rumbling noises in intestines

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Posted by HFHS M.D.-RF on January 12, 1998 at 18:05:26:

In Reply to: rumbling noises in intestines posted by RB on January 11, 1998 at 19:57:47:

: I have IBS and I have been socially destroyed by embarassing, gasy, rumbling noises that seem to come from my intestines and colon.  I don't understand what causes this.  I do have terrible problems with gas and I'm not sure what I can do about that.  Simethicone tablets, such as gasX,
  haven't helped.  Any info would be greatly appreciated.
  Thank you  
___________________________________________
Dear RB,
Irritable Bowel Syndrome is a common condition.  Individuals can have a variety of symptoms including abdominal pain associated with defecation, constipation alternating with diarrhea, and abdominal noises (the medical term is BORBORYGMI).  
You are correct in your conclusion that the abdominal noises and gas are related.  Although Irritable Bowel Syndrome is a frequent cause of the gas and noise, there are other conditions that can cause these complaints.  Diet can influence the quantity of gas.  Individuals with lactose intolerance (an inability to digest the sugar in milk or soft cheeses) can have abdominal gas and borborygmi.  Also, many people can not handle the sugar load in soft drinks, even that of a single 8 oz can of soda.  Drinking soda can produce gas, bloating, and borborygmi.  Finally, foods such as cabbage and beans are universally recognized as causing problems such as the one that you describe.
A second frequent cause of abdominal gas is swallowed air.  This can occur in several ways.  Many people are mouth breathers and will swallow air.  People who talk when they eat will frequently swallow air.  Finally, if you drink with a straw you are likely to swallow air.
Initial therapy should be focused on modifications of life style.  Clearly, dietary manipulation should be a first step.  Lactaid or equivalent compounds can be tried if you are lactose intolerant.  If you are an “air swallower” you may consider being evaluated by an ear nose and throat specialist to exclude problems in your nose that could be contributing to the swallowed air.
Pharmacological treatment, including over the counter products, have variable success rates in the control of symptoms. There is no agent that can be recommended with any certainty of an acceptable response.  Anti gas agents such as simethicone and charcoal are the initial therapies.  Sometimes increasing the dosage will provide relief.  Librax, a combination of librium and an antispasmodic, works for some patients.  Prokinetic agents, e.g. Cisapride, are used for people with gas and bloating.  A beneficial effect is seen in some patients although the borborygmi may get worse.  Nevertheless you may want to discuss this option with your physician.
I assume from your letter that you have been evaluated by a physician.  As you are probably aware, there is no gold standard for the diagnosis of Irritable Bowel Syndrome.  This diagnosis is made after other possible causes for the gastrointestinal symptoms have been excluded.  If you have not had an evaluation, you should see your MD. If you are in the Detroit area and wish to be seen, please call [phone] and request an appointment with Dr. Fogel, one of our experts in the treatment of intestinal diseases.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question pertaining to your health.

I hope that this information will be helpful to you.
HFHS M.D.-RF
*keyword: irritable bowel syndrome, gas, abdominal pain