Diarrhea is a common symptom and not a disease on its own as is often thought. It occurs with a host of different diseases, mainly those conditions that affect the bowels. A number of different symptoms may accompany diarrhea such as abdominal pains or cramps, excessive flatulence, nausea and sometimes vomiting. One of the symptoms that may occur is bubbling in the bowels that may both be felt and heard.
Reasons for Bubbling Sounds with Diarrhea
Bowel sounds are a common and normal part of digestive physiology that occurs through the gut. It is due to movement of food and fluid with contractions that pushes food and waste through the gastrointestinal tract. These sounds are often heard after eating and when hungry. These sounds are medically referred to as borborygmi. It includes bubbling, growling or rumbling stomach noises.
However, in diarrhea these sounds like bubbling may be louder and more frequent than normal and the reason for this is linked to diarrhea itself. Firstly there is excess fluid in the bowels in diarrhea which causes the loose watery stool that is characteristic of diarrhea. Secondly there are strong and fast bowel contractions which moves the gastrointestinal contents rapidly through the gut.
This excess fluid combined with strong bowel contractions can lead to loud bubbling sounds that may be uncharacteristically louder and more frequent than normal. It is not uncommon for the bubbling to precede the urge to pass stool and persist while having a diarrheal bowel movement.
Another factor that may also contribute to these sounds with diarrhea is that the disturbance in the normal bowel bacteria may cause an overgrowth of certain bacterial species which may produce large amounts of gas as a byproduct. This may be accompanied by passage of the gas as flatulence and less frequently as belching.
Causes of Diarrhea and Bubbling Bowel
The causes of diarrhea and bubbling bowel sounds is not significantly different from acute causes of diarrhea in general. It is important to differentiate between diarrhea and frequent but normal bowel habit. Diarrhea is the passage of 200g/200mL of stool in a day or more than three bowel movements within a 24 hour period. Some people do pass stool more often than others in a day but this may not be considered abnormal.
Infections and Inflammation
- Gastroenteritis can be due to bacteria, viruses or fungi. It may be transmitted directly from person to person or through contaminated food and water. Viral gastroenteritis is commonly referred to as stomach flu. The infection is short lived usually lasting less than a week and resolving on its own in many instances without any treatment.
- Diverticulitis is an infection of the outpouchings of the large intestine known as diverticula. This condition is more common among older people but the pouches may not cause any symptoms until it is inflamed or infected. It may present similar to gastroenteritis with nausea, vomiting and fever.
- Proctitis is inflammation of the rectum that may be due to a host of causes including sexually transmitted infections. It usually presents with severe pain in the rectum and anus as well as with diarrhea.
- Antibiotic-associated diarrhea (AAD) is caused by disturbances of the bowel bacteria following the use of antibiotics. It is also known as pseudomembranous colitis. The diarrhea is usually very watery and may persist for days or weeks until the bowel bacteria is restored.
- Inflammatory bowel disease (IBD) is a condition where the bowel is inflamed due to autoimmune factors. Ulcers and other lesions form in the bowels and can extend higher up the gastrointestinal tract. There may also be blood and mucus in the stool.
- Food intolerance is commonly due to deficiencies of enzymes that are responsible for breaking down specific foods. Lactose intolerance is among the most common type of food intolerance. Symptoms like bloating, gas, nausea and diarrhea start up shortly after consuming the problem food.
- Food malabsorption is where the body cannot absorb certain substances. This may be seen with substances like fructose (fruit sugars) and sorbitol. The presence of these substances may draw water into the bowels, lead to a bacterial overgrowth and result in symptoms like excessive gas and diarrhea.
- Irritable bowel syndrome (IBS) is a functional bowel disorder that is believed to be associated with abnormally over- or underactive bowel contractions. It is only diagnosed when other similar bowel conditions have been excluded. It present with abdominal cramps or pain, constipation, diarrhea or a mix of both diarrhea and constipation.
- Gallbladder disease includes gallstones and gallbladder infections which may affect the outflow of bile into the small intestine. Bile helps to emulsify fats that are consumed in food. Without bile the fat remains in the bowels where it can lead to diarrhea.
A number of ingested substances can irritate, inflame and even damaged the bowel lining. Some of these substances may affect the nerves supplying the gut wall muscles which can hasten movement through the gastrointestinal tract. These substances may include:
- Alcohol excess
- Certain medication and supplements
- Toxic substances including heavy metals and pesticides
- Tobacco (chewing)
- Stimulants like excessive caffeine
Never stop prescription medication if it is suspected to be causing diarrhea or other symptoms. Speak to your doctor or pharmacist first and alternative medication may be prescribed.
- Psychological factors such as anxiety can also cause abnormal bowel habit due to increased stimulation of the nerves supplying the bowels.
- Overeating can sometimes lead to diarrhea especially when the foods consumed are spicy, very greasy or foods to which a person is not accustomed.
- Excessive use of laxatives is often done intentionally and may be a part of eating disorders as a person attempts to purge or lose weight.
- Cancer of the rectum and/or colon can also present with diarrhea and bleeding from the rectum. This may not be present in the early stages of the cancer.
WARNING: Large volume bloody diarrhea needs to be immediately assessed by a medical professional as it can lead to serious complications and death within a few hours.