Changes

=====Auscultation=====

=====Auscultation=====

Auscultation of the abdomen, usually performed in a four quadrant approach, can be a useful tool.  Auscultation of the ventral abdomen can also be useful in regions where sand impaction is common.  Increased gut sounds are not usually found with major changes, and may be indicative of spasmodic colic, or impending diarrhea. A decreased amount of sound, or no sound, may be suggestive of serious changes. Trapped gas, particularly in the caecum, can often be heard by "pinging", where a flick of the finger against the skin over the affected area causes a sharp sound audible through the stethoscope. This sound is sometimes compared to the ringing sound made by a rubber ball hitting a solid surface.

[[Auscultation]] of the abdomen for intestinal borborygmi, usually performed in a four quadrant approach, can be a useful tool.  Increased borborygmi are not usually associated with major changes, and may be indicative of spasmodic colic, or impending diarrhea. Increased borborygmi can be found early on in cases of enteritis, colitis and intestinal obstruction. Later in the progression of the disease there is decreased borborygmi due to the pain and inflammation associated with the gastrointestinal tract. Decreased borborygmi, or a sustained absence, may be suggestive of serious and potentially irreversible changes to the intestine.   Trapped gas (tympany), particularly in the caecum and colon, can often be heard as a high pitched "pinging" during concurrent auscultation and percussion of the right (caecal) and left (colonic) flanks. Auscultation of the ventral abdomen over a 5 minute period can also be useful in regions where sand impaction is common. Auscultation reveals a sound similar to that of an ocean wave in these patients.

===Rectal Examination===

===Rectal Examination===