SYMPTOMS

What is bowel sound?

"Bowel sound," also known as "borborygmus," refers to the intermittent gurgling or bubbling noises produced by the movement of gas and fluid within the intestines during peristalsis. It is a normal physiological phenomenon, typically occurring 4–5 times per minute ^[1,2]. Excessive or diminished bowel sounds may indicate certain medical conditions, such as acute gastroenteritis or mechanical intestinal obstruction.

What are the types of bowel sounds, and what are their symptoms?

Based on frequency, bowel sounds are generally classified as active, hyperactive, diminished, or absent. This classification often helps diagnose diseases or assess recovery progress ^[1,3].

• Active bowel sounds: Increased intestinal peristalsis may result in bowel sounds exceeding 10 times per minute, though the tone remains moderate. This occurs in conditions like acute gastroenteritis, after taking laxatives, or during gastrointestinal bleeding.
• Hyperactive bowel sounds: Frequent, loud, high-pitched, or metallic sounds audible without placing a stethoscope on the abdomen, often indicating mechanical intestinal obstruction.
• Diminished bowel sounds: Sounds heard only once every few minutes, suggesting persistent intestinal obstruction, senile constipation, impaired intestinal blood flow, intestinal necrosis, paralytic ileus, peritonitis, electrolyte imbalances (e.g., hypokalemia), or reduced gastrointestinal motility.
• Absent bowel sounds: No sounds detected after auscultation for over two minutes, even with light tapping or scratching of the abdomen, typically seen in acute peritonitis or paralytic ileus ^[1].

TREATMENT

How to Relieve Abnormal Bowel Sounds?

If the patient is at home, the following measures can be taken:

• Rest as much as possible and avoid eating.
• Listen and record the frequency, volume, and other abnormalities of bowel sounds, either by oneself or with the help of family members.
• If there is no improvement, seek medical attention promptly.

If the patient seeks medical treatment, the doctor may perform the following procedures:

• Medication: For patients with severe abdominal pain, after determining the cause, the doctor may prescribe pain relief medication to alleviate discomfort. Commonly used drugs include intramuscular or oral 654-2, oral belladonna tablets, or pinaverium bromide. For patients accompanied by diarrhea, timely fluid replacement therapy is necessary to enhance nutrition and maintain water and electrolyte balance. Commonly used medications include saline solution and potassium chloride. For those with constipation, prompt laxative treatment is required to relieve symptoms, with commonly used drugs such as lactulose or glycerin enema.
• Surgical Treatment: After identifying the cause, targeted surgical treatment may be performed. For example, patients with bowel sounds caused by intestinal obstruction may undergo intestinal resection. The specific surgical method will depend on the actual condition.

DIAGNOSIS

Under what circumstances should patients with abnormal bowel sounds seek medical attention?

• Seek immediate medical attention if symptoms such as severe abdominal pain, cessation of gas or bowel movements, or bloody stools occur to determine the underlying cause.
• Note: When bowel sounds occur without obvious accompanying symptoms like abdominal pain or diarrhea, patients may tolerate them or self-medicate, which can delay treatment. If discomfort arises, prompt medical consultation is necessary to avoid worsening the condition.

Which department should patients with abnormal bowel sounds visit first?

Gastroenterology.

What tests are required for patients with abnormal bowel sounds?

Physical examination:

• Inspection: The doctor observes the patient's abdominal skin for distension, gastrointestinal peristaltic waves, rashes, or bleeding spots to assess potential digestive system disorders.
• Auscultation: The doctor uses a stethoscope to listen to the abdomen, evaluating the frequency and volume of bowel sounds.
• Palpation: The doctor manually examines the abdomen to check for tenderness, distension, or masses.
• Percussion: The doctor taps the abdomen to assess gastrointestinal gas levels, detecting air or fluid accumulation and masses, providing an initial evaluation of gastrointestinal status.

Laboratory tests:

• Complete blood count (CBC): Measures white blood cells, neutrophils, and hemoglobin levels to identify infections or blood loss.
• Stool examination: Microscopic analysis checks for pus cells or red blood cells, while culture tests detect pathogenic bacteria.

Ancillary tests:

• Gastrointestinal endoscopy or upright abdominal X-ray: Determines the presence of bleeding or obstruction in the gastrointestinal tract ^[1].

POTENTIAL DISEASES

What may be the causes of abnormal bowel sounds?

Abnormal bowel sounds are mainly caused by diseases, often infectious or non-infectious, and some patients may also experience them due to surgery.

Disease factors:

• Infectious diseases: such as acute enteritis;
• Non-infectious diseases: such as gastrointestinal bleeding, constipation, or intestinal obstruction.

Surgical factors: For example, after undergoing abdominal-related surgeries, such as colon repair, if recovery is unsatisfactory or the surgical site fails to heal promptly, infection may occur, leading to abnormal bowel sounds ^[1].

What daily precautions should patients with abnormal bowel sounds take?

• Strictly follow medical advice for treatment and medication, and closely monitor changes in symptoms;
• Maintain a reasonable diet, opting for easily digestible foods like fresh fruits and vegetables. If abdominal pain or bloating worsens, fasting is necessary, and medical attention should be sought promptly;
• After identifying the cause, engage in appropriate physical exercise and maintain a positive mindset;
• Schedule regular health check-ups, at least once a year.