What causes Bowel Sounds?
Noises in the stomach can be caused by:
- Muscular contraction of the intestinal wall
- The presence within the intestines of liquid
- The presence within the intestines of gas
The food we eat and the fluids we drink mix with GI secretions in the intestine. It takes about two gallons of enzyme-rich fluid to break down what we eat each day. These enzymes are substances that break down food and nutrients, most of which is then absorbed.
When we are awake, our intestines rhythmically move as the walls contract and relax to mix food with secretions in the GI tract.
It is important to separate the noisy movement of fluid and gas from other gases that may be present. They include belching, bloating, and the passing of intestinal gas. While these symptoms of gas may occur along with loud bowel sounds, they do not occur for the same reason.
Gases are always present in the intestine. They originate either from swallowed air or the release of gases within the GI tract. Hydrogen, carbon dioxide, and other gases released by the bacterial fermentation of undigested food in the lower gut. Fermentation is a chemical process where bacteria break down substances, such as sugar.
Medical Importance of a Noisy Tummy
Bowel sounds without other significant symptoms are normal. Typically, there is no medical significance of bowel sounds; however, in certain medical circumstances, hyperactive or absent bowel sounds can cause concern.
Hyperactive Bowel Sounds – Hyperactive is defined as being overly active or occurring more than usual. Bowel sounds are often noted to be hyperactive when someone is experiencing diarrhea. With diarrhea, muscle movements, fluid, and gas in the intestines increase. This causes the sounds of watery stool splashing through the gut to be louder.
Some malabsorption conditions may also cause loud bowel sounds. Malabsorption occurs when nutrients are not absorbed well by the small intestine. One common example is the bowel sounds and gas resulting from lactose intolerance. Due to reduced levels of the small intestinal enzyme needed to digest milk sugar (lactose), the lactose to reach the colon intact. Bacteria in the colon then ferments the lactose.
This releases hydrogen and other substances and gases into the gut. Fluids in the gut then increase, causing muscle contractions in the gut to increase. Thus, all of the conditions that produce abdominal sounds are increased (muscular contractions along with the presence of liquid and gas within the intestines) causing hyperactive bowel sounds.
Celiac disease is another disorder that causes malabsorption.
Hyperactive bowel sounds occur when there is an obstruction of the gut. This can be a blockage that is just forming or one that partially blocks the gut. This is a serious condition and requires medical attention. In this emergency situation, increased intestinal contractions attempt to force solids, liquids, and air through a narrowing of the intestine. The result is very loud bowel sounds. Individuals suffer from symptoms including:
- Severe abdominal pain – pain varying from dull to sharp that occurs inside the stomach or intestines
- Nausea – a feeling of sickness with an urge to vomit
- Vomiting – bringing food back up from the stomach
- Constipation – having 3 or fewer bowel movements a week, and/or difficulty passing bowel movements
- Inability to pass gas from below
- A general feeling of discomfort or sickness
Although there is much variation from person to person, in most cases of loud noises from a hyperactive stomach are normal. However, your healthcare provider should be made aware of these sounds if you are also experiencing diarrhea, pain or other symptoms.
Absent Bowel Sounds – While the intestines may be quiet during sleep and at certain times of the day, they should not be silent for long. The complete absence of sounds in the GI tract during an attack of severe abdominal pain could be a sign of an emergency. This often requires immediate admission to the hospital and sometimes surgery.
Examples of such uncommon events include late-stage bowel obstruction or bowel perforation. It is important to note that the intestines also become quiet after abdominal surgery. In this instance, returning bowel sounds is an early and reliable sign of recovery.
Too much of certain sugars may cause a noisy tummy. Try reducing the amount of fructose and sorbitol that you eat.
- Fructose, naturally present in fruits, onions, artichokes, pears, and wheat, is also used as a sweetener in some soft drinks and fruit drinks.
- Sorbitol, found naturally in fruits, including apples, pears, peaches, and prunes, is also used as an artificial sweetener in many dietetic foods and sugar-free candies and gums.
What you can do about a Noisy Tummy
There is no specific treatment for a noisy movement of fluid and gas in the GI tract. Loud bowel sounds may occur with changes of intestinal function. Common conditions causing this are dyspepsia and irritable bowel syndrome (IBS). Dyspepsia is a condition with indigestion and upper abdominal discomfort. IBS is a common GI condition characterized by changes in bowel habits and abdominal pain or discomfort.
Dietary adjustment may help if you have a malabsorption issue (such as lactose intolerance). It may also be helpful to change a diet high in fructose or the artificial sweetener sorbitol. These sweeteners are commonly present in diet gums, candies, and preserves. High amounts of these sugars may cause diarrhea, flatus, and increased intestinal noise. Flatus is gas occurring in the intestines or stomach
Bowel sounds are normal. But if you feel that your bowels’ noises are interfering with your enjoyment of life, you should discuss the problem with your healthcare provider.
Source: Adapted from IFFGD publication #234 A Noisy Tummy: What Does it Mean? By: Darren Brenner, M.D., Associate Professor of Medicine and Surgery, Northwestern University Adapted from article by: W. Grant Thompson, M.D., Professor Emeritus, Faculty of Medicine, University of Ottawa, Ontario, Canada Edited by: Lin Chang, M.D., UCLA School of Medicine, Los Angeles