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Abdominal sounds

Considerations:
The abdominal sounds (bowel sounds) are evaluated by listening to the abdomen with a stethoscope ( auscultation ).

Absent bowel sounds, called ileus , is a condition in which the examiner is unable to hear any bowel sounds after listening to each area of the abdomen (the examiner usually listens for at least 5 minutes in each area). This indicates a lack of intestinal activity, which can quickly become life-threatening because gas, secretions, and intestinal contents can accumulate to the point where the bowel wall ruptures.

Reduced bowel sounds (hypoactive) include a reduction in the loudness, tone, or regularity of the bowel sounds. They indicate a slowing of intestinal activity. Hypoactive bowel sounds are normal during sleep, and also occur normally for a short time after the use of certain medications and after abdominal surgery.

Increased bowel sounds (hyperactive sounds) are sometimes heard even without a stethoscope. They occur at a higher pitch and greater frequency than normal bowel sounds. Hyperactive bowel sounds reflect an increase in intestinal activity.

The sudden stopping of bowel sounds, or absent bowel sounds after a period of hyperactive bowel sounds, are significant findings that can indicate a potentially life-threatening crisis such as rupture of the intestines or strangulation of the bowel with subsequent death of the bowel tissue ( necrosis ).

In many cases, hyperactive bowel sounds occur as the intestines respond to a problem (such as an obstruction). Then, the bowel sounds can become hypoactive, indicating progression of the condition. They may quickly disappear (absent bowel sounds), indicating that the disorder has become potentially life-threatening.

Common Causes:
Hyperactive , hypoactive, or absent bowel sounds:

mechanical bowel obstruction (caused by hernia , tumor , adhesions , or similar conditions that can physically block the intestines)
blood vessel obstruction and its resulting tissue damage (for example, blood clots can cause mesenteric artery occlusion , which prevents the intestines from obtaining a proper blood flow)
paralytic ileus , a problem with the nerves to the intestines (reduced nerve activity can result from infection, overdistended bowel, trauma, bowel obstruction, vascular obstruction, and chemical imbalances such as hypokalemia )

Hypoactive bowel sounds (other causes):

drugs that reduce intestinal movements, including opiates (such as codeine), anticholinergics, phenothiazines, and others
general anesthesia and spinal anesthesia
irradiation of the abdomen ( radiation therapy for cancer )
surgery in the abdomen (may cause reduced bowel sounds for 1 to 5 days)

Hyperactive bowel sounds (other causes):

diarrhea (any cause including emotional stress )
Crohn's disease
GI bleeding
ulcerative colitis
food allergy
infectious enteritis

Note: There may be other causes of a change in the bowel sounds. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as location, quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for a change in the bowel sounds, occurring alone or in combination with other problems.

Home Care:
Consult your health care provider.

Call Your Healthcare Provider If:
(Changes in bowel sounds are usually detected by your primary health care provider, nurse, or other health examiner.)

What to Expect:
The medical history will be obtained and a physical examination performed. If there are signs of an actual or impending emergency condition, measures may be taken immediately to empty the bowel (decompression). A tube may be placed through the nose or mouth into the stomach or intestines (nasogastric tube) and attached to suction.

Usually no fluids or food are allowed by mouth, to allow the intestines to rest. Intravenous fluids are often needed. Medications may be given to reduce symptoms and to treat the cause (the specific medication depends on the situation). Surgery may be needed emergently in some cases.

Medical history questions concerning abdominal sounds may include:

What other symptoms are also present?
Have you noticed any abdominal pain ?
Have you noticed any diarrhea ?
Have you noticed any constipation ?
Have you noticed any abdominal distention ?
Have you noticed any excessive gas (flatus) ?

Note: A finding of abnormal bowel sounds is usually discovered by the health care provider, and the affected person may or may not have been aware of its presence.

Careful abdominal examination will be performed. Temperature, pulse , respiratory rate, and blood pressure will probably be checked.

Diagnostic tests to determine the cause may include:

various blood tests ( CBC , blood chemistries , and similar tests)
abdominal X-ray
endoscopy (for example, an EGD )

After seeing your health care provider:
You may want to add a diagnosis related to a change in the bowel sounds to your personal medical record.