Increased bowel sounds

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Increased (hyperactive) bowel sounds can sometimes be heard even without a stethoscope. Hyperactive bowel sounds means that there is an increase in intestinal activity. This can sometimes occur with diarrhea and after eating. Very high-pitched bowel sounds may be a sign of early bowel obstruction.

Most of the sounds heard in the stomach and intestines are due to normal digestion and are no need for concern. Many conditions can cause hyperactive or hypoactive bowel sounds. Most are harmless and do not need to be treated.

Complete history is critical in evaluation of the patient with increased bowel sounds.

X-rays (flat and upright) are useful in evaluating the cause of increased bowel sounds.

Etiology is demonstrated best by abdominal CT scan.

Enteroclysis helps to determine the degree of obstruction.

Complete bowel obstruction usually requires surgical intervention.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2], Maheep Singh Sangha, M.B.B.S.

Most of the sounds heard in the stomach and intestines are due to normal digestion and are no need for concern. Many conditions can cause hyperactive or hypoactive bowel sounds. Most are harmless and do not need to be treated.

• Bowel obstruction
• Crohn’s disease
• Hernia
• Strangulation
• Enteritis

• Abdominal surgery

• Anticholinergics

• Babesiosis ^[1]

• Bowel obstruction

• Ciguatera poisoning^[2]

• Codeine

• Crohn’s disease

• Dextromethorphan

• Diarrhea

• Food additive adverse reaction

• Food allergy

• Food poisoning

• Gastroenteritis

• Gastrointestinal hemorrhage

• General anesthesia

• GI bleeding

• Herbal agent overdose (Pygeum africanum)^[3]

• Hernia

• Hyponatremia^[4]

• Infectious enteritis

• Ogilvie’s syndrome

• Pancolitis

• Polyarteritis nodosa^[5]

• Porphyria ^[6]

• Radiation

• Rhubarb overdose

• Serotonin toxicity

• Spinal anesthesia

• Spironolactone ^[7]

• Strangulation

• Sympathomimetic overdose

• Ulcerative colitis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Differential diagnosis includes: ^{[1] [2]}

• Abscess
• Acute gastroenteritis
• Adhesions (from previous surgery)
• Benign etiologies
• Carcinoid syndrome
• Colonic-pseudo obstruction
• Crohn’s disease
• Diarrhea
• Foreign body
• Gallstone ileus
• Hernias
• Hiatal hernia
• Infection
• Intussusception
• Lactase deficiency
• Malabsorption syndrome
• Mechanical bowel obstruction
• Neoplasms
• Peutz-Jeghers syndrome
• Succussion splash
• Volvulus

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