Bowel sounds, often described as gurgling or rumbling, are the noises produced by the digestive system as food, fluids, and gas move through the intestines. These sounds are a natural indication that the gastrointestinal tract is active. A colostomy is a surgical procedure that creates an opening, called a stoma, on the abdominal wall, rerouting a portion of the colon to allow waste to exit the body into an external pouch. This surgical alteration does not stop the body’s natural digestive processes.
Why Bowel Sounds Occur with a Colostomy
The digestive process continues in much the same way after a colostomy as it did before the surgery. The muscular contractions, known as peristalsis, continue to propel digested material, gas, and fluids through the remaining sections of the intestines. These ongoing movements are the source of the audible bowel sounds.
Since the stoma, the new exit point for waste, is located on the abdomen, individuals may notice these sounds more distinctly than before their surgery. This increased audibility, along with the internal echoing of sounds within the hollow intestines, similar to water flowing through pipes, confirms the bowel’s continued activity.
What Different Bowel Sounds Mean
Normal bowel sounds are typically irregular, intermittent gurgling or clicking noises. These sounds can occur approximately every 5 to 15 seconds, or between 5 to 30 times per minute, with varying intensity and frequency throughout the day. They are generally soft in volume and are often more active during and after meals, reflecting ongoing digestion. A loud, prolonged gurgle, known as borborygmus, is also considered a normal sound.
Reduced or “hypoactive” bowel sounds occur less frequently, sometimes fewer than five sounds per minute, and are quieter. These sounds suggest a slowing of intestinal activity, which can be a normal occurrence during sleep, after taking certain medications, or following abdominal surgery. Hypoactive sounds might also be associated with constipation.
Conversely, “hyperactive” bowel sounds are loud, frequent, and often high-pitched, sometimes exceeding 30 sounds per minute. These indicate increased intestinal activity and commonly occur with diarrhea or after eating a meal. When bowel sounds become notably high-pitched, tinkling, or metallic, it can suggest fluid and gas are building up under pressure within the intestines. This specific pattern of sound may be a sign of an early bowel obstruction. Evaluating bowel sounds always requires considering other accompanying symptoms and the overall context of the individual’s health.
When to Contact Your Doctor
It is important to contact a healthcare provider if there is a sudden and significant change in bowel sound patterns. This includes a complete absence of bowel sounds for an extended period, or the development of new, persistent, very loud, or high-pitched sounds. These changes are particularly concerning when accompanied by other symptoms.
Individuals should seek medical attention if they experience severe abdominal pain or cramps that last more than two to three hours. Other warning signs include nausea or vomiting, especially if the vomit is green, and noticeable abdominal bloating or distention. A lack of stool or gas output from the stoma, or a significant reduction in output, also warrants medical evaluation.
Changes in the stoma’s appearance, such as unusual color, increased swelling, or if it appears to retract or prolapse, should be reported. Additional symptoms like fever, signs of infection around the stoma (including redness, warmth, or pus), excessive bleeding from the stoma, or watery stool lasting more than five hours are also reasons to contact a healthcare professional.