Borborygmi: Stomach Noises and Rumbling

By Sonia Gulati. Medically reviewed by Tom Iarocci, MD. May 7th 2016

Do you ever wonder if your stomach is trying to tell you something when it rumbles and growls?

This rumbling sound is called a borborygmus (or borborygmi in the plural form), and most of the time it is just the natural sound of your digestive system at work. “Borborygmus” actually comes from a Greek word that imitates this sound when spoken (an example of onomatopoeia).

Typical sources of borborygmi include hunger and gas from the break down of undigested food. Excessive borborygmi can be a sign of an underlying problem. The sounds that you can hear are just the tip of the iceberg – there is a whole world of sounds that can be heard only with a stethoscope. Borborygmi are just one of several types of sounds doctors can hear coming from the abdomen; these sounds are collectively referred to as “bowel sounds.”

Causes of Stomach Noise

Digestion. Much of the digestive tract is a hollow tube that moves food and drink from the mouth to the anus. When you ingest something, your digestive system makes waves of muscle contractions, called peristalsis, to move things along. Food is first broken down and mixed with fluid secretions in the stomach and in the small intestine to become what is referred to as chyme—a thick liquid of partly digested food.

But it is not just liquid that gurgles. Gas gets into the system when you swallow air, and also through the action of intestinal bacteria that break down undigested food. This mixture is pushed down the gastrointestinal tract, which produces the rumbling you might hear after a meal.

Hunger. Why, then, do you hear rumbling when you are hungry? Fluctuating levels of certain hormones signal your brain that it is time to consume food. These signals then release another set of hormones that stimulate the secretion of gastric juices and promote muscles movement in the stomach walls. This too can make your stomach growl, and the sounds tend to be louder because they reverberate as the mostly empty stomach propels into the duodenum what little juices and remnants might be left from the last meal.

Incomplete digestion of food. Eating certain foods (such as those that contain lactose, gluten, wheat, or barley) may also cause borborygmi when a person is unable to digest these items properly due to an underlying condition such as lactose intolerance or celiac disease. Incomplete digestion of food can lead to excess gas, which produces the gurgling you may hear.

Bowel Sounds Can Be Clues

Although most bowel sounds are normal, there are some instances in which abnormal bowel sounds may indicate the presence of an underlying condition.

Altered bowel sounds are evaluated together with a person’s medical history and physical signs and symptoms such as gas, distension, nausea, presence or absence of bowel movements and vomiting.

Hypoactive sounds (defined as a reduction in loudness, tone, or regularity) are detected using a stethoscope and may indicate that intestinal activity has decreased. A reduction in bowel sounds occurs normally when you are sleeping and when you are constipated. Hypoactive sounds can also stem from some medications such as codeine and anticholinergics, as well as some types of anesthesia and in recovery after abdominal surgery.

A complete lack of intestinal activity is a condition known as ileus. The doctor may not be able to hear any sounds when listening to the abdomen. There are many conditions that can lead to ileus, and it is a serious medical state that can lead to intestinal rupture.

Sometimes bowel sounds are loud enough to be heard even without a stethoscope. Louder continuously hyperactive sounds indicate that there is an increase in intestinal activity. These may occur with a bout of diarrhea or after eating. Other causes of hyperactive sounds include:

  • Irritable bowel syndrome
  • Crohn's disease
  • Food allergies
  • Bleeding in the gastrointestinal tract
  • Infectious enteritis
  • Ulcerative colitis

Hyperactive sounds may also be heard with viral gastroenteritis, a very common cause of diarrhea in adults and children. Some of the more serious conditions that can cause bowel sound abnormalities include blocked blood flow to the intestines, bowel obstruction, and paralytic ileus.

Next Steps

More often than not, the sounds you hear from the stomach and intestines are normal. Hyperactive or hypoactive bowel sounds have numerous causes, many of which do not need to be treated. But if you are experiencing abnormal abdominal sounds that are accompanied by other abnormal symptoms, you should see a doctor. At your appointment your doctor will initially perform a comprehensive physical exam and medical history.

Specifically your doctor may ask if you are experiencing any of the following symptoms:

  • Diarrhea
  • Constipation
  • Abdominal pain
  • Excess or the absence of flatulence
  • Stool discoloration
  • Blood in the stools
  • Abdominal distension

If your doctor needs more information, he or she may also order the following tests in order to identify if you have an underlying gastrointestinal condition.

  • Abdominal CT scan (cross sectional images)
  • Abdominal X-ray (flat view through abdomen)
  • Endoscopy (flexible tube with a small camera at the end is inserted).
  • Blood tests. 

Most bowel sounds are harmless and simply mean that the gastrointestinal tract is working. However, prolonged or absent abdominal sounds may indicate a more serious underlying condition, especially if you are also experiencing other gastrointestinal symptoms.

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