Gut Feelings: Insight Into Some Common Stomach Troubles.

“What does it mean if I have a chronically noisy stomach?”

This is something patients ask me all the time. Yet all of us have that noisy abdomen on occasion. And everyone’s baseline is a bit different: one person’s very noisy abdomen is another person’s normal belly sound.

In most cases, odd noises from your stomach are simply part of your normal digestive process. For example, if you’re in a fasting state and you’re hungry, something as simple as seeing images of food or smelling food may signal the stomach to start contracting in anticipation of eating.

Also, your body has a process called the migrating motor complex that occurs every hour or so. It basically sends a shockwave down the digestive tract to keep digested material moving along, and this can likewise create unusual noises.

What’s making your stomach rumble?

Typically, it’s food moving through a “choke point” or sphincter. For example, noises you hear may be caused by food traveling from the stomach through the pylorus, the opening into the small intestine. Or they may be caused by contents moving from your small intestine through the valve that separates it from the large intestine (the colon).

As these muscles contract, they push food products or liquids through your digestive tract, producing small whooshing or gurgling sounds. Most of the time, this is totally normal, provided there are no associated symptoms, like significant abdominal pain, nausea, or vomiting. In those cases, further investigation is warranted.

Why the abdomen may be bloated or distended

Several factors can lead to abdominal bloat. For many people, an overproduction of gas can be created by gut microbia breaking down the food we eat. However, bloating and distension could also be caused by an obstruction, or by a region of your digestive tract where contents pass through more slowly and may begin to back up.

In addition, some people suffer from irritable bowel disease, which is hypothesized to be caused by low levels of inflammation in the digestive tract or by gut hypersensitivity. Here, the amount of gas or distension may spur symptoms of severe pain in the affected person. This type of hypersensitivity is the result of many factors occurring in the peripheral or central nervous system and can also be a factor in the development of a spastic colon, also a possible cause of irritable bowel syndrome (IBS).

Leaky gut syndrome: real or myth?

Leaky gut, or increased intestinal permeability, is a digestive condition in which toxins and bacteria may start to seep—or “leak”—through the intestinal wall. Although not historically considered a true condition, there is much conversation in the medical community concerning leaky gut.  Is it just one of several types of inflammatory conditions? Does it occur when intestinal inflammation interrupts normal cell function there? Is it caused by a restricted blood supply, or ischemia? Is it genetic? Is it related to diet?

One thing we know for certain: diet plays a role in cancers of the gastrointestinal (GI) tract. Certain foods lead to chronic inflammation in various parts of the GI tract and, over time, can lead to cancer formation. We’re also beginning to see that genetics has a more significant impact on the disease process than previously thought. But eating a diet of fresh fruits and vegetables and high fiber and increasing hydration—rather than smoking and consuming processed foods, red meat and alcohol—may help prevent a leaky gut, or at least encourage a less inflamed one.

When it’s time to seek attention via telehealth

If you’ve had an upset stomach for three or four days, you may have picked up a bug. But symptoms lasting for weeks or months might signify something more serious. A recurring or long-term issue calls for a deeper look by a gastroenterologist.

In most cases, it’s something relatively common and treatable, such as a functional GI disorder or IBS. Also, certain medications can provoke GI issues—for example, iron supplements or non-steroidal anti-inflammatory drugs like naproxen and ibuprofen. So be prepared to discuss not just your symptoms but your medications with your specialist.

At MedStar Washington Hospital Center, you can consult a gastroenterologist quickly and easily via a telehealth visit. In an effective video call, we can tell a lot by how someone looks, their skin color and their movements. The patient’s responses to our questions often enable us to begin determining the severity of their condition.

Video is also useful to help the patient identify where pain is located. For example, if you indicate the upper right quadrant of your abdomen, we know that’s where the liver, gallbladder and bile ducts are. That could be a starting point to determining next steps in testing or treatment.

Another example is appendicitis. Initially, the pain is mid-abdomen, near the belly button. As the infection worsens, pain shifts to the lower right quadrant. Understanding how the pain is migrating can often help us deliver a diagnosis quickly.

When it’s time to seek attention on-site

For serious symptoms, we recommend you call the Hospital Center and let us determine if you should seek immediate medical attention on-site here. These symptoms might include severe pain that impacts your day, persistent diarrhea or constipation, blood in your stools, vomiting blood, significant weight loss, or marked loss of appetite. All these indicators call for quick attention and a deeper dive into their cause.

Patients with conditions of the digestive tract often endure them for years before their conditions are accurately identified. At the Hospital Center, our nationally recognized gastroenterologists can diagnose your condition, provide effective treatments and therapies, and help to restore your gut health, which has a positive effect on your overall health as well. Whether your concern is large or small, we are happy to provide a consultation.