Abdominal Pain Evaluation
Abdominal pain can have many causes. Our primary care physicians evaluate your symptoms, perform an appropriate examination, and coordinate testing, treatment or specialist care when needed.
How We Evaluate Abdominal Pain
Abdominal pain can come from many different organs and conditions. Evaluation begins with understanding where the pain is located, how it started, which symptoms occur with it, and whether urgent care is needed.
Symptom History
Your physician will ask where the pain is located, when it started, whether it is constant or intermittent, and what makes it better or worse.
Focused Examination
The visit may include checking vital signs and examining the abdomen for tenderness, swelling, guarding, bowel sounds, or other important findings.
Testing When Needed
Depending on the symptoms and examination, your physician may order laboratory work, urinalysis, imaging, or other appropriate testing.
Treatment or Referral
The plan may include treatment for a common condition, follow-up testing, emergency evaluation, or referral to the appropriate specialist.
Tests or Orders That May Be Considered
Testing is selected according to your symptoms, medical history, and examination. Not every patient requires every test.
- Blood work sent to an outside laboratory
- Urinalysis when urinary symptoms are present
- Pregnancy testing when clinically appropriate
- Stool testing in selected cases
- Abdominal or pelvic ultrasound orders
- X-ray orders when appropriate
- CT or MRI orders when clinically indicated
- Review of previous emergency-room records
- Review of prior imaging or specialist reports
- Referral for additional diagnostic evaluation
Helpful Information to Bring
Recent records and accurate medication information can help your physician better understand the concern and avoid repeating tests unnecessarily.
- Current medication bottles or pharmacy medication list
- Recent emergency-room or urgent-care paperwork
- Previous laboratory results
- Imaging reports or specialist notes
- List of recent foods, travel, or possible exposures
- Timeline of when the pain and other symptoms began
- Information about bowel or urinary changes
- Temperature or other home readings when available
Abdominal Pain Can Have Many Different Causes
Stomach or abdominal pain is a common reason to visit a primary care physician. Some causes are mild and temporary, while others may require testing, imaging, emergency evaluation, or referral to a specialist.
Digestive Conditions
Heartburn, acid reflux (GERD), constipation, viral stomach illnesses, food intolerance, indigestion, and gas are common causes of abdominal discomfort that can often be evaluated in primary care.
Gallbladder and Liver Concerns
Pain after eating, especially in the upper right abdomen, may require laboratory testing or imaging to evaluate the gallbladder, liver, or bile ducts.
Urinary Problems
Urinary tract infections, kidney infections, and kidney stones may cause abdominal or flank pain. Urinalysis and additional testing may be recommended depending on the symptoms.
Women's Health
Pelvic pain, ovarian cysts, and certain gynecologic conditions may present as abdominal pain. Depending on the symptoms, referral to a gynecologist may be appropriate.
Infections
Viral illnesses, foodborne illness, and some bacterial infections may cause abdominal pain, nausea, vomiting, or diarrhea that requires medical evaluation.
Other Medical Conditions
Abdominal pain may also be related to medications, muscle strain, chronic medical conditions, or problems involving organs outside the digestive system.
Primary Care, Gastroenterology or Emergency Care?
Many digestive concerns can begin with your primary care physician. The appropriate next step depends on symptom severity, how long the problem has been present, examination findings, and whether additional testing or specialty care is needed.
What We May Manage in Primary Care
Stable, uncomplicated digestive symptoms can often begin with a primary-care evaluation and treatment plan.
- Mild or intermittent constipation
- Uncomplicated diarrhea
- Heartburn or reflux symptoms
- Gas and bloating
- Mild nausea or vomiting without warning signs
- Dietary or medication-related digestive symptoms
- Initial hemorrhoid evaluation
- Follow-up after urgent-care or emergency evaluation
- Review of abnormal laboratory or imaging results
When Gastroenterology May Be Appropriate
Referral may be recommended when symptoms persist, testing is abnormal, or specialized procedures or management are required.
- Persistent or recurring digestive symptoms
- Chronic constipation or diarrhea that is not improving
- Persistent difficulty swallowing
- Unexplained bowel habit changes
- Ongoing or unexplained rectal bleeding
- Abnormal liver or digestive-related laboratory results
- Abnormal abdominal imaging
- Suspected inflammatory bowel or complex digestive disease
- Need for endoscopy, colonoscopy, or specialty procedures
Seek Emergency Care for Severe Symptoms
Do not wait for a routine office appointment when digestive symptoms are severe, sudden, or potentially life-threatening.
