Why does my stomach make growling noises?

DEAR DOCTOR K:

As I get older, it seems my stomach is more likely to make growling noises. Why does it do this, and what can I do about it? It’s embarrassing.

DEAR READER:

Maybe your stomach is trying to talk to my stomach. My stomach is periodically trying to talk to someone, that’s for sure.

Stomach noises happen in everyone, although they seem to plague some people more than others. It’s not just an issue with older people; it happens all the time, to people of all ages. Doctors put weird (often Latin) names on things. We call the gurgling noises borborygmi (bor-be-RIG-me).

For centuries, people have associated stomach growling with hunger. But do these noises always mean you’re hungry? I’ll come back to that later. And could these growling noises ever be a sign of illness? Yes, but uncommonly.

First, a little anatomy. The abdomen (the belly) is where the noise is coming from. The abdomen includes most of the digestive system: the stomach and intestines. The mouth, throat and esophagus (the swallowing tube) are the parts of the digestive system that lie above the abdomen.

The digestive system is really a series of tubes. It moves food from the mouth to the stomach and small intestine, where it is digested. Then it moves the waste material (what’s left after digestion) down the large intestine and out of the body.

The movement of food, and then of waste, occurs by the process called peristalsis (pear-uh-STAL-sis). Peristalsis is an organized, sequential squeezing of the tubes of the digestive system. (It’s a bit like squeezing a tube of toothpaste.)

The stomach and intestines are filled with a mix of solid material, fluid and air. Air is a gas, and in the abdomen it is under pressure. When peristalsis moves liquid and semi-solid material around, pockets of gas under pressure move toward parts of the gut that have less pressure. That movement of air causes the odd noises you sometimes hear.

Occasional stomach growling is entirely normal. In fact, if you have abdominal pain, doctors worry more when the gurgling is absent than when it is present. Hearing no bowel sounds in someone who has abdominal pain could be an indication of a serious condition that has signaled peristalsis in the gut to stop. Such conditions include an inflamed pancreas, inflammation of the lining of the abdomen, or a tear in the wall of the intestine.

Also, most people who come out of major surgery have exceptionally quiet digestive tracts. That’s because normal movement of the bowel wall temporarily stops after a major trauma such as surgery.

If you have a partial or complete intestinal blockage or obstruction, the intestines try to push fluid, gas and waste products past the blocked area. This can cause high-pitched sounds heard by the doctor through the stethoscope, but they may not be audible to you.

Finally, a noisy abdomen does not necessarily mean you are hungry. It’s simple: You’re hungry when you are actually feeling hungry, regardless of whether your stomach is growling.

(This column is an update of one that ran originally in September 2013.)