Common Tests Used to Diagnose Abdominal Pain

Abdominal pain is a common medical problem. Its severity ranges from annoying to life-threatening. Abdominal complaints may be as simple as an upset tummy from overeating or as complex as needing emergency surgery to remove an oxygen-starved part of the intestine.

While abdominal pain is common, each case is unique. Your symptoms and health history will determine what tests you need to find out what's causing your pain.

This article explains some of the most common tests used to find the source of abdominal pain. It also explains when to seek medical care.

A woman with her hands on her stomach which experiencing cramps
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Acute vs. Chronic Abdominal Pain

An acute illness is one that starts suddenly. The pain is often severe right from the start. One example: appendicitis. An infection in the appendix makes it swell and become more and more painful.

An acute illness may come one quickly, but it can go on for weeks or even months. For example, a broken leg is an acute problem, but the leg may hurt for a long time.

A chronic illness is one that lasts six months or longer. Chronic pain often stems from an ongoing problem that can't be cured, such as cirrhosis of the liver.

History Taking

If you are have abdominal pain, don’t be surprised if your healthcare provider asks a lot of questions. Finding out the history of the illness, as well as your medical history, helps narrow down the potential causes.

For example, a patient who has been drinking heavily for decades will be more likely to have a liver problem. A woman of childbearing age who is sexually active and not using birth control could have a pregnancy complication.

Some of the questions may seem personal. Do your best to answer them clearly, because your answers may influence which tests you have.

Physical Exam

One of the best ways to diagnose this kind of pain is a physical examination of the abdomen performed by a trained clinician. The standard physical exam is done in the following order:

  • Inspection: Your doctor will look at your abdomen for any external clues about the problem. Bruises, scars, and other marks on the skin can help suggest potential problems.
  • Auscultation: Your doctor will listen to different areas of your abdomen with a stethoscope. The sounds your intestines make—or don’t make—can help rule different problems in or out.
  • Percussion: The clinician will tap on different areas of the abdomen. This process can help determine organ size without an X-ray or imaging studies.
  • Palpation: Your doctor will press gently on different areas to see if they're painful or tender. This narrows down the area of concern to help with diagnosis.

For example, if the pain is mostly in your right lower abdomen, also known as the right lower quadrant, the appendix might be the cause of the pain. If the left upper quadrant hurts after a serious car accident, the cause of pain could be the spleen.

Pelvic exams

Pelvic exams involve checking reproductive organs, including:

  • Vulva
  • Vagina
  • Cervix
  • Uterus
  • Fallopian tubes

A healthcare professional will check for signs of infection, irritation, cysts, or other growths that could be causing pain. The exam could also include collecting cells with a swab or small brush.

Rectal exams

The digital rectal exam (DRE) is a test where a healthcare professional inserts a gloved and lubricated finger in the rectum.

They are checking rectal tone, which is the strength of the muscle that closes the anus. They will also look for obvious blood or growths in the rectum. This exam is also used to check the prostate gland, which sits between the penis and bladder.

In some cases, a healthcare provider may take a small stool sample is often during the rectal exam. The sample can be analyzed in an occult stool test. This exam can also be used to find out if you have constipation. If so, the stool will feel small or hard.

Lab Tests

One way to diagnose a health problem is to analyze substances in your body. This may mean drawing blood, taking a stool sample, or collecting a sample of saliva, among other options. Blood tests and urine tests are among the most common tests for abdominal pain. Depending on the results, you may need further tests.

Complete Blood Count

A complete blood count (CBC) is a blood test that can help detect an infection in the body. When you have an infection, your body increases certain types of blood cells.

If you have an infection, a culture and sensitivity lab test can identify the infection so your healthcare provider can decide on the best treatment.

Liver Enzymes/Hepatic Function Test

A liver enzyme test shows whether the liver is working as it should. Other liver tests indicate whether the liver is removing enough harmful toxins from the body.

The liver can be damaged in many ways. If you take too much of certain medications, drink too much alcohol, or have a health condition affecting your liver, you may have abdominal pain.

Urinalysis

This test looks at the urine to see if there is blood or infection in the urinary tract. A urinary tract infection (UTI) can cause pain in any of these body parts:

  • Kidneys
  • Ureters
  • Bladder
  • Urethra
  • Back
  • Abdomen
  • Pelvis

Amylase and Lipase

These blood tests look at enzyme levels produced by the pancreas. Higher levels may be a sign of an infection or inflammation in the pancreas called pancreatitis. This condition is extremely painful and can lead to hospitalization.

Occult Stool/Hemoccult Test

This test checks for blood in the stool, which isn't considered normal. You can't always see blood in the stool with the naked eye. If blood is there but you can't see it, you may have a problem in your upper digestive tract.

Pregnancy Test

If you are of childbearing years and you have abdominal pain, a pregnancy test might be a good starting place. A positive pregnancy test can explain many symptoms. For example, pain could be a sign of an ectopic pregnancy.

