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Tue 29
Know which noises the body makes, and do they “mean”

Know which noises the body makes, and do they “mean”

The human body does not work silently. From top to bottom, it produces a wide variety of sounds

The human body does not work silently. From top to bottom, it produces a wide variety of sounds. Many of them are the natural consequence of a complex gear, which involves solids, liquids, and gases in constant motion. Such is the case of belching and flatulence, infamous and not very noble, but completely normal and expected. It would be problematic not to expel such gases.

Other noises are the result of the organism’s defense mechanisms. Whenever the body detects some sort of threatening invader, it reacts by trying to expel it. That is the case of sneezes, coughs, and hiccups. In most cases, these three are nothing but a manifestation with no further consequences – but they may also be a sign of an ailment that deserves attention.

There are also sounds whose very existence indicate that there is something wrong happening. Snoring, for instance, shouldn’t happen: it indicates a sleep disorder. Wheezing, for instance, is the tip of an iceberg: it indicates something is out of control in the respiratory system. In its base, there may lie an asthma or bronchitis crisis, for example.

Here are the origins and meaning of nine of the most common body noises:

Sneezing

Sneezing is a defense mechanism of the human being. When the organism detects the presence of a foreign body, or the existence of secretion in the airways (which happens during colds, for instance), it triggers a violent involuntary reaction to expel the threat or unblock the airways.

Sneezing will only be of medical concern when it happens continuously, one after the other, in large quantities. Under such circumstances, the cause of the phenomenon may be a disease. A doctor should be sought to identify it and treat it. The most common diagnoses are allergic rhinitis and allergic sinusitis. In some cases, it may involve an asthmatic crisis. The causing agents may be mites or pollen, for instance, and come from curtains, linings, carpets, and air conditioners. The doctor will test the patient for allergies and probably ask for image exams, such as tomography of the sinuses and the thorax, looking for signs of inflammatory or infectious processes. “The treatment may be medicamentous, or even surgical. For instance, if there is a nasal polyposis, a condition in which strange bodies are present in the nasal mucosa, surgery may be recommended,” says Kalil Moussalle.

Flatulence

Breaking wind is such an important act that evolution has granted human beings a structure in the anal orifice to discriminate between solids, liquids, or gases. Thanks to that, we are able to expel gases with the certainty that what’s coming out are indeed gases (except, naturally, in cases of diarrhea). A person in normal circumstances farts on average from 18 to 20 times a day.

Flatulence is a consequence of the process of fermentation of food residue in the intestine, done by bacteria. Gases are generated, and these gases must be expelled – otherwise, they would distend the intestine and cause pain.

The amount of expelled gas varies according to the diet (fibers are the big villain). Another factor which may mean more and fewer flatuses is the ability to accumulate gas. Some people have a sensible intestine, and even small amounts stimulate their elimination. Others can tolerate larger amounts, and relieve themselves at once when they go to the bathroom.

Despite being a natural phenomenon, unrelated to any pathology, many people usually go to a doctor because of flatuses, thinking it could a symptom of some diseases. “In these cases, the role of the doctor is putting the patient at ease about the normality of eliminating gases,” says Francesconi.

Belching

Just like flatuses, belches are also the expulsion of a gas inside the organism that needs to be eliminated. But there are some significant differences. The first concerns the origin of these gases. Whereas in the case of flatulence the gases are formed inside the intestine, in the case of belches they came from outside – from carbonated beverages, such as soft drinks, or from the air we swallowed. Another difference is that the gas that comes out when we break wind comes from the intestine, while the gas we burp was inside the stomach or the esophagus.

If it came from the esophagus, it was air that had been swallowed and got stuck there. The gas from carbonated drinks goes deeper into the organism, until the stomach, and then is expelled through the eructation. Gastroenterologist Carlos Francesconi explains that part of the gas from soft drinks and similar beverages may be absorbed by the stomach, enter the blood circulation, and is later eliminated by the lungs, through the respiration.

Why does someone get onion or garlic breath? Because it went into the circulation. The taste of onion and garlic does not remain in the mouth. Just as in the case of flatulence, eructation is a natural phenomenon. In rarer situations, a disorder may occur which causes the person to belch constantly, and that requires treatment.

Francesconi says that this situation may happen with people who swallow too much air, a condition usually related to anxiety, which, despite generating discomfort, is not a disease.

Snoring

Sleeping with someone who snores is a torment that can cause many divorces, and even documented cases of deafness. Usually, it is the woman who suffers: snoring is much more frequent among males, due to anatomical causes, such as the fat distribution pattern. But what is exactly a snore?

It is a noise that originates from the vibration of the structures in the oropharynx – palate, uvula, and tongue. That vibration happens when the air that is breathed moves with excessive speed due to a narrowing of the airways. The reasons may vary, but one of the most common is overweight. More fat in the neck, for example, may lead to a compression of the oropharynx. Alcohol may also cause snoring, since it relaxes the muscles of the area, causing it to vibrate more. There are also anatomical causes: a recessed chin, amygdalae, or an excessively large tongue, as well as the shape of the face.

Rizzo claims there are alternatives for all cases. If the problem is excessive weight, options range from physical activities, diets, or even bariatric surgery. If alcohol is the root of the problem, changes in the drinking habits may be a solution. If the tongue is too big, sleeping on one’s side may unblock the oropharynx.

