Normal bowel sounds vary considerably in intensity, pitch and frequency. Due to the wide range of physiological variation, the clinical significance of abdominal bowel sounds is limited. There is no clear evidence that very high-pitched bowel sounds have clinical pertinence. Small bowel obstruction is more commonly associated with hyperactive bowel sounds than with substantially diminished or absent bowel sounds. In 4-20% of young adults, systolic bruits are heard in the epigastric region that are not associated with abnormalities. There is no evidence that abdominal aortic aneurysms are associated with abdominal bruits. An abdominal bruit is indicative of renal artery stenosis when blood pressure control remains unsatisfactory, in particular when the bruit is also heard during diastole.