Growling Stomach Causes, Symptoms, Treatment, Ayurveda Concept

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Stomach growling which also means bowel sounds refers to the noises made in the intestines (small and large). These sounds typically occur during digestion of food. The sounds are similar to the sounds of water moving through the pipes. Abdominal or bowel sounds usually occur normally. When the abdominal sounds are unusually loud or when they are absent they indicate an underlying disease / condition within the digestive system and is abnormal.

Stomach growling is known by different names. They all mean the same. They are –
Bowel sounds
Noisy abdomen / stomach noises
Borborygmi
Noisy tummy
Gurgling stomach
Read – Understanding Digestion Process From An Ayurveda View

How common is stomach growling?

Sounds in the stomach or gut may occur at any time and in any one. These are the sounds of peristalsis and are normal. Peristalsis is a series of wavy muscle contractions which mix food in the stomach with digestive juices and enable movement of food in the intestines. When this process is going on, the air and gases produced by digestion get squeezed and make noises in abdomen. It is a normal process experienced during digestion and is the body’s way of communicating the feeling of hunger.

Usually the growling of an empty stomach will be there for roughly 10-20 minutes until you fill your stomach with food again. It is common before eating i.e. when hungry.
Read – How To Know That Your Digestion System Is Working Fine?

Causes of growling stomach

Growling of the stomach most likely indicates movement of food, liquid, air or digestive juices through the intestines. Hunger is one of the most common reasons for growling of stomach.

Why are the sounds caused during hunger?

When one feels hungry, the brain produces hormone like substances. They activate the desire to eat food and then send signals to the stomach and intestines. Consequentially the muscles of the digestive system undergo contraction. These contractions cause abdominal sounds

As intestines start processing the food, the abdomen may start to growl. The gastrointestinal walls made up of the muscles contract to mix and squeeze the food passing through intestines enabling it to be digested. This is a physiological process and is called peristalsis. This happens to all of us. It is responsible for the rumbling sounds that we hear coming from our intestines after eating food. These sounds may be caused many hours after eating the food and even at night when trying to sleep.
Read – Indigestion Causes, Symptoms, Treatment

Why does the stomach growl in the absence of hunger?

As hunger is one of the main causes of stomach growling. This is considered as a normal phenomenon and is experienced by everyone. But the stomach can also growl when you are not hungry. In these conditions the stomach growling may be linked to the other underlying diseases.

Bowel noises are produced due to vigorous movements of the gut when the liquids and gases are shuffled inside the lumen of the intestine. This is also called borborygmi. These noises essentially don’t come from the stomach alone but might come from the entire digestive system which includes the small intestine and the colon.

Apart from being caused by hunger the stomach growling may also be caused from fright or anxiety. These noises are very common in IBS. Loud sounds may also be caused by gut disorders like Crohn’s Disease or Bowel Obstruction. These conditions apart from growling of the stomach are also associated with other symptoms such as severe pain in the abdomen etc. This demands immediate medical attention and one should immediately report to the doctor.

The other conditions associated with borborygmi (also the causes of growling of stomach / abdomen) include –
Diarrhea
Celiac disease
Intestinal blockage
IBS – Irritable Bowel Syndrome
Food allergies
Lactose intolerance

Also fructose rich foods and sorbitol – sweeteners (used in soft drinks and juices) might cause stomach growls.
Read – Benefits of Sweet Taste – Ayurveda Description, Effect On Body

Types of Abdominal sounds

Normal sounds
Hypoactive sounds
Hyperactive sounds

Normal sounds happen in all and are physiological.
Hypoactive (reduced) bowel sounds indicate slowed down intestinal activity.
Hyperactive bowel sounds relate to increased intestinal activity. These sounds are louder and are felt. These can occur after eating food or when you suffer from diarrhea.

Hypoactive and hyperactive bowel sounds are abnormal. When they occur occasionally they are normal. But when they occur frequently along with other abnormal symptoms they should be considered as abnormal and pathological. This calls for immediate medical attention.
Read – Symptoms Of Vata Dosha Increase And Imbalance – Vata Vruddhi Lakshana

Symptoms of growling of stomach

Increased abdominal sounds when accompanied with the below mentioned symptoms might indicate an underlying health issue.

