What Are Hyperactive Bowel Sounds?
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Medically reviewed by Jay N. Yepuri, MD
Hyperactive bowel sounds are abdominal sounds that are louder and more frequent. It's normal to notice bowel sounds (borborygmi) as food moves through the stomach and intestines, which can sound like stomach growling or rumbling. Hyperactive bowel sounds indicate increased intestinal activity, often after eating or having diarrhea.
Normal bowel sounds usually aren't a health concern. However, experiencing hyperactive bowel sounds can mean you have an underlying health condition like food intolerances, gastrointestinal (GI) bleeding, infection, Crohn's disease, or ulcerative colitis.
Types of Bowel Sounds
Your intestines are hollow like pipes. Sounds echo through your abdomen when they contract to push food and waste through your digestive system. As a result, you may hear your stomach gurgle, growl, or rumble. These are normal bowel sounds that indicate your body is digesting food.
Bowel sounds may be considered underactive or overactive when the regularity, tone, and volume decrease or increase.
Hypoactive Bowel Sounds
Hypoactive bowel sounds are reduced bowel noises caused by slow intestinal activity. You likely have hypoactive bowel sounds if you notice quieter or fewer bowel sounds throughout the day. You may also experience no bowel sounds at all—especially with constipation.
Reduced bowel sounds are normal during sleep, but they can also be a side effect of certain medications and abdominal surgery.
Hyperactive Bowel Sounds
Hyperactive bowel sounds are increased bowel noises that occur when intestinal activity kicks up—often with gas or diarrhea. Hyperactive bowel sounds occur more frequently per minute, are loud, and may sound high-pitched.
Causes of Hyperactive Bowel Sounds
It's normal to experience hyperactive bowel sounds after you eat. As your gut digests food, it contracts and creates more noise that can echo in your intestines. Excess gas in your gut can also contribute to bowel sounds.
A loud, grumbling stomach can indicate hunger. Hunger triggers your digestive system to contract, which increases bowel sounds.
However, if your hyperactive bowel sounds occur with symptoms like abdominal pain, bloating, bloody stools, or diarrhea, you may have an underlying health condition.
Gastroenteritis
You may notice more hyperactive bowel sounds, vomiting, and diarrhea if you have gastroenteritis—inflammation of the stomach and intestinal lining. This type of GI infection is caused by viruses, parasites, and bacteria. Viral gastroenteritis (aka the stomach flu) is the most common type. You may also get gastroenteritis from food poisoning if you eat food contaminated with bacteria, viruses, or parasites.
Gastroenteritis causes more fluids and gas to enter your intestines. This can lead to diarrhea, which is one of your body's defense mechanisms to eliminate pathogens. The main gastroenteritis symptoms that often accompany hyperactive bowel sounds include:
Food Allergies and Intolerances
Hyperactive bowel sounds can indicate a food allergy, or a food intolerance or sensitivity. These conditions can cause excess gas and diarrhea as your body struggles to digest certain foods. Some food intolerances are due to enzyme deficiencies. Other food intolerances involve sensitivity to food additives or components.
Many people don't produce enough of the enzyme lactase, which leads to lactose intolerance. Lactase helps break down lactose—a sugar in milk and dairy products. If you're lactose intolerant, your gut can't digest lactose and instead moves the milk sugar to the large intestine. There, it breaks it down into acid and gas, which can lead to hyperactive bowel sounds and GI symptoms like:
Diarrhea
Abdominal pain or cramping
Bloating
Increased flatulence (gas)
Other food intolerances include gluten, monosaccharides (simple sugars like fructose), carbohydrates, and sugar alcohols.
Gut Microbiome Dysbiosis
An imbalance of microorganisms in your gut microbiome can contribute to food intolerances. This is known as dysbiosis. Dysbiosis leads to an overgrowth of microorganisms that have the potential to harm your health and create an inflammatory gut environment.
Celiac Disease
People with celiac disease may notice hyperactive bowel sounds if they eat foods containing gluten. Celiac disease is an autoimmune disease that causes your immune system to attack your small intestine when you eat gluten—a protein found in wheat, barley, and rye. This leads to intestinal inflammation and damage, which makes it difficult for your body to absorb nutrients.
Other symptoms of celiac disease that occur with increased bowel sounds include:
Nausea
Diarrhea or constipation
Nausea
Stomach pain
Inflammatory Bowel Diseases
Inflammatory Bowel Disease (IBD) includes Crohn's disease and ulcerative colitis. These conditions cause chronic (long-term) inflammation of your GI tract, which can damage your intestines and alter digestion. Both conditions may be caused by a weakened immune system, autoimmune response, or genetics.
Crohn's disease causes multiple GI tract layers from your mouth to your anus to become inflamed—usually affecting a portion of your small intestine first. Ulcerative colitis causes inflammation in the innermost layer of your colon (large intestine).