Recap

Lab tests give healthcare professionals an idea of how the body is functioning. By looking at samples of your blood, urine, stool, and enzymes, they can identify disorders that may be causing your pain.

Imaging Studies

Imaging tests are studies that produce a "picture" of part of your body. These tests can be helpful in finding the cause of abdominal pain.

Computed Tomography Scan

The computed tomography imaging study (CT scan, often pronounced "cat scan") looks at the inside of the human body without having to go inside or even touch the body. This scan uses many x-ray type images to create a picture of the inside of the body. A radiologist can "read" the picture.

Sometimes these scans involve the use of special dyes called contrasts. They can highlight the details of the images. But contrasts aren't safe for everyone. People with kidney conditions may not do well with contrasts.

Magnetic Resonance Imaging

Magnetic resonance imaging (MR) uses magnetic fields to produce images of the inside of the body. Like the CT scan, it allows images of the body to be made without touching the body directly.

An MRI isn't safe for people with certain types of metal in their body. The test uses strong magnets that can harm patients with some implants. Contrast may be used to enhance the images if the kidneys are healthy.

Upper Endoscopy

Known as an upper GI, this test is used to inspect the upper digestive tract from the inside.

A healthcare provider inserts a lighted endoscope with a camera into the mouth. The camera allows a trained physician to view the inside of the esophagus, stomach, and duodenum (the first part of the small intestine).

This test checks for signs of acid reflux or stomach ulcers. You'll have anesthesia and will be sedated throughout the exam.

Colonoscopy

This test allows a physician to inspect the inside of the colon (large intestine) with an instrument that has both a light and a camera. Images appear on a monitor.

During this test, a trained physician checks the large intestine for sources of pain or bleeding. They may also take tissue samples and perform other minor procedures. This test requires anesthesia so that you can sleep through it.

X-Ray of the Kidneys, Ureter, and Bladder (KUB)

If you're having abdominal pain, an X-ray can be used to find the cause. Common locations include:

  • Kidneys
  • Ureters
  • Bladder
  • Intestines
  • Spine
  • Bones of the pelvis

This test can make it clear whether gas, constipation, or kidney stones are causing you pain.

Ultrasound

Most people are familiar with how ultrasounds are used in pregnancy. They show images of the fetus and can be used to find out its sex. The test can also be used to find the source of abdominal pain.

The test uses sound waves to create images of the inside of the human body. The sound waves are too high for the human ear to hear. An ultrasound can often detect problems with the gallbladder and kidneys.

Recap

Imaging tests use magnetic fields, x-rays, or sound waves to create detailed pictures of the inside of your abdomen. They can highlight places where blockages, growths, ulcers, or other problems are located.

Summary

Because so many health conditions can cause abdominal pain, you may need tests to identify the problem. The process will likely start with a medical history and physical exam. After that, you may need lab tests of your blood, urine, feces, and enzymes. Imaging tests can also help doctors spot abnormalities in your abdomen. Together, these tests can help your healthcare team arrive at the right diagnosis so you can make a treatment plan.

Frequently Asked Questions

  • What tests are used to diagnose appendicitis?

    Your doctor will start with a physical exam. Imaging tests used may include a CT scan or an ultrasound. Blood tests cannot confirm a diagnosis, but they may be used to check for infection.

  • How do I tell if I have a stomach virus?

    Doctors often diagnose viral gastroenteritis based on symptoms. They don’t usually need to run labs or tests. In some cases, doctors may do stool tests to rule out other gastrointestinal diseases, such as ulcerative colitis.

  • Why do I still have abdominal pain if the CT scan is normal?

    CT scans cannot always find the cause of pain. If the image is focused on the wrong area, it'll miss the source of the problem. Blood counts, stool samples, and other tests may be needed to find the cause of the pain.

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5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Ismail OZ, Bhayana V. Lipase or amylase for the diagnosis of acute pancreatitis?. Clin Biochem. 2017;50(18):1275-1280. doi:10.1016/j.clinbiochem.2017.07.003

  2. The American College of Obstetricians and Gynecologists. Ectopic Pregnancy.

  3. National Institutes of Diabetes, Digestive, and Kidney Diseases. Diagnosis of appendicitis.

  4. National Institutes of Diabetes, Digestive, and Kidney Diseases. Diagnosis of viral gastroenteritis.

  5. Mendelson R. Diagnostic tests: Imaging for chronic abdominal pain in adults. Aust Prescr. 2015;38(2):49-54. doi:10.18773%2Faustprescr.2015.019

Additional Reading
  • Mendelson R. Imaging for chronic abdominal pain in adultsAust Prescr. 2015;38(2):49-54. doi:10.18773/austprescr.2015.019

  • A Practical Guide to Clinical Medicine. Exam of the Abdomen. University of California San Diego.