Your doctor needs to discover what is causing your abdominal pain. Your pain could be due to indigestion, or it could be due to gall stones, hepatitis, irritable bowel syndrome (IBS), appendicitis, diverticulitis, pancreatitis as well as other possible causes.
Your doctor needs to discover what is causing your abdominal pain. Your pain could be due to indigestion, or it could be due to gall stones, hepatitis, irritable bowel syndrome (IBS), appendicitis, diverticulitis, pancreatitis as well as other possible causes. Once the physical examination is completed, your doctor may need more information which can only be derived from certain tests. The tests will be discussed below.
Tests: Diagnostic evaluation of abdominal pain
Urinalysis – The first test your doctor will ask you to do is to submit urine for a urinalysis and possibly a urine culture and sensitivity.
The urinalysis can screen for urinary tract infection, kidney infection, kidney stones, ketones (shows muscle breakdown), and glucose level may indicated diabetes mellitus. The urinalysis will also screen for blood in the urine. You may or may not see red tinged urine, if blood is present in the blood. If the urine doesn’t look red or pink, there could be occult blood in the urine, which means there aren’t enough red blood cells in the urine to color the urine.
A culture and sensitivity test can identify an organism causing an infection in the urinary tract, and it will test the organism’s sensitivity to certain types of antibiotics.
Blood tests – The doctor will likely order a CBC (complete blood count), pancreatic enzymes, liver enzymes.
The CBC will show if there is an elevated white blood cell count, which could be indicative of an inflammatory infection such as pancreatitis, appendicitis, colitis or diverticulitis.
Pancreatic enzymes will measure the amount of amylase and lipase in the blood. If you have pancreatitis, these enzymes should be elevated.
Elevated liver enzymes may indicate gall bladder disease, or fatty liver disease.
X-rays – The doctor may order a type of abdominal X-ray called a KUB. A KUB is an X-ray that shows the kidneys, ureters, and bladder. The KUB may also show other problems in the abdomen, such as an intestinal obstruction, or air in the abdominal cavity. If a person has a perforated ulcer in the stomach or gut, air could seep out into the abdominal cavity. The air bubbles may collect on the underside of the diaphragm; the air can be seen in a KUB X-ray. The KUB may also show if an individual has kidney stones.
Another type of X-ray is the barium X-ray. A barium X-ray can be done as an upper GI or a lower GI (gastrointestinal) X-ray. The upper GI is done by swallowing barium and an X-ray is taken. The lower GI is done with a barium enema and an X-ray is taken. These X-rays may be done with a moving X-ray in fluoroscopy.
Ultrasound – An abdominal ultrasound may also be done to evaluate the internal organs. If an individual has gall bladder disease, appendicitis, enflamed uterus, ovarian cysts, and other internal problems, an ultrasound may be able to identify the problem inside the abdomen and/or pelvis.
CT scan – Computerized tomography may also be done to visualize the internal organs within the abdominal cavity. A CT scan can also identify problems such as appendicitis, diverticulitis, and other problems in the abdomen.
If indicated, the doctor may order a special kind of CT scan (CTA scan) to evaluate the blood vessels supplying the internal organs. The computed tomography angiogram (CTA) scan is done by injecting a contrast medium into the blood stream. The CTA scan can determine if the internal organs are getting enough blood flow.
MRI scan – Magnetic resonance imaging scans use magnetic field and radio frequency to visualize the differences between the soft tissues of the body. When a nuclear contrast is used, this is called nuclear magnetic resonance imaging (NMRI). The doctor may choose the MRI or NMRI over the CT scan in some instances, because magnetic imaging often shows more detail than the CT scan.
There are many other diagnostic tests that a doctor might order to identify the cause of your abdominal pain. Sometimes, it is quite obvious what is causing the pain and discomfort you feel, and other times it may take lots of investigation to come to a definitive diagnosis. Tests, such as endoscopy, colonoscopy and capsule enteroscopy (a tiny camera in a pill that is swallowed) may need to be administered so that a diagnosis can be made.
Your doctor wants to help you to feel better. Your doctor may treat you for what seems to be the problem, and if you aren’t better within a week or so, you will be instructed to come back for further evaluation. Oftentimes, the body heals itself, but when it doesn’t, we look to our doctors to help us to get well and feel better.