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Medical Importance of a Noisy Tummy

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Whether audible or not, bowel sounds in the absence of other significant symptoms are normal phenomena of no medical significance. Their harm is embarrassment, a social rather than a medical affliction.

However, in certain medical circumstances, hyperactive or absent bowel sounds are abnormal.

Hyperactive Bowel Sounds – Bowel sounds are often noted by an examining physician to be hyperactive when the patient is experiencing diarrhea. The increased peristaltic movement of the intestines coupled with increased net intestinal accumulation of fluid and gas amplify the sounds of watery stool splashing through the gut.

Certain malabsorption states are associated with exaggerated bowel sounds. For example, reduced small intestinal levels of the enzyme needed to digest the milk sugar lactose, permits that sugar to reach the colon intact where it is fermented by colon bacteria.

These organisms release hydrogen and products that attract fluids into the gut and stimulate its contractions. These amplify the three conditions that produce abdominal sounds: gut movement, gas, and fluid.

Learn more about lactose intolerance

Another example of malabsorption is that occurring with celiac disease.

Learn more about celiac disease

A more serious instance of hyperactive bowel sounds occurs in incomplete mechanical obstruction of the gut. In this emergency situation, increased intestinal contractions attempt to force solids, liquids, and air through a narrowing of the intestine producing very loud sounds, often in high-pitched peristaltic episodes. When obstruction occurs, illness is obvious and the patient suffers severe abdominal pain and malaise.

While there are occasions where observers agree that a person’s bowel sounds are hyperactive, the threshold of abnormality is indistinct. There is much individual variation, and even ingestion of a large amount of fluid can result in loud tummy gurgling. Borborygmi, however loud, are seldom a sign of disease in the absence of diarrhea or other symptoms and are a rare and unreliable sign of malabsorption.

Absent Bowel Sounds – While the intestines may be quiet during sleep and at certain times of the day, their complete absence during an attack of severe abdominal pain is a sign of a serious intra-abdominal event; an emergency requiring immediate admission to hospital and sometimes surgery. The intestines also become quiet following abdominal surgery and the return of bowel sounds is an early and reliable sign of recovery.

Food Tip

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 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.

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