What is meant by belly?
The abdomen is the area between the chest and the pelvis. The anterior part is often called the stomach in everyday language, but medically the abdomen includes both the abdominal cavity and the areas behind the peritoneum. This area contains the liver, gallbladder, pancreas, spleen, stomach, small intestine, large intestine and parts of the urinary tract.
The organs are close together and pain can radiate. Problems high in the abdomen can come from the stomach, bile ducts, liver, pancreas, heart or lungs, for example. Pain further down can be related to the intestines, urinary tract or pelvic organs.
Learn more about abdominal organs and abdominal pain.
What are the functions of the organs in the abdomen?
The abdominal organs are responsible for digestion, nutrient absorption, storage, hormones, bile production, blood filtration, and fluid regulation. The liver processes nutrients and produces bile. The pancreas produces digestive enzymes and hormones. The kidneys purify the blood and produce urine.
The stomach and intestines break down food and transport its contents through the body. The spleen is part of the immune system and blood circulation. The organs work together, which means that a disorder in one area can affect several symptoms at the same time.
Function cannot always be assessed through imaging. Blood tests, urine tests and functional examinations are often at least as important.
Common abdominal complaints
Abdominal pain, bloating, nausea, changes in bowel habits and appetite are common symptoms. Causes may include temporary infections, constipation, gallstones, inflammation, urinary tract problems or functional gastrointestinal problems.
Sometimes cysts or other changes are discovered by chance. Many are benign, but some need to be followed up depending on their appearance, size and symptoms. Read more about unclear abdominal discomfort.
The duration of symptoms, location of pain, fever, weight change, blood in stool or urine, and previous illnesses determine how urgent the investigation is.
It can be helpful to note connections with meals, bowel movements, menstrual cycles, urination, physical activity and medications. A symptom diary can provide better information for healthcare, but it should not delay contacting healthcare if warning symptoms occur.
When should you seek care for abdominal pain?
Seek medical attention if abdominal pain is recurrent, increasing, or combined with fever, vomiting, yellow skin, blood in stool or urine, unexplained weight loss, or clearly changed bowel habits.
Seek emergency care if you experience sudden severe pain, a stiff or very tender abdomen, fainting, cold sweats, bloody vomiting, black stools, severe dehydration, or rapid deterioration in your general condition. Pregnant women with severe abdominal pain or bleeding also need a quick assessment.
Pain in the upper abdomen along with chest pain or difficulty breathing may be coming from the heart or lungs and should be evaluated immediately.
How are abdominal complaints investigated?
The investigation begins with questions about symptoms and an examination of the abdomen. Blood tests can provide information about inflammation, liver, pancreas, blood counts, and kidney function. Urine tests can show infection, blood, or other abnormalities.
Ultrasound is often used for the liver, gallbladder, bile ducts, kidneys, and fluid. CT is fast and provides a wide view of the abdomen, which is important in many acute conditions. MRI can provide detailed soft tissue images and is used for, among other things, the liver, pancreas, bile ducts, and some kidney issues.
Gastroscopy, colonoscopy or other targeted examinations may be more relevant when the issue concerns the mucous membranes and intestinal tract.
When can abdominal MRI be relevant?
MRI abdomen may be relevant for characterizing changes in the liver, pancreas, biliary tract, kidneys and other soft tissues. MRCP is an MRI technique that specifically shows the bile and pancreatic ducts.
MRI is not always the first choice. In acute abdominal complaints, CT is often used because the examination is quick, while ultrasound is often a good first step in gallstones and certain liver or kidney issues.
The choice depends on what the doctor suspects, whether contrast media is needed, and what previous examinations have been performed.
Limitations and next steps
No imaging method shows all causes of abdominal discomfort. Functional gastrointestinal disorders, early mucosal changes and certain infections require other types of investigation. An incidental finding on an image does not necessarily explain the symptoms.
The next step may be follow-up imaging, endoscopy, specialist assessment, new tests or treatment aimed at the likely cause. If the condition worsens, care should be sought again.
Recurrent abdominal pain can sometimes be due to several concurrent factors, such as sensitive bowel, biliary problems and drug effects. A normal imaging result can therefore be reassuring without concluding the investigation. The focus can then be shifted to function, diet, drugs or endoscopy depending on the symptoms.