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Ask Dr. K: What your growling stomach is trying to tell you

DEAR DOCTOR K: Why does my stomach sometimes make growling noises?

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 happens all the time: I’m examining a patient, his or her stomach growls, and I say, “Time for lunch?” I assume it means the patient is hungry.

That’s an ancient belief. For centuries, people have associated stomach growling with hunger. But do these noises always mean you’re hungry? And could these growling noises ever be a sign of illness?

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 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. Often air and liquid are mixed up and rearranged by peristalsis. This causes the odd noises you sometimes hear. When a doctor puts a stethoscope on your abdomen, he or she can often hear the gurgling noises, even if they are not loud enough (at the moment) for you to hear. The gurgling noises are called borbyrygmi (bor-be-RIG-me).

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 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.

On rare occasions, a growling stomach may indicate illness. Your stomach may growl louder, or sound high-pitched or even “tinkling,” if there is an infection.

Growling sounds may also change if you have a partial or complete intestinal blockage or obstruction. What you’re hearing is your intestines trying to push fluid, gas and waste products past the trouble area. But if there’s obstruction, the patient is also typically bloated, has cramping pain and may be nauseated and vomiting.

Finally, a noisy abdomen does not necessarily mean you are hungry. A much more reliable sign is actually feeling hungry.

Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.

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