to absorb water, which can lead to watery feces.

How quickly can food give a person diarrhea?

Diarrhea as a symptom of food poisoning can begin between 30 minutes to 8 hours after eating contaminated food. However, this time frame can depend on the type of germ involved.

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

Staying hydrated

In many cases, the person just needs to wait for their diarrhea to pass. However, it is important to replenish lost fluids. An individual can consume fluids and electrolytes in:

  • broth
  • vitamin water
  • low-sugar sports drinks

Avoiding certain foods

When experiencing diarrhea, a person should avoid:

  • sugary foods and drinks
  • spicy foods
  • overly greasy or fatty foods

Taking medication

Some people may wish 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.

People should speak to their healthcare team about additional treatment options in severe cases.

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

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

  • Always wash the hands thoroughly for 15–30 seconds after using the bathroom, handling diapers, and handling food.
  • Stay up to date with vaccines, including the rotavirus vaccine. Infants should receive all doses of the rotavirus vaccine by the time they are 8 months of age for it to be effective.
  • When traveling to countries where they may be a higher risk of getting traveler’s diarrhea, drink only filtered water, and thoroughly cook local produce and other types of food. A person may wish to avoid:
    • unpasteurized milk
    • juices
    • food from street vendors
    • meat, fish, or shellfish that is not served piping hot
    • raw fruits and vegetables

Always store, cook, clean, and handle foods safely.

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 professional.

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 professional 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.

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.

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.

Explosive, or severe, diarrhea can be forceful. It happens when the rectum fills with too much stool or gas, which results in the body expelling the diarrhea or gas suddenly.

Diarrhea is often the result of viral or bacterial infection, sometimes after eating contaminated food. However, it can also be the result of certain conditions, such as inflammatory bowel disease (IBD).

In acute cases, diarrhea should resolve on its own, but a person should take care to stay hydrated. In chronic cases, they should speak to a doctor to find the right regimen to help manage their symptoms.

A person should contact a doctor if they experience severe pain, fever, they feel dehydrated, or the diarrhea is persistent.