Stomach rumbling, the sound produced when the stomach and intestines contract to mix, grind, and transport food, fluid, and gas within the digestive tract, is usually a normal physiological phenomenon. Most people experience it. You do not need to worry if rumbling occurs without other symptoms.

Even when you are not eating, the stomach and intestines operate in cycles to clear residual food and prepare for the next meal. This is why stomach rumbling is often more noticeable when hungry, as an empty stomach contracts strongly. After a meal, increased intestinal peristalsis for digestion and food absorption also creates sounds in the abdomen.

Certain habits can increase gas in the digestive tract, leading to more rumbling. These include eating too quickly, talking while eating, consuming many carbonated drinks, or eating gas-producing foods like beans, cabbage, cauliflower, and onions. Anxiety or stress can also stimulate intestinal motility via the gut-brain axis, creating more pronounced sounds.

However, if rumbling occurs continuously for many weeks, along with abdominal pain, belching, and impacts daily life, it may indicate digestive disorders or illnesses.

Doctor Khiem examines and advises a patient. Illustration: Tam Anh General Hospital

One common cause is irritable bowel syndrome (IBS). IBS symptoms include recurrent abdominal pain, bloating, stomach rumbling, diarrhea, constipation, or alternating between the two. Patients often experience worsened bowel movements after eating or during stress.

Another factor is lactase enzyme deficiency. When the body lacks this enzyme, lactose sugar in milk is not fully digested and ferments by gut bacteria. This produces a lot of gas, leading to stomach rumbling, bloating, abdominal cramps, and diarrhea. An imbalance in gut microbiota after antibiotic use or gastrointestinal infections can also cause increased gas production, altered intestinal motility, and prolonged stomach rumbling.

This symptom also occurs due to chronic enteritis (Crohn's disease or ulcerative colitis), Celiac disease, intestinal stricture syndrome, polyps, or gastrointestinal cancer. These conditions are less common but often come with other warning signs such as weight loss, anemia, bloody stools, or prolonged changes in bowel habits.

Seek immediate medical attention if stomach rumbling is accompanied by severe abdominal pain, rapid abdominal distension, and inability to pass gas or stool. These are often signs of bowel obstruction or partial bowel obstruction – a surgical emergency that can lead to intestinal ischemia, intestinal necrosis, and infection.

To determine the cause, a doctor may order various tests: blood tests, stool tests, abdominal ultrasound, or gastroscopy. If a more complex condition is suspected, the doctor may recommend an abdominal CT scan or other specialized tests.

If stomach rumbling is physiological, adjusting your lifestyle can help. Eat on time, avoid prolonged fasting, eat slowly, chew thoroughly, and limit talking while eating. Reduce carbonated drinks, alcohol, and fatty foods. Regular exercise, sufficient sleep, and stress management contribute to a more stable digestive system.

You should not self-medicate with anti-flatulence drugs, anti-diarrhea medication, antibiotics, or digestive enzymes without a doctor's prescription.

Master of Science, Doctor Pham Khac Khiem

Department of Gastroenterology, Hepatology, and Pancreatology

Tam Anh General Hospital, Hanoi