Causes of Borborygmi
Borborygmi are primarily caused by the movement of gas and fluid through the intestines, and can be associated with various gastrointestinal conditions including irritable bowel syndrome (IBS), dumping syndrome, and normal digestive processes. 1
Normal Physiological Causes
- Normal intestinal peristalsis causing movement of gas and fluid through the intestines 1
- Regular digestive processes, especially during hunger or after meals 1
- Increased intestinal motility due to hunger 2
Pathological Causes
Functional Gastrointestinal Disorders
- Irritable Bowel Syndrome (IBS) - borborygmi commonly occur with abdominal pain, distension, and altered stool consistency 1, 3
- Functional dyspepsia - may present with borborygmi along with epigastric pain 3
- Increased intestinal sensitivity to normal gas movement 1
Post-Surgical Conditions
- Dumping syndrome - particularly early dumping syndrome occurring within the first hour after meals in patients who have undergone gastric or esophageal surgery 1
- Post-bariatric surgery complications - occurs in up to 40% of patients after Roux-en-Y gastric bypass or sleeve gastrectomy 1
- Post-esophagectomy - affects up to 50% of patients 1
- Low Anterior Resection Syndrome (LARS) - after rectal surgery 1
Malabsorption Disorders
- Lactose intolerance - characterized by borborygmi, abdominal pain, distension, flatus, and diarrhea after consuming dairy products 4
- FODMAP intolerance - fermentable oligosaccharides, disaccharides, monosaccharides, and polyols causing increased gas production 4
- Short bowel syndrome - particularly with high output stomas or fistulas 1
- Bile acid malabsorption - especially after ileal resection 1
Infectious Causes
- Gastroenteritis - viral or bacterial infections of the gastrointestinal tract 1
- Intestinal parasites - such as Capillaria philippinensis, which can cause chronic diarrhea with borborygmi 5
Anatomical Abnormalities
- Intestinal obstruction - partial obstruction can cause increased borborygmi 1
- Positional compression of the stomach or intestines - rare cases where anatomical positioning causes increased bowel sounds 6
- Malrotation with or without volvulus - particularly in infants 1
Other Medical Conditions
- Hyperthyroidism - can increase intestinal motility 1
- Guillain-Barré Syndrome - may have preceding gastrointestinal symptoms including borborygmi 1, 7
- Gastroesophageal reflux disease (GERD) - may present with borborygmi among other symptoms 8
Social Impact and Quality of Life Considerations
- Borborygmi can cause significant social embarrassment and restriction of activities 1
- May lead to avoidance of social situations, particularly those involving food 1
- Can impact quality of life when associated with other symptoms like pain, bloating, or altered bowel habits 1
Diagnostic Approach
- Clinical history focusing on associated symptoms (pain, altered bowel habits, bloating) 1
- Dietary history to identify potential triggers (lactose, FODMAPs, etc.) 1, 4
- Physical examination to rule out other causes of abdominal symptoms 1
- Consideration of diagnostic tests based on associated symptoms and suspected underlying cause 1
When borborygmi are persistent, bothersome, and associated with other symptoms, they should be evaluated in the context of the complete symptom profile to identify the underlying cause and guide appropriate management.