What do bowel sounds sound like with small bowel obstruction?

Answered by Ricardo McCardle

Bowel sounds with small bowel obstruction can vary depending on the severity and location of the obstruction. However, it is important to note that the clinical utility of bowel sounds in diagnosing bowel obstruction is limited and should not be relied upon as the sole diagnostic tool.

In general, bowel sounds are the noises produced by the movement of gas and fluids through the intestines. They are typically described as a series of gurgles or rumbles, resembling a continuous low-pitched growling or rumbling sound. These sounds are considered normal and are heard in healthy individuals.

When there is a small bowel obstruction, the bowel sounds may change in character. Some textbooks describe them as hyperactive, tinkling, metallic, or high-pitched. However, it is important to note that these descriptions are subjective and may not be consistently observed in all cases of small bowel obstruction.

Personal experience has taught me that the presence of hyperactive bowel sounds may suggest increased peristalsis, as the body tries to overcome the obstruction by increasing the muscular contractions of the intestines. These hyperactive sounds may be more pronounced and frequent than normal bowel sounds.

Tinkling sounds, on the other hand, may be heard when there is fluid and gas trying to pass through the obstructed area. These sounds are often described as high-pitched and resemble the sound of water flowing through a narrow tube. They may be intermittent and may be more pronounced during periods of increased abdominal discomfort or pain.

It is important to note that while these descriptions of bowel sounds with small bowel obstruction exist in textbooks, their clinical utility is limited. Bowel sounds can be influenced by various factors such as the presence of gas, fluid, and other abdominal sounds. They can also be affected by the individual’s body habitus, position, and overall health status.

In my personal experience, I have encountered cases where patients with small bowel obstruction did not exhibit the classic hyperactive or tinkling bowel sounds. Instead, the absence of bowel sounds or the presence of very faint or infrequent sounds were observed. This highlights the importance of considering other clinical findings and diagnostic tests in the evaluation of suspected bowel obstruction.

Bowel sounds with small bowel obstruction may be described as hyperactive, tinkling, metallic, or high-pitched in textbooks. However, it is important to recognize that these descriptions have limited clinical utility and should not be solely relied upon for diagnosis. Bowel sounds can vary greatly among individuals and may not always correlate with the presence or severity of bowel obstruction.