Diarrhea and Bubbling Abdominal Sounds

There are various sounds that emanate from the gastrointestinal tract. This is known as borborygmi and is a normal part of the abdominal sounds. It is caused by the movement of fluid and gas through the bowels in particular. Most of the times the majority of these sounds are not audible although the odd rumbling and gurgling can be heard even by others.

However, there are instances where overactivity of the bowels and excess gas and fluid can cause loud and recurrent abdominal sounds. Even in this instance it would not be considered unusual unless the sounds are accompanied by other symptoms, like diarrhea. Sometimes referred to as bubbling diarrhea, the combination of the watery stool and unusually loud and frequent abdominal sound often signals some underlying disease.

It is important to note that both diarrhea and bubbling abdominal sounds are common symptoms that occur together. In fact both diarrhea and bubbling sounds occur for similar reasons – overactivity of the bowel wall. The term diarrhea is often used loosely for any type of bowel habit abnormality where the stool is water. However, diarrhea specifically refers to passing stool more than three times a day where the stool is typically watery and of large volume.

Reasons for Bubbling and Diarrhea

In order to understand the excessive bubbling sound in the bowel, it is helpful to look at the mechanism of diarrhea. Both symptoms are due to similar processes. Diarrhea is largely a combination of :

• hyperactivity in the bowels with strong contractions or rapid ,
• excess water that is either not absorbed properly from the gut or dumped into the gut from the tissue spaces,
• inflammation of the bowel wall by microbes (infections) or toxins.

These factors will inadvertently lead to bowel sounds. Excessive gas in the intestines is a common occurrence with diarrhea and is an additional factor for bubbling in the bowels. A person suffering with diarrhea will often report  bubbling and gurgling sounds intensifying during a strong urge to pass stool. This arises with :

• excess water in the colon which normally is resorbed here but instead remains in the bowels in diarrhea.
• strong muscles contractions as the colon in preparation for a bowel movement as a result of of the defecation reflexes.

Although the focus has been on the bowels and the colon in particular, some conditions can cause strong muscle contractions higher up the gut, like in the stomach. Here the food or drink churning with the strong muscle contractions particularly with infections and toxins can cause loud stomach bubbling sounds.

Furthermore a person with certain conditions where diarrhea is present may have a lack of appetite or be unable to eat due to concomitant vomiting. An empty stomach in these instances may be the cause of loud bubbling sounds even if the stomach is unaffected by the condition causing diarrhea.

Video

The following video on diarrhea and bubbling sounds in the abdomen was produced by the Health Hype team.

Causes of Bubbling and Diarrhea

There is no single cause of bubbling abdominal noises and diarrhea, both of which are symptoms and not diseases on its own. Due to the mechanism of diarrhea and the conditions being set for bubbling, the causes of both symptoms can be broadly discussed under the causes of diarrhea. It is worth noting any additional symptoms because diarrhea and bubbling sounds are common to many diseases.

Infections

• Gastroenteritis is an acute infection of the upper gastrointestinal tract, namely the stomach and small intestine. Intense nausea and vomiting are often the first symptoms, even before the onset of diarrhea.
• Enteritis and enterocolitis (infectious) is inflammation of the small intestine, either on its own or simultaneously with the large intestines. Abdominal cramps are a common symptom.
• Colitis (infectious) is inflammation of the colon only. It is marked by watery and at time bloody diarrhea with very foul smelling stool.
• Diverticulitis is inflammation of the pouches (diverticula) mainly in the colon wall due to an infection. These pouches are more common in the elderly and tend to be asymptomatic until infected.

Non-infectious

• Inflammatory bowel disease (IBD) includes Crohn’s disease and ulcerative colitis. The gut wall is inflamed mainly due to autoimmune mechanisms. It is a chronic condition marked by acute symptoms with intense symptoms. Mucus and even blood in the stool are major factors.
• Antibiotic-associated diarrhea (AAD) is where the bowels becomes inflamed (mainly colitis) after the use of antibiotics. Certain bacteria establish itself once the normal bowel flora (“good” bacteria) is  disrupted by antibiotic use. These “bad” bacteria then secrete toxins which can colitis. A person with antibiotic associated diarrhea usually has a history of recent antibiotic use.
• Food poisoning is inflammation of the stomach and bowels from eating food contaminated with bacterial toxins. It is the toxins that cause the disease and not the bacteria damaging the bowel wall.  The term food poisoning is sometimes used to refer to food intoxication.
• Irritable bowel syndrome (IBS) is a functional bowel disorder of no known cause. Gut motility is altered and bowel transit time may be too slow (constipation-predominant IBS) or too fast (diarrhea-predominant IBS). It is a chronic condition that is worst in short periods of acute exacerbation. Bloating and abdominal discomfort usually accompany the abnormal bowel habit.
• Gallbladder disease including gallstones and gallbladder inflammation may affect the secretion of bile which is important for emulsifying fats. These fats may not be broken down fully by the fat-dissolving enzymes leading to malabsorption and diarrhea. The stool may be fatty (steatorrhea).

Food

• Food intolerance to certain foods like dairy (lactose intolerance), sorbitol, mannitol and wheat (gluten intolerance) may cause both diarrhea and bubbling in sensitive people. This condition occurs when the body is unable to digest certain nutrients due to a lack of specific digestive enzymes.
• Malabsorption is the inability to absorb certain foods mainly associated with deficient enzymes for metabolizing specific nutrients (like fructose) or with bowel disorders that affect the absorption capability of the bowel wall.

Other conditions

• Excessive alcohol consumption
• Poisoning
• Prescription and OTC medication
• Psychological stress
• Post-operative

References:

1. Diarrhea. Medscape

Last updated on August 9, 2018.