What Causes Explosive Diarrhea—And When To Seek Treatment

Having diarrhea is unpleasant under the best of circumstances. But having so-called "explosive diarrhea" is the stuff of nightmares. But what does it mean, exactly? Experts break it down, plus what to do if you're unlucky enough to experience this.

Defining Explosive Diarrhea

Technically, explosive diarrhea isn't a medical term, but it can be used to describe some pretty intense bowel action. "When people say 'explosive diarrhea,' they usually mean there's an urgency to it and a sort of violent expulsion," said Kyle Staller, MD, a gastroenterologist at Massachusetts General Hospital.

It's not necessarily the same thing as severe diarrhea, which healthcare providers usually think of as having more than six loose, watery stools a day, along with symptoms of dehydration and abdominal pain, Dr. Staller explained. But explosive diarrhea can lead to severe diarrhea, Dr. Staller added.

Causes

Many conditions can cause explosive diarrhea. Dr. Staller listed the following common causes:

• Rotavirus
• Norovirus
• Cryptosporidium
• Inflammatory bowel disease
• Crohn's disease
• Ulcerative colitis
• Celiac disease
• Clostridium difficile
• Certain chemotherapy drugs
• Giardia

The giardia parasite causes the diarrheal disease giardiasis. Giardia can be found on surfaces or in soil, food, or water that has been contaminated with poop from infected people or animals.

Treatment

Your healthcare provider will often want to take a stool sample to try to determine what's behind your diarrhea, Dr. Gorwana said. Given that it can take time to get test results back, Dr. Staller said that many healthcare providers will prescribe an antibiotic, just in case.

As for whether you should use an OTC anti-diarrheal medication like Imodium, Dr. Staller said that it may actually work against you in the long run. "The worry is that you may keep the infection inside," Dr. Staller explained. If you're having "average diarrhea," a medication like Imodium is fine, Dr. Staller suggested. But if you're having more severe symptoms like a fever and bloody poop, you actually won't want to take one of these medications, Dr. Staller said.

At home, it's best to make sure you're taking care of yourself while you recover. "Hydration and a bland diet are important," Dr. Gorwana said. You may benefit from going on the BRAT diet until your symptoms clear up. The BRAT diet (Bananas, rice, applesauce, and toast) is a bland food diet that is often used to treat diarrhea. These foods are low in fiber so they will make your stool more firm and high in nutrients.

When To See a Healthcare Provider

If you're just having explosive diarrhea but otherwise feel OK, Dr. Staller said you're probably fine waiting it out at home.

Dr. Staller advised calling your healthcare provider ASAP if you have these symptoms along with your explosive diarrhea:

• Fever
• Abdominal pain
• Bloody diarrhea
• Mucus in your diarrhea
• Dark colored urine
• Feeling lightheaded when you stand up

"This would indicate that, at a minimum, you'll need intravenous fluids," Dr. Staller explained. Also, if you have a condition like Crohn's disease, ulcerative colitis, or are immunocompromised or pregnant, Dr. Staller recommended calling your healthcare provider right away. You could be at a higher-than-usual risk for complications from severe diarrhea.

If you suspect that you have giardiasis (meaning, you recently swam in a lake, river, or pool that may not have been well-chlorinated), don't sit on that either, said Anita Gorwara, MD, a family medicine physician and medical director of urgent care at Santa Monica Family Physicians. "You should come in and be seen," Dr. Gorwara said. If it's not treated, you run the risk of spreading it to your family members, friends, and other people around you, Dr. Gorwara pointed out.

A Quick Review

Explosive diarrhea can be uncomfortable and may lead to severe diarrhea. Whether your symptoms were caused by a virus, celiac disease, ulcerative colitis, or something else, it is important to keep your body hydrated with a lot of fluids. If your symptoms include fever, abdominal pain, or dark-colored urine, or you are unsure about treatment, reach out to your healthcare provider to figure out the next steps.