Describe the normal peristaltic sound :
- Place the stethoscope on one side of the abdominal wall and keep it there minimally for one minute
- until the bowel sounds are heard.
- Usually the stethoscope is placed just to the right of the umbilicus.
- Normal bowel sounds are intermittent low or medium-pitched gurgles mixed with occasional high-pitched tinkle.
Bowel sounds are increased in the following situations
- In mechanical intestinal obstruction—Frequent loud low-pitched gurgles (borborygmi) are heard,often interspersed with high-pitched tinkles occuring in a rhythmic pattern with peristalsis. As a whole, the peristaltic sounds are exaggerated.
- Increased bowel sounds with colicky pain is pathognomonic of small bowel obstruction,in between colicky pain, bowel is quiet and no sounds are audible.
- Malabsorption
- Severe GI bleeding
- Carcinoid syndrome.
- Paralytic ileus
- Peritonitis.