• Excessive presence of gas in the abdomen (gaseous distension, bloat)
• Nausea
• Vomiting
• Fever
• Frequent diarrhea
• Blood in stools
• Constipation
• Fullness of abdomen
• Weight loss (unintentional, sudden)
• Heartburn which do not respond to any medicines / treatment

Hypo and hyperactive sounds of the abdomen are also suggestive of bowel and digestive issues and might not always indicate a bigger issue in the backdrop.
Read – Severe Bloating And Gas? Ayurvedic Herbal Home Remedies

Example
Paralytic ileus – caused when the nerves of the intestines are affected
Improper blood supply to the intestines due to the blockage of blood vessels supplying the intestines
Obstruction of bowel – caused by hernia, adhesions, tumor etc conditions

Other specific causes of reduced bowel sound (hypoactive)
Drugs – which slow your digestion and process of elimination in the intestines
Effect of general anesthesia
Abdominal surgery and its effect
Spinal anesthesia
Radiation therapy of the abdomen

Other specific causes of increased bowel sound (hyperactive)
Food allergies
Diarrhea
Bleeding from gastrointestinal tract
Crohn’s disease
Ulcerative colitis
Infectious enteritis

Occasional growling of stomach is often considered as a sign of a healthy digestive system.
Read – Ayurveda Ulcerative Colitis Diet Tips, Home Remedies

When to consult doctor?

If the abdominal sounds appear with other bothersome symptoms and seem abnormal you need to see your doctor immediately. After taking a thorough history doctor may examine your abdomen through auscultation. One or more of the below mentioned tests may be advised for ruling out other associated conditions –
CT scan
Endoscopy
Blood tests to rule out infection, inflammation or damage to the organs

Very loud high pitched sounds may be produced in case of bowel obstruction. These pains are not only heard and felt but also occur with pain in the belly, bloating and lack of bowel movement.

If you are diagnosed to have associated conditions or causal abdominal conditions like ulcerative colitis or Crohn’s disease your physician may prescribe medications for the same.
Read – Colitis In Ayurveda: Pathogenesis, Causes, Treatment, Diet

Medical emergencies associated with abdominal sounds
You may require hospitalization if bleeding, bowel damage or severe intestinal obstruction or any other signs of medical emergency are found. In many others intravenous fluids and rest to the intestines will ward off the symptoms. Other people will need surgical interventions.

Surgery will be needed if you have serious injury or infection to your intestines or if there is total intestinal obstruction.

Treatment, Preventive measures

There is no perfect way of diagnosing or treating borborygmi. This is because they occur every day and usually do not suggest any underlying concerns. If growling is caused by some underlying cause your doctor may refer you for getting certain essential investigations like endoscopy, blood tests etc done. The doctor may diagnose and treat your stomach growl properly following investigations. This also could involve planning a diet plan and increasing fluid intake.

Growling of the stomach generally does not require treatment. You should consider limiting intake of those foods which might produce more gas in your stomach if your abdominal sounds are accompanied by bloating and feeling as if gases are filled in your stomach. Such foods include –
Fruits including raisins, apples etc
Vegetables like cabbage, broccoli etc
Beans
Artificial sweeteners
Whole grain and bran products
Carbonated drinks
Dairy products especially if you have lactose intolerance

You also need to avoid the below mentioned to reduce collection of excessive air in your digestive tract –
Eating too quickly – you would swallow lot of air when you eat food in a hurry
Drinking liquids and juices using straw
Regularly chewing gum
Read – Home Remedy For Bloating And Gas Trouble Using Buttermilk

Natural remedies

• Drinking water – drink water slowly, at regular intervals throughout the day. Do not gulp water in large quantities. This can cause gurgling sounds in abdomen.
• Eat food slowly – one should chew food slowly and eat it. This can reduce the amount of air swallowed and prevent digestive distress.
• Limit sugars (fructose, sorbitol etc), alcohol and acidic foods.
• Limit citrus fruits and coffee.
• Keep away from alcohol.
• Find out your food intolerances. Avoid foods which cause symptoms of growling.
• Be physically active. Take a walk after your meals. This can speed up the rate at which your stomach empties its contents.
• Be calm – because the growling of the stomach can become more apparent in stressful situations.
  
