Most of us can hold off defecation till we are able to reach a toilet. In diarrhea, people have diminished control over their bowel movements and most people are not able to hold the defecation process for as long as they normally can. In severe cases of diarrhea, the control over bowel movement may become almost non-existent. This results in defecation before the affected individual can reach a toilet. In some cases of uncontrollable diarrhea, even medication and cessation of solid food may be ineffective in restoring control over bowel emptying. However, this is usually temporary until the diarrhea resolves.
Total Loss of Bowel Control
The total inability to restrain the expulsion of stools is technically known as fecal incontinence. In these cases, the affected individuals are not able to hold off the time of defecation voluntarily. Expulsion of stool happens immediately after an urge to empty the bowels is felt, leaving insufficient time to get to a toilet. In some cases, stool may come out even without any urge to defecate.
Fecal incontinence is a broad term. It is mainly seen with severe diarrhea in acute cases due to the nature of the disease and watery stool. However, fecal incontinence can also occur in cases where stool consistency and bowel habits are normal, but control over bowel emptying is not. This may be seen with chronic conditions where there is damage or disturbances with the muscles and nerves that regulate bowel control.
When is diarrhea uncontrollable?
Diarrhea can be classified into two main categories: acute and chronic. Acute diarrhea happens in conditions such as viral gastroenteritis and food poisoning. In most cases, acute diarrhea is a self-limiting condition. It generally lasts for 48 to 72 hours, and resolves on its own without any medical treatment. In some cases though, acute diarrhea may extend for even 5 to 7 days.
In contrast to acute diarrhea, chronic diarrhea occurs over a much longer duration. In these cases, diarrhea persists for many weeks or months. In some rare cases, diarrhea may even persist for years. Cases of chronic diarrhea usually respond to medications only temporarily. It is also possible that medications may not have any effect at all.
Uncontrollable diarrhea is usually seen with acute cases, particularly where the diarrhea is severe. In older people particularly, fecal incontinence may be a chronic problem and simply worsened when diarrhea arises.
Read more on recurrent diarrhea.
Causes of Uncontrollable Diarrhea
The following are some of the common causes of both acute and chronic diarrhea.
The most common cause of diarrhea is infection by pathogenic microbes. Diarrhea caused by infectious agents are usually acute in nature. Medical treatment may or may not be required in these cases. Examples of infectious diarrheal diseases include gastroenteritis (caused by viruses, bacteria and protozoa), giardiasis, salmonellosis, cholera, shigellosis, and infectious colitis.
Food intolerance, malabsorption syndromes, and food allergies are common causes of diarrhea. The digestive system of certain individuals cannot tolerate or absorb certain components of foods, such as lactose, sorbitol and fructose. Some people may also have food allergies, such as those elicited by gluten (a component of wheat), cow’s milk and soy protein.
Diarrhea can also be caused by certain medical treatments or errors. For example, uncontrollable diarrhea may be caused by certain antibiotics, laxative overuse, chemotherapy, antacids containing magnesium, and radiation therapy.
Certain vitamin deficiencies (such as dietary deficiency of niacin and folate) could also result in diarrhea.
Uncontrollable diarrhea is a characteristic feature of inflammatory bowel diseases (commonly abbreviated as IBD). Crohn’s disease and ulcerative colitis are the two main types of inflammatory bowel diseases.
Functional diseases of the digestive system
Sometimes, uncontrollable diarrhea may occur even in the absence of any detectable structural abnormalities in gut. Such conditions are termed as functional diseases. Irritable bowel syndrome (IBS) is a common example of a functional gastrointestinal disease. Diarrhea and constipation can both occur in irritable bowel syndrome.
Diarrhea may also be a result of toxicity, caused by overdose of vitamins or ingestion of heavy metals. Poisoning caused by ingestion of certain mushrooms, plants and animals may also cause diarrhea.
Severe and persistent diarrhea is common in people with HIV infection or AIDS. The immune system in these individuals is severely weakened by the disease. HIV-infected individuals are also prone to diarrhea caused by some rare infections.
Treatment for Uncontrollable Diarrhea
Treatment for diarrhea vary according to underlying causes. Some of the acute forms of diarrhea are self-limiting, and do not require any explicit intervention. Dietary and lifestyle remedies may be sufficient in many cases. In other cases, medical treatment may be a necessity.
Dietary and Lifestyle
In many acute cases of diarrhea, no medication is required. This is especially the case in diarrhea caused by certain infectious agents. Changes in diet and lifestyle can support the automatic resolution of diarrhea in such cases. The following are some of the commonly prescribed dietary and lifestyle changes for treating diarrhea:
- Hydration: Maintaining adequate hydration through regular intake of oral rehydration solutions is the primary treatment measure in any type of diarrhea. These solutions replace water and electrolytes lost through diarrhea, and prevent onset of dehydration.
- Dietary modifications: It is not necessary to stop consumption of solid foods in diarrhea, unless vomiting occurs. The ideal meal for patients suffering from diarrhea should be non-greasy and bland, with adequate nutrients. Easily digestible foods may be given. Consumption of dairy products should be avoided in diarrhea, since they may worsen the condition.
- Probiotics: Probiotics can help in restoration of normal gut flora. Your doctor can recommend some good quality probiotics that may be available in local market.
- Increased fiber intake: Increasing dietary fiber intake could help in the formation of solid stools. However, excess amount of fiber could also worsen diarrhea.
- Activated charcoal: In case of diarrhea caused by some toxins or poisons, activated charcoal tablets may be prescribed. However, these tablets are not effective when the cause of diarrhea is infection.
- Bed rest: Bed rest is important for allowing the body to recover from physical exhaustion caused by diarrhea. Increased physical activity in this condition may aggravate dehydration caused by diarrhea.
Read more on how to stop diarrhea without drugs.
Anti-diarrheal medications are not recommended as the first line of treatment in diarrhea. They have the potential to cause further complications. It is advisable to first wait and see if diarrhea resolves on its own within 48 to 72 hours. Supportive dietary and lifestyle remedies may be given during this period. Medication may be required in some cases. Examples of medication used to treat diarrheal conditions include antibiotics, antidiarrheals, corticosteroids and methotrexate.