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Explosive Diarrhea and Violent Bowel Movements

Diarrhea is a symptom of some underlying disturbance of the gastrointestinal tract (gut), particularly the intestines. There are many diseases that present with diarrhea and on its own, it is difficult to identify the exact cause of diarrhea. Other symptoms need to be taken into consideration or tests may be necessary to identify the cause of the diarrhea.

Although most of us see diarrhea as very frequent or loose and watery stools, there definition in a bit broader. Sometimes in severe cases, diarrhea may be almost “explosive”. The passing of stool can seem “violent”, erupting with force and at times messing the toilet bowl extensively. Understanding some of the causes of explosive diarrhea is important as sometimes even the most harmless causes can present with violent bowel movements that may be concerning to a person.

Bowel Movements Volume and Frequency

Normal bowel habit can vary from person to person. Therefore the definition of the two extremes of abnormal bowel habit is either less than 3 stools in a week (constipation) or more than 3 stools in a day (diarrhea). However, just the frequency of stool may be insufficient to diagnose diarrhea as some people may have more frequent bowel movements, like patients with irritable bowel syndrome, yet it is not diarrhea as such.

In addition to the frequency, normal bowel movements is where a person passes less than 200g (grams) or 200mL (milliliters) in a day. Passing a larger volume than this is considered as diarrhea. Lastly, the consistent of stool can also be considered as an indicator. Very loose stool or watery stool is another feature of diarrhea but should be passed out more than 3 times in a day and exceed 200g to 200mL to be considered as diarrhea.

What is explosive diarrhea?

Stool is passed out of the bowel due to the contractions in the lower parts of the gut, namely the colon and rectum. These contractions are quite forceful at the time of defecation compared to the normal contractions that moves food and wastes through the gut. Explosive diarrhea is a common way to describe the passage of stool that is very forceful. It is largely facilitated by stronger than normal contractions, passage of large volumes of gas that ejects the stool from the rectum and a watery consistency which allows the stool to “run” more freely.

There are several types of diarrhea and some may be more explosive in nature than others. Explosive diarrhea is therefore often accompanied by large volumes of gas, making it a “loud” bowel movement due to flatus, and often messing the entire toilet bowel and even the buttocks of a person. Apart from the embarrassment and discomfort, there is also the hygiene factor. The stool may be spread beyond the areas where the flushing water can wash away the stool leaving fecal remnants splattered within the toilet bowel. Some patients may experience violent bowel movements to the point that it is painful – associated with both lower abdominal pain and even rectal pain.

Picture from Wikimedia Commons

Causes of Explosive Diarrhea

Although diarrhea on its own is a symptom that cannot be definitively linked to a specific cause, there are some diseases where bowel movement tends to be more violent than usual. The causes of explosive diarrhea are largely the same as the most common causes of acute diarrhea but at times one person may experience more violent bowel movements than others.Although the main causes of explosive diarrhea are discussed below, this does not exclude various other conditions.

Infections

Infectious causes of diarrhea are more commonly due to gastroenteritis. Most cases are viral in origin and have earned the name ‘stomach flu’. It is an acute condition often passing on its own within 2 to 3 days. Viral gastroenteritis is more common in children. Bacteria and protozoa can also cause infectious diarrhea. The most violent bowel movements of note are with bacillary dysentery (shigellosis bacteria) and amoebic dysentery (cause by the amoeba Entamoeba histolytica). Cholera, a bacterial infection with Vibrio cholerae, also causes explosive diarrhea.

Toxins

Various toxins can cause diarrhea. Sometimes it is sourced from microbes like bacteria. Bacterial toxins in contaminated food leads to food poisoning. Although the vomiting is more “explosive” than the diarrhea, it can also lead to quite violent bowel movements. Other toxins maybe ingested intentionally or accidentally, as is seen with heavy metals and various poisons. Some of these poisons may also be sourced from animals, reptiles or aquatic organisms.

Medication

Although many different types of drugs can cause diarrhea, the medication of note is laxatives. Diarrhea is common with laxative use and overuse can cause extremely violent bowel movements. It is of concern only in patients with a known eating disorder as laxatives are used for purging. However, many other drugs can also cause diarrhea and stopping the medication will lead to a cessation of diarrhea in most cases. Antibiotic-associated diarrhea (AAD) is common after using antibiotics especially for a prolonged period of time.

Treatment of Explosive Diarrhea

Overall diarrhea, whether mild, moderate or severe, is treated in the same way. Supportive measures are often all that is necessary until the diarrhea resolves on its own. These measures include :

  • Oral rehydrating solutions (ORS) for replacement of fluid and electrolytes in order to prevent diarrhea.
  • Bland diet of soft foods which is nutritionally balanced to replace lost nutrients. The BRAT diet (bananas, rice, apple sauce and toast) is not necessary if the patient is not vomiting.
  • Probiotics containing Lactobacillus casei and Saccharomyces boulardii help to replace the normal bowel bacteria.
  • Anti-diarrheal agents like loperamide must not be used in infections and poisoning but can be helpful for short term relief when a person has to travel away from suitable toilet facilities.

More specific treatment options may be necessary depending on the cause. For example, a bacterial infection may require antibiotics. Although diarrhea is not often thought of as a serious symptom, medical attention should be sought if a person is showing signs of dehydration, the diarrhea is persisting or the symptoms are severe.


Posted by in Digestive and Gut

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