Bowel noises

Bowel noises are an expression of the peristalsis of the stomach and intestines. Based on the presence and intensity of bowel noises, a doctor can estimate the likelihood of illnesses such as diarrhea or bowel obstruction. However, further examinations are always necessary to provide evidence.

What are bowel sounds?

If the peristalsis now mixes heavy, insufficiently chopped up food components and thin liquids and transports them further, the bubbling noises known as intestinal noises occur.

The determination of the intestinal noises is part of every medical examination of the abdomen.

With the stethoscope, the examiner can determine whether there are intestinal noises at all, whether they sound normal "bubbling" or whether they sound different in individual areas of the abdomen, for example whether there is an intestinal obstruction.

Even without a stethoscope, intestinal noises can be heard with the ear on or - if the stomach growls - from a few meters away.

causes

In order for the gastrointestinal tract to carry out its daily work of transporting and absorbing fluids and nutrients, it has to be very active. The word peristalsis describes the ability of the intestinal wall to contract in waves and thus to move the contents of the intestinal tube further towards the anus.

Peristalsis occurs along the entire length of the gastrointestinal tract and is therefore responsible, among other things, for being able to eat and swallow while standing on the head without the contents of the stomach and esophagus falling out of the mouth.

If the peristalsis now mixes heavy, insufficiently chopped up food components and thin liquids and transports them further, the bubbling noises known as intestinal noises occur.

The growling of the stomach is one example of this, the gurgling of the stomach after eating or when having diarrhea is another. Flatulence also becomes noticeable as intestinal noises when air bubbles are moved through the intestinal contents.

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Diseases with this symptom

• Three-month colic
• Food poisoning
• Ulcerative colitis
• Gastric perforation
• gastritis

• Irritable bowel syndrome
• abdominal influenza
• Crohn's disease
• Intestinal obstruction (ileus)
• Malnutrition

• Celiac disease
• Cholangitis
• Intestinal inflammation
• Food intolerance
• Lactose intolerance

Diagnosis & course

While these intestinal noises can be easily heard with the ear by placing it on the abdominal wall or even from a few meters away, a doctor uses his stethoscope as an "elongated ear" for hygienic reasons. This filters the noises well and allows the examiner to concentrate fully on what he wants to hear.

Examining the abdomen with a stethoscope, also known as auscultation, always includes listening to all four quadrants of the abdominal wall, i.e. all four fields on the right and left, above and below an imaginary line at the level of the navel, as different diseases are different in each case may exist. To record the intestinal noises, it is often necessary to listen for at least half a minute per quadrant. If the intestine is very active, a shorter auscultation time is often sufficient.

The doctor describes normal bowel sounds as "lively" or "brisk" and "across all four quadrants". If the bubbling and gurgling is noticeably violent, this can indicate a diarrheal illness, for example an infection by viruses and bacteria. Even with food intolerances such as lactose intolerance, strong intestinal noises may be heard. Due to the presence of other symptoms, the auscultation of the bowel sounds is of little importance in these cases.

The situation is different if the opposite is present: If no intestinal noises are heard over the entire abdominal wall, this can indicate an intestinal obstruction (ileus) due to intestinal wall paralysis, a so-called paralytic ileus. In the presence of abdominal pain and no bowel movements or bloody stools, the lack of evidence of bowel noises can therefore be an important part of the medical diagnosis and treatment decision.

There is also a second variant of the intestinal obstruction: If the ileus is mechanically caused, the intestinal wall tries to work against the occlusion point, the intestinal noises then sound stronger, the doctor describes them as "raised" or "ringing". With the stethoscope, it basically sounds like someone hitting an iron against a heating pipe.

The cause of such a mechanical ileus can be a foreign body or a cancerous ulcer that obstructs the intestinal passage. Less common occasions in which the auscultation of intestinal noises is of immediate importance are malformations in infancy, for example when intestinal noises can be detected in the chest due to the permeability of the diaphragm.

Complications

Bowel noises are a temporary symptom but can cause various complications. These include skin diseases and nerve disorders, which can occur as a result of malnutrition, and rheumatic inflammation of the joints, which occur as a result of typical allergies that cause intestinal noises. Those affected who change their diet as a result of flatulence often suffer from deficiency symptoms, and children may fail to thrive.

If the intestinal noises are also accompanied by severe abdominal pain and shock symptoms, there is a risk of an acute abdomen. Intestinal obstruction, appendix or gastric perforation are possible complications. Intestinal noises are mostly related to gastric complaints and can indicate aerocolia or aerogastria in the intestinal tract. As a rule, intestinal noises are harmless and indicate an unproblematic upset of the gastrointestinal tract. Diarrhea, stomach pain and constipation are usually the result, and the quality of life is often impaired, as the accompanying symptoms can sometimes severely limit the mobility of those affected.