Coughing

If you insert a cotton swab in your ear and poke it insistently, you will probably cough. That happens because there is a nerve ending there, which, when stimulated, causes the organism to interpret that there is a threat trying to enter the respiratory system. Under such circumstances, the body will react in such a way as to try to expel the irritating particle, generating a sudden change in intrathoracic pressure which will increase powerfully and noisily the air expelling speed. That is what coughing is.

As you can see, it is a primordial defense mechanism, similar to sneezing. Sneezing, however, is more associated with the superior airways, while coughing is more associated with the inferior airways: trachea, bronchia, lungs. José Miguel Chatkin, president of the Brazilian Pneumology Society, and a professor of pneumology at the PUCRS Medical School, says a doctor should be sought in cases of persistent coughing, for periods of more than one week, since in such cases it may be a symptom of a more serious condition.

One of Chatkin’s emphatic recommendation is not to use cough syrups, except in very specific medical conditions, since they numb the nerves associated with coughing, suppressing the defense mechanism. “Coughing is always a warning sign. One should never numb coughing.”

Hiccups

Hiccups are a spasmodic contraction of the diaphragm. It happens when some nerve ending of the phrenic nerve – which extends from the neck until the diaphragm – suffers some form of irritation.

“That nerve passes through a gorge, it must be free to it remains unhampered. If something there is not well, hiccups occur. Their function is showing that there is something wrong, like an inadequate functioning of the digestive tract,” explains pneumologist José Miguel Chatkin.

Hiccups almost always appear after the inhalation of colder air, or the ingestion of iced water, lasts only for a few minutes, and goes away spontaneously. To make it end quicker, one may hold the breath for some time, modifying internal pressure and temperatures, with some degree of efficacy.

In most cases, therefore, it’s nothing more than an inconvenient situation, and somewhat ridiculous, which usually causes laughter around the person involved. But there are some rarer cases in which hiccups demand medical attention. If it is persistent, it means there is a permanent condition causing it – there are many possibilities, such as an infection, or even a tumor in the area through which the phrenic nerve passes. “There are complicated situations, in which the hiccups last for a long time, and the patients must be hospitalized to be placed on anesthesia,” tells Chatkin.

The pneumologist suggests that a doctor should be sought when hiccups last for more than one day.

Wheezing

Pneumologist José Miguel Chatkin compares wheezing to the wind that through a gap in a window and whistles. “The air is coming at a speed and finds a narrow passage to pass through. That is precisely what happens when a person wheezes: the air is trying to come out, but there is a reduction of the bronchial or tracheal caliber, through which it was supposed to pass. And then it wheezes,” he says.

That noise, which can often be heard from afar, is always a reason for concern and requires medical attention. It indicates that the air that entered the body is finding it hard to come out, which may be due to the closing of the trachea, but usually is due to an inflammation of the bronchia. The most frequent causes are asthma and chronic bronchitis. Among people who smoke, it may be a case of a chronic obstructive pulmonary disease. The treatment involves the use of bronchodilators and anti-inflammatories.

Abdominal sounds

When the belly rumbles, we are quick to associate it with hunger. That is a correct association; abdominal or bowel sounds result from movements which happen in the digestive tract, especially after a fasting period. “People must understand that the digestive tract is not a straight tube. It is a hydraulic system, a hollow tube covered by muscles. It produces waves, because it pushes forward the content of the bowels, creating an eddy, a sound. After meals, these movements are more rhythmical, they happen at a certain frequency, so there’s no accumulation of liquids, everything is pushed forward at a slow pace. But when we fast, the body continues to create these waves to clean the organism, beginning at the stomach all the way to the large intestine, so we can hear the rumbling getting louder, since there is more accumulation of water and air. That doesn’t mean there is any disease or disorder,” explains gastroenterologist Carlos Francesconi, professor at UFRGS internal medicine department.

Bowel rumbling may be related to a medical issue in cases of intestinal infections, but in such cases the most relevant symptom is the pain. Francesconi says that the situation in which an abdominal noise should be a warning sign is when the so-called metallic sounds are detected – but in such cases these noises can only be heard with the use of a stethoscope.

Creaky joints

You move any of your joints – the ankle, knee, elbow, neck, any of them – and a loud creak can be heard. What is that? Should you be worried? Physiatrist and neurophysiologist Anthero Sarmento Ferreira explains that this phenomenon, technically known as crepitation, has two possibilities: one of them a normal phenomenon, and another that indicates a problem which requires treatment.

“The first case is a natural phenomenon, associated with the intra-articular gases we have. With the movement of the articular capsule, these gases get dislocated, causing a situation of vacuum, which then causes the sound. It is the same thing that happens when we intentionally crack our fingers. It has absolutely no relevance from a medical standpoint,” says Sarmento Ferreira.

Crepitation, however, may occur among some people as a consequence of the wear-and-tear of articular cartilages – in these contexts, the sound may come from the grinding of one bone against the other. Behind this cartilaginous wear-and-tear may lie pathologies such as arthrosis and osteoarthrosis.

That condition may require medications to regenerate the cartilage, as well as physical therapy. How can we identify a normal and benign creak from the other, associated with pathologies? The physiatrist says it is simple: if there is any pain along with the noise, we are talking about the second case. Limitation of movements is also a warning sign. “If the sound is associated with pain, there is an active inflammatory process, that joint has some sort of disease. If it is just the creaking sound, there is no reason to worry,” he says.

 

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