Dear Doctor,

I normally experience a lot of rumbling sounds in my stomach. At times it is so loud that it makes me feel embarrassed whenever I imagine the people who sit next to me at the workplace hear the rumbling. What causes it?

Gift, Kacyiru

Dear Gift,

Rumbling or growling sounds are produced in the stomach due to peristaltic movements of the intestine. This occurs as muscular walls of the intestines squeeze, contract and propel the food forwards in the process of digestion. Rumbling sounds can be heard from one to several hours, after intake of food and also sometimes due to hunger. When one is hungry, neurochemicals in the brain send signal to the body, causing contraction of the muscles of gastro intestinal tract, manifesting as rumbling sounds.

Loud rumbling sound (borborygmi) can be normal as occurs after eating high fat food or taking a very heavy meal. Foods like fruits, beans, broccoli,whole grain products and cauliflower, among others, can cause this problem due to much flatulence. Sodas, carbonated drinks, ulcers in the stomach or intestine, food allergies, infection or inflammation of the alimentary system, diarrhoea, are other conditions which can cause loud rumbling sounds in the stomach. It may also occur due to use of laxatives.

Rarely loud growling sounds from the abdomen can be due to serious conditions like obstruction of the bowel, where there is hyper peristalsis before the site of obstruction. Bleeding from the intestinal tract can also cause loud rumbling sounds. It can also be a manifestation of low blood potassium.

Hernia, where part of some adjacent organ pushes through weak part of stomach lining, any tumor of stomach or intestine, can have loud rumbling sounds as manifestation.

The problem can be corrected by correcting the diet. One can try removing food substances like artichoke, beans and milk products, among others, from the diet and see the response. If removing an item improves the problem, then that should be avoided. It is good to avoid sodas and soft beverages.

If the rumbling continues, if there are associated other problems like diarrhoea, vomiting, burning abdominal pain, severe abdominal pain after food, then it is advisable to consult a doctor for diagnosis and treatment of underlying pathological condition.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital