Borborygmus is the sound produced by gas moving through the intestine, caused by peristalsis. It can be altered or absent in diseases, and excessive gas can lead to bloating and belching. In serious cases, bowel obstruction can cause an absence of bowel sounds and requires emergency surgery.
Borborygmus, plural borborygmi, is the gurgling sound produced by the normal intestine. It is also known as stomach rumbling or stomach rumbling. The sound occurs when gas moves through the intestine, propelled by waves of muscle contraction in the intestinal wall. These waves of contraction are known as peristalsis and they are what pushes food through the intestines. A louder rumbling may be heard when hungry or anxious, as the stomach can contract rapidly and move the contents of the intestine back and forth.
Gases commonly found within the intestines include carbon dioxide from digestive juices, oxygen and nitrogen taken in through the mouth, and hydrogen and methane produced by bacterial fermentation in the colon. The borborygmi are altered or absent in many diseases. Listening to them, preferably with a warmed stethoscope placed on the abdomen, can be an important part of the diagnostic process.
Air is drawn in when talking or swallowing food and drink, and this can create a rumbling along the gastrointestinal system. Normally, gas is produced in the intestines when food is broken down by bacteria and enzymes. Sometimes eating foods like cabbage or beans, which are high in fiber and take longer to digest, can lead to more gas buildup. Alternatively, a sudden change in diet can lead to increased gas, as the intestinal bacteria that used to be appropriate for the usual diet are not optimized to digest new food substances.
With more gas, as well as an increase in the frequency and volume of the borborygmo, there may be bloated sensations associated with belching and flatulence. While borborygmas are generally harmless, abnormal levels are particularly associated with a number of diseases. Disorders in which food is not absorbed properly by the intestines, such as celiac disease, or those in which the intestines are inflamed such as diverticulitis, can cause increased gas and bowel sounds. Irritable bowel syndrome is another possible cause, as is a stomach infection or gastroenteritis. Some medications, such as laxatives, can also lead to excessive loud gas in the intestines.
In more serious conditions, where part of the intestine becomes blocked, perhaps by a tumor or a strangulated hernia, a swollen, crampy abdomen may be accompanied by high-pitched grumbling and vomiting. The high-pitched sounds are the result of increasing waves of peristaltic contraction approaching the obstruction, in combination with a gas-filled distended intestine. Patients are usually admitted to the hospital for emergency surgery.
As it progresses, bowel obstruction eventually leads to an absence of bowel sounds. Blood flow to the intestine is impaired, peristalsis ceases and the intestine is effectively paralysed. Because normal bowel sounds can be infrequent, it’s important to listen long enough to make sure the rumblings are truly absent, perhaps for about three minutes or so.
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