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How to examine for Bowel Sounds?

Describe the normal peristaltic sound :
  • Place the stethoscope on one side of the abdominal wall and keep it there minimally for one minute
  • until the bowel sounds are heard.
  • Usually the stethoscope is placed just to the right of the umbilicus.
  • Normal bowel sounds are intermittent low or medium-pitched gurgles mixed with occasional high-pitched tinkle.
Normal motility of the gut creates a characteristic gurgling sounds every 5-10 seconds that can be heard by unaided ear (Borborygmi).
Bowel sounds are increased in the following situations
  • In mechanical intestinal obstruction—Frequent loud low-pitched gurgles (borborygmi) are heard,often interspersed with high-pitched tinkles occuring in a rhythmic pattern with peristalsis. As a whole, the peristaltic sounds are exaggerated.
  • Increased bowel sounds with colicky pain is pathognomonic of small bowel obstruction,in between colicky pain, bowel is quiet and no sounds are audible.
  • Malabsorption
  • Severe GI bleeding
  • Carcinoid syndrome.
Bowel sounds are absent in following conditions
  • Paralytic ileus
  • Peritonitis.