  Avoid gas producing foods and drinks like –
• Beans
• Broccoli
• Cabbage
• Cauliflower
• Mushrooms
• Peas
• Onions
• Lentils
• Whole grains
• Brussels sprouts
• Beer
  Read – Importance Of Diet (Pathya) For Specific Diseases

Prognosis

In most people stomach growling is normal. Some complications might prove to be life-threatening in rare cases of growling stomach especially if the condition is left untreated. Intestinal obstructions are dangerous conditions and might become life-threatening. It is important to keep a track record of your abdomen and abdominal sounds and if any abnormal signs are found it is important to contact your doctor immediately so that the condition doesn’t progress to become worse. You need to remember that there might be a serious problem hidden in the backdrop of abdominal sounds.

Ayurveda Concept

Growling abdomen are often compared to a condition called as atopa which has been explained in Ayurveda treatises. Atopa is a vata disorder and is said to present itself in the form of ‘abnormal sounds in the abdomen’. Apart from this small piece of information we do not get a detailed explanation of atopa in Ayurveda texts. Even this definition is given by Master Chakrapani, the commentator of Charaka Samhita.

Atopa

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Atopa is considered as ‘gurgling sounds produced in the intestines’ since it matches with the definition of atopa given in Ayurveda.

The word Atopa has following meanings –
Gurgling sounds / noises in the intestines (caused due to movement of gases and fluids in the intestines)
Flatulence
Swelling / puffing
Read – Severe Bloating And Gas? Ayurvedic Herbal Home Remedies

Atopa definition 

Sounds like ‘gud gud’ produced from the abdomen are called atopa. Thus ‘atopa’ is a condition in which abnormal sounds are heard and perceived as coming from the abdomen.

Sounds of gases and liquids flowing through the intestines during their contractile peristalsis movements to propel the ingredients to the next part of the gut are quite common in all of us. These sounds are not regularly heard or felt. Therefore, this condition is normal. But when these sounds occur on a regular basis and frequently it should be considered as a pathological state. Atopa is a term limited to ‘abnormal sounds heard and felt in the intestines.
Read – Effects Of Forcible Stopping Of Fart, Remedies

Atopa in relation to Adhmana and Anaha

We do not find an elaborate explanation of atopa in Ayurveda treatises. But the word atopa is mentioned as a symptom of many diseases. The term atopa is often used along with similar conditions occurring in the abdomen i.e. adhmana which is a painful distension of abdomen and anaha which is an obstruction caused by ama or feces in stomach or colon respectively. It is also used in comparison with other conditions called udavarta caused due to abnormal movement of vata in upward direction.
Read: Adhmana and Pratyadhmana – Meaning, Treatment

Atopa is a symptom of Adhmana. Adhmana is correlated to generalised tympanitis or meteorism. But in atopa we do not find gaseous distension of abdomen or pain as found in adhmana. Similarly, there is no obstruction of feces or urine as found in anaha. These features differentiate atopa from adhmana and anaha. Though it has not been specifically mentioned anywhere it is assumed that atopa is caused due to aggravated vata. Anti-vata measures are found to relieve gurgling sounds of the abdomen effectively to a greater extent.
Read – Symptoms Of Vata Dosha Increase And Imbalance – Vata Vruddhi Lakshana

Sanskrit Verses

Treatment of Atopa

Anti-vata remedies – Since atopa is caused due to imbalance of vata in the gut and causes disturbance in free movement of gases and liquids and consequently causes abnormal sounds in the abdomen, vata should be balanced initially. Therefore, vata alleviating and propelling medicines, purgation with oils prepared with vata destroying herbs and herbal enemas should be included in the treatment of atopa. Vata balancing diet and lifestyle changes also should be included.

Atopa shall be treated on the lines of treating the below mentioned conditions
Adhmana
Anaha
Udavarta
Pakvashayagata Vata
Read – How To Balance Vata Dosha? Line Of Treatment And Reasoning

Modern correlation

Atopa can be correlated to –
Stomach Noises
Borborygmi
Noisy tummy
Gurgling stomach
Stomach growling
Click to Consult Dr Raghuram Y.S. MD (Ayu)