Symptoms of Crohn's disease and ulcerative colitis include:
Diarrhea
Abdominal pain
Rectal bleeding
Fatigue
Unexpected weight loss
Bowel Obstruction
High-pitched, tinkling, or metallic hyperactive bowel sounds can indicate a small or large bowel obstruction. Bowel obstruction occurs when your intestines become partially or fully blocked. The blockage prevents normal movement of food, liquid, and waste through your intestine during digestion, making it difficult or impossible to poop or pass gas.
Bowel obstruction is often caused by certain medications, intestinal adhesions (abnormal scar tissue), hernias, or tumors. Eating non-food items or developing hardened stool buildup from constipation can also cause bowel obstruction.
Loud, hyperactive bowel sounds can indicate a bowel obstruction, but they are not the primary symptom used for diagnosis. Other symptoms of bowel obstruction include:
Severe abdominal pain or cramps
Nausea
Vomiting
Constipation
Inability to pass gas
Bloating or abdominal swelling
Gastrointestinal (GI) Bleeding
Bleeding in the GI tract can increase the intensity of your bowel sounds. The bleeding might occur in your esophagus (the muscular tube that moves food from your throat to your stomach), stomach, small intestine, colon, or rectum. In this case, bowel sounds will occur with symptoms like:
Tarry black stools
Vomiting blood
Rectal bleeding
GI bleeding is caused by health conditions that damage the GI tract, including hemorrhoids, cancer, intestinal polyps (tissue growths), stomach ulcers (stomach lining injury due to excess acid), infections, and IBD.
When To See a Healthcare Provider
Hyperactive bowel sounds are common after eating foods your body can't properly digest, especially if you have a known food intolerance or celiac disease.
Contact your healthcare provider if you have persistent hyperactive bowel sounds along with symptoms like rectal bleeding, nausea, vomiting, chronic diarrhea, or chronic constipation. These symptoms indicate a possible gastrointestinal infection or underlying health condition, like IBD, that requires medical treatment.
Seek immediate medical care if you have signs of complete bowel obstruction or GI bleeding, such as:
Severe abdominal pain or cramping
Vomiting with or without blood
Abnormal abdominal swelling (distension)
Constipation or inability to pass gas
Black, tarry stools
Rectal bleeding
Drop in blood pressure
Without emergency treatment, a complete bowel obstruction can lead to complications like ruptured bowels and infection. GI bleeding can also indicate GI tract injury or damage that needs immediate care.
How Are Hyperactive Bowel Sounds Diagnosed?
If you have hyperactive bowel sounds that don't go away, your healthcare provider can perform exams and testing to determine the root cause. They will start by asking about your symptoms and medical history. They may also listen to your stomach, with or without a stethoscope, for any unusual bowel sounds.
Your provider may order additional tests if they need more information, including:
Imaging tests: An abdominal CT scan or X-ray can help the provider view inside your body for bowel obstructions and intestinal abnormalities.
Blood tests: Running blood panels can help identify certain conditions, intolerances, and infections causing GI issues.
Enteroscopy: Inserting a flexible tube with a camera (an endoscope) down your throat and into your upper GI tract can help identify damage or lesions causing unexplained diarrhea or bleeding.
How To Reduce Bowel Sounds
Maintaining a healthy digestive system and managing underlying conditions can help reduce hyperactive bowel sounds. Lifestyle tips that can help reduce gas and improve gut health and digestion include the following:
Follow a gluten-free diet if you have Celiac disease
Try to reduce foods with fructose, fiber, or lactose that can trigger gas
Be mindful of cruciferous vegetables that trigger gas, including broccoli, cabbage, Brussels sprouts, as well as legumes like beans, lentils, and peas
Reduce high-fat and fried foods
Limit carbonated beverages
Drink plenty of water to help move digestion along
Eat your meals slowly to swallow less air
Manage stress with exercise, breathwork, or mindful activities to help reduce IBD flares
If you think you have food intolerances, try to identify foods that are difficult for your body to digest. A food diary can help you keep track of symptoms. Work with a healthcare provider like a registered dietician on how to proceed from there. For example, you might be able to include certain quantities of trigger foods in your diet as long as you're mindful of portions.
A Quick Review
People with hyperactive bowel sounds experience loud and more frequent abdominal sounds like growling and rumbling. These sounds indicate increased intestinal activity—usually after eating, having gas, or experiencing diarrhea.
Hyperactive bowel sounds can also be a sign of an underlying health condition like celiac disease, food intolerances, IBD, GI infection, or bowel obstruction. See a healthcare provider if you have hyperactive bowel sounds accompanied by symptoms like diarrhea, constipation, vomiting, or severe abdominal pain. They can help diagnose any underlying causes of hyperactive bowel sounds and help you manage your symptoms.
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