- Severe or rapidly worsening abdominal pain
- Vomiting blood or material resembling coffee grounds
- Black, tarry, or significant bloody stools
- Fainting, confusion, or severe weakness
- Severe dehydration or inability to keep fluids down
- Major difficulty breathing or chest pain
- A very hard, swollen, or extremely tender abdomen
- Severe symptoms following an abdominal injury
Not Sure Where to Start?
For stable, non-emergency digestive symptoms, contact Harbor Physicians to request an appointment. Your physician can evaluate the concern and determine whether primary-care treatment, testing, or gastroenterology referral is appropriate.
Digestive Health Questions
Answers to common questions about digestive symptoms, primary-care evaluation, testing, treatment, and when gastroenterology referral may be appropriate.
Can a primary care physician evaluate digestive problems?
Yes. Many stable digestive concerns can begin with a primary-care evaluation. Your physician can review symptoms and medications, perform an appropriate examination, order testing when needed, and determine whether treatment or specialist referral is appropriate.
Is Harbor Physicians a gastroenterology practice?
No. Harbor Physicians is a primary-care and internal-medicine practice. We evaluate many common digestive concerns and coordinate gastroenterology referrals when specialized evaluation or procedures are needed.
Can you evaluate constipation?
Yes. Your physician can review bowel habits, diet, fluid intake, medications, and medical history to help identify possible causes. Treatment or additional testing depends on the individual case.
Can you evaluate diarrhea?
Yes. Evaluation may include reviewing how long symptoms have been present, recent food or travel exposures, medications, hydration status, and other symptoms. Laboratory or stool testing may be ordered in selected cases.
Can Harbor Physicians treat heartburn or acid reflux?
Primary care can often evaluate and manage uncomplicated heartburn or reflux symptoms. Persistent, severe, or unusual symptoms may require additional testing or referral to gastroenterology.
Will I need blood work?
Not necessarily. Testing depends on your symptoms, examination, and medical history. When appropriate, your physician may order blood work through an outside laboratory.
Do you perform blood draws in the office?
No. Harbor Physicians does not perform routine blood draws on-site. If laboratory testing is needed, an order is provided for completion at an outside laboratory.
Can you order an abdominal ultrasound, CT scan or MRI?
Yes. When clinically appropriate, your physician may order diagnostic imaging. These studies are performed at outside imaging facilities and may require insurance authorization.
Do you perform colonoscopy or endoscopy?
No. Harbor Physicians does not perform colonoscopy, upper endoscopy, or other gastroenterology procedures. When these services are appropriate, your physician can refer you to a gastroenterologist.
When might I need a gastroenterology referral?
Referral may be recommended for persistent or recurrent symptoms, unexplained bowel changes, ongoing rectal bleeding, abnormal laboratory or imaging results, suspected complex digestive disease, or the need for procedures such as endoscopy or colonoscopy.
Should I see my PCP for rectal bleeding?
Limited, non-emergency rectal bleeding may begin with a medical evaluation, but bleeding should not automatically be assumed to be hemorrhoids. Your physician may recommend testing or specialist evaluation depending on the amount, duration, and associated symptoms.
What digestive symptoms may require emergency care?
Seek emergency care for severe or rapidly worsening abdominal pain, vomiting blood, black or significant bloody stools, severe dehydration, fainting, confusion, major breathing difficulty, chest pain, or other severe or potentially life-threatening symptoms.
What should I bring to my digestive-health appointment?
Bring your current medication bottles or pharmacy-generated medication list, recent laboratory results, imaging reports, emergency-room or urgent-care paperwork, and gastroenterology records when available.
Can medications cause digestive symptoms?
Yes. Some prescription medications, over-the-counter products, and supplements can contribute to nausea, constipation, diarrhea, reflux, or other digestive symptoms. Bring an accurate medication list so your physician can review possible contributors.
What if my symptoms keep coming back?
Persistent or recurring digestive symptoms should be reevaluated. Your physician may recommend additional testing, medication changes, dietary adjustments, or referral to gastroenterology depending on the pattern and previous results.
Having Ongoing Digestive Symptoms?
Contact Harbor Physicians to schedule a primary-care evaluation. Our physicians can assess your symptoms, recommend appropriate treatment or testing, and coordinate gastroenterology referral when specialized care is needed.