Bowel sounds in shock

#KYJ Bowel sounds.

Understanding bowel sounds in a trauma patient does not need to be a complicated process that is difficult to interpret. 

Here is the thing, smooth muscles lining the intestines require a healthy blood flow to continue peristalsis (movement).  When well perfused, the bowel rhythmically contracts to move food chyme through the digestive system.  As it does, the movement is heard using the diaphragm of a stethoscope in all four quadrants of the abdomen.  These sounds of squelching, are called bowel sounds.

In trauma or sick medical/surgical patients, shock may reduce bowel sounds through a simple process of redistribution of blood volume to more vital organs.  When this happens, peristalsis ceases, thus bowel sounds stop being heard.

So let's apply the typical assessment of a patient in shock. As blood loss worsens, the vascular system starts shutting blood flow to non critical  organs .

First is skin (pale, cold and clammy skin is the symptom)

Next is the gut. Poor gut perfusion ceases gut peristalsis and subsequent bowel sounds.

Loss of bowel sounds is not necessarily a gut pathology, but most commonly a significant indicator of shock.