Irritable bowel syndrome in particular can negatively affect well-being due to the subsequent symptoms that occur. Due to the sensitive bacterial cultures in the gastrointestinal tract, the treatment itself, especially with medication, a change in diet or the use of home remedies, can initially also worsen the intestinal noises. However, professionally supervised treatment usually leads to the symptoms subsiding without long-term complications.

When should you go to the doctor?

Bowel noises should be clarified by a doctor if they occur together with other symptoms, do not improve with a change in diet, or even develop into a chronic problem. If a lot of intestinal gas escapes excessively and sometimes has an unpleasant smell, this is an indication of food intolerance, which should always be examined by a specialist (e.g. gastroenterologist) in order to avoid the development of secondary diseases.

If there is accompanying vomiting, nausea or abdominal cramps, or if a feeling of fullness occurs even when the stomach is empty, there may be a serious cause that requires clarification. The same applies if appetite decreases for no apparent reason or if there is excessive weight loss with a normal diet. If the intestinal noises are accompanied by flatulence or even diarrhea, there may be a disorder in the gastrointestinal tract - a medical examination clarifies the cause and can provide important information for rapid treatment.

Indicators of a disease of the gastrointestinal tract are, for example, suddenly changed stool characteristics, severe flatulence or pain in the stomach area. Bowel noises are not a problem if they occur in irregular spurts and without accompanying symptoms.The doctor should, however, determine whether there is a possible food intolerance or whether another illness is the cause of the intestinal noises.

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Treatment & Therapy

However, more extensive diagnostic equipment almost always follows in order to track down the exact causes of the altered bowel noises and to substantiate or refute any suspected illnesses.

Depending on the intestinal disease, drug or surgical procedures can ultimately be considered for therapy. A paralytic ileus can often be observed for a certain period of time as long as it is not caused by an intestinal infarction; With mechanical ileus, for example due to a growing tumor, there is no avoiding an operation.

Outlook & forecast

Bowel noises can annoy people or be unpleasant in certain situations. However, you do not have to indicate a malfunction immediately. Bowel noises are usually a sign of a well-functioning bowel. Treatment is usually not carried out by a doctor, since in this case the patient can control the generation of these noises himself.

They do not necessarily have to lead to further problems and often represent natural noises that arise during digestion. However, if they are associated with pain or nausea, a doctor should be consulted for treatment and eating habits should be changed.

Changing the diet to something that is light and easy for the stomach to digest can cause the intestinal noises to go away. They often only occur with certain foods, so that these can be dispensed with. In such cases, targeted treatment is possible, which is often successful.

Treatment with medication is optional. These calm the intestines and thus prevent intestinal noises from developing. However, they do not fix the cause of the problem and can only be used temporarily. In most cases, intestinal noises result in a positive course of the disease.

You can find your medication here

➔ Medicines against flatulence and digestive problems

prevention

If you want to prevent intestinal diseases in general, you should ensure a healthy diet in moderation with sufficient fiber. For the prophylaxis of gastrointestinal infections, good hygiene is crucial: wash food or store it in a cool place overnight, do not eat anything that may be spoiled, wash hands or disinfect if you come into contact with others with diarrhea. Of course, malformations or food intolerance cannot be prevented.

You can do that yourself

Bowel noises are mostly harmless, but always embarrassing. Patients who suffer from this can contribute a lot themselves to prevent this disorder from occurring in the first place.

When you eat hectically, a lot of air gets into the gastrointestinal tract. Those affected should therefore eat slowly and chew well. In addition to how, what we eat also plays a major role in digestive disorders. Hard to digest such as animal fats and red meat should be avoided. Flatulent vegetables and legumes, especially onions, all types of cabbage as well as beans and lentils, are at best well cooked and tolerated in small portions. Alcohol, acidic drinks such as fruit juices or coffee can irritate the stomach and worsen existing digestive disorders. Many sweeteners such as lactose, fructose or sorbitol can also irritate digestion.

If the intestinal noises are accompanied by flatulence, simple home remedies will quickly improve the situation. Fennel tea soothes, relaxes the stomach and works against flatulence. The same applies to caraway and peppermint oil. Gentle clockwise massages relax the stomach and help to alleviate the stomach gurgling. Placing a hot water bottle often has the same effect. Regular exercise combats indigestion and constipation, two of the most common causes of bowel noises.