Hyperactive bowel sounds are most often seen in mechanical intestinal obstruction. In patients with mechanical intestinal obstruction, a high-pitched metallic sound can be heard on auscultation of the abdomen, which is a characteristic feature of the physical examination of intestinal obstruction. In addition, diarrhoea, intestinal foreign bodies, intestinal polyps and, in paediatric patients, congenital small bowel obstruction can also cause hyperactive bowel sounds.