Auscultating bowel sounds is an important aspect of physical assessment as it provides valuable information about the function of the gastrointestinal tract. Bowel sounds are a normal occurrence in the abdomen and can be heard using a stethoscope. In this article, we will discuss the steps involved in auscultating bowel sounds and what sounds to look out for.
Preparing for Auscultation
Before auscultating bowel sounds, it is important to prepare the patient and the environment. The following steps should be followed:
- Have the patient lie flat on their back with their shirt lifted to expose the abdomen.
- Ensure that the patient has an empty bladder and has not eaten for at least two hours.
- Ensure a quiet environment and eliminate any background noise that may interfere with hearing bowel sounds.
- Warm the stethoscope by rubbing it in your hands, this helps to prevent any discomfort or chills for the patient.
Locating the Bowel Sounds
The bowel consists of several different sections including the small intestine, large intestine, and rectum. To identify the location of bowel sounds, the abdomen is divided into four sections:
- Right Upper Quadrant (RUQ)
- Left Upper Quadrant (LUQ)
- Right Lower Quadrant (RLQ)
- Left Lower Quadrant (LLQ)
The stethoscope is then placed on each quadrant of the abdomen to listen for bowel sounds. The sounds can vary in intensity, pitch, and frequency. Generally, the sounds are higher pitched and more frequent in the small intestine and lower pitched and less frequent in the large intestine.
Interpreting Bowel Sounds
Bowel sounds can vary from person to person and can be influenced by various factors such as food intake, medications, and illness. The following are examples of what normal and abnormal bowel sounds sound like:
Normal Bowel Sounds
| Sound | Description |
| Borborygmi | Rumbling and gurgling sounds that are heard most commonly in the small intestine. |
| Clicks and Gurgles | Occasional clicks and gurgles that can be heard throughout the abdomen. |
Abnormal Bowel Sounds
| Sound | Description |
| Hyperactive Bowel Sounds | Increased frequency and loudness of bowel sounds heard in one or more quadrants. This can indicate bowel obstruction, inflammation, or infection. |
| Hypoactive Bowel Sounds | Decreased or absent bowel sounds heard in one or more quadrants. This can indicate a decrease in bowel motility or ileus. |
| High-Pitched Bowel Sounds | Bowel sounds that are higher pitched than normal. This can indicate bowel obstruction, ileus or early intestinal obstruction. |
| Low-Pitched Bowel Sounds | Bowel sounds that are lower pitched than normal. This can indicate inflammation or peritonitis. |
| Continuous Bowel Sounds | Bowel sounds that are heard continuously. This can indicate a mechanical bowel obstruction or paralytic ileus. |
| Altered Bowel Sounds | Bowel sounds that are altered in pitch or quality. This can indicate an underlying GI disorder or disease. |
Documentation
It is important to document the bowel sounds heard during auscultation. The documentation should include the location heard, frequency, intensity, and if the sounds were normal or abnormal. Any abnormal sounds should also be documented in detail, including the characteristics and location heard. This documentation can assist healthcare providers in diagnosing and treating any underlying GI disorders or diseases.
Conclusion
Auscultating bowel sounds is an important part of assessing the function of the gastrointestinal tract. Normal bowel sounds sound like borborygmi and occasional clicks and gurgles, while abnormal bowel sounds can indicate underlying GI disorders or diseases. By following the proper steps in preparing for auscultation and accurately documenting the bowel sounds heard, healthcare providers can provide the best possible care to their patients.
Common Questions and Answers Related to Bowel Sounds
- How often should bowel sounds be auscultated?
- What is the significance of hypoactive bowel sounds?
- What causes hyperactive bowel sounds?
- Can medications affect bowel sounds?
- Are there any risks associated with auscultating bowel sounds?
Bowel sounds should be auscultated during a physical exam. The frequency of the physical exam is determined by the patient’s condition and risk factors for GI disorders and diseases.
Hypoactive bowel sounds can indicate a decrease in bowel motility or ileus. This can lead to a buildup of gas and stool and can cause discomfort and distension. Healthcare providers may recommend medications, such as laxatives, to increase bowel motility and prevent complications.
Hyperactive bowel sounds can indicate bowel obstruction, inflammation or infection. The underlying cause should be identified and treated to prevent complications.
Yes, certain medications can affect bowel sounds. For example, opioids can decrease bowel motility and cause hypoactive bowel sounds. Healthcare providers should be aware of any medications the patient is taking when auscultating bowel sounds.
Auscultating bowel sounds is a non-invasive procedure and is considered safe. However, if a healthcare provider suspects an underlying GI disorder or disease, additional testing may be necessary. In some cases, invasive procedures may be required.
References:
- Seidel, H. M., Ball, J. W., Dains, J. E., & Flynn, J. A. (2018). Mosby’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier.
- Sommers, M. S. (2007). Auscultating bowel sounds. Journal of Wound, Ostomy, and Continence Nursing, 34(2), 177-179.
- Royal Children’s Hospital Melbourne. (2018). Bowel sounds, auscultation. Retrieved from https://www.rch.org.au/clinicalguide/guideline_index/Bowel_sounds_auscultation/