Abdominal Pain in Ajax: What an Ultrasound Can Look For

“Surely the scan will show what’s causing it.” It is a natural thing to think when your provider hands you a requisition for an abdominal ultrasound after weeks of stomach pain. Sometimes it does exactly that. Just as often, the scan’s most useful job is to rule things out, narrowing down the possibilities so your provider can choose the next step with more confidence.

Understanding what an ultrasound can and cannot see makes the result easier to understand, whichever way it goes. This article explains how ultrasound fits into the investigation of abdominal pain, how the location of your pain shapes the exam, and why a “normal” report can still be useful. It is written for patients in Ajax and across Durham Region who have been referred for a scan, or who are simply curious about how the process works.

When pain is an emergency, not a booking

Before anything else: some abdominal pain cannot wait for a scheduled appointment.

Call 911 or go to the nearest emergency department if you have sudden, severe abdominal pain; pain with a rigid or very tender belly; pain with vomiting blood or passing black or bloody stools; pain with fainting, a racing heart or difficulty breathing; pain during pregnancy with bleeding; or pain after a significant injury. Severe pain that keeps getting worse, especially with a fever, also needs urgent assessment.

A community imaging clinic handles planned exams arranged by your health-care provider. It is not set up to assess emergencies, and an emergency department can do imaging, blood work and treatment together. The rest of this article is about the more common situation: pain that has been assessed by a provider who has decided an ultrasound is a sensible next step.

Why ultrasound is so often the first test

For many types of abdominal pain, ultrasound is the first imaging test a provider reaches for. There are good practical reasons for that:

• It uses sound waves, not radiation, so it can be repeated if needed and is used routinely in pregnancy.
• It shows solid organs, such as the liver and kidneys, in good detail.
• It is excellent at showing fluid, stones in the gallbladder, and changes in the size or shape of organs.
• It is done in real time, so the sonographer can scan directly over the spot that hurts.
• It is widely available and generally comfortable.

If your provider needs a different kind of detail, they may order a CT scan or another test later. Ultrasound often comes first because it can answer many questions simply. For a broader look at how imaging tests are chosen, see our article on ultrasound versus X-ray.

How the location of your pain guides the scan

Your requisition will usually describe where the pain is and what your provider wants examined. That matters, because the abdomen holds many organs and the exam is tailored to the question. Here is a rough map of what ultrasound can look at in each region. It is a general guide, not a way to work out what is wrong.

Upper right

This area holds the liver, the gallbladder and the bile ducts. Pain here, especially after fatty meals, is one of the classic reasons for an abdominal ultrasound, because gallstones and gallbladder inflammation show up well. Our article on kidney and gallbladder ultrasound goes into these scans in more depth.

Upper middle

The pancreas, part of the liver, the stomach and the main blood vessels sit here. Ultrasound can often see the pancreas, though gas in the stomach and bowel sometimes hides parts of it. The aorta, the large artery running down the abdomen, can also be measured.

Upper left

The spleen and the left kidney are here. Ultrasound can assess the size of the spleen and look at the kidney.

The flanks and back

Pain in the side or back, sometimes travelling toward the groin, may lead a provider to ask for a kidney ultrasound. Ultrasound can show whether a kidney is swollen because urine is not draining properly, and can sometimes show stones.

Lower abdomen and pelvis

This region includes the bladder, the lower bowel, and, depending on your anatomy, the uterus and ovaries or the prostate. A pelvic ultrasound often needs a full bladder; our guide to pelvic ultrasound and the full bladder explains why. Lower right pain is sometimes investigated for appendicitis, but sudden or severe lower right pain is usually an emergency department matter rather than a booked scan.

Around the belly button or groin

A bulge that comes and goes with pain may be a hernia. Ultrasound is often used to look for one, and we have written a separate guide on hernia ultrasound.

What ultrasound does not see well

This is the part that surprises many patients. Some very common causes of abdominal discomfort are invisible, or nearly invisible, to ultrasound.

1. The inside of the stomach and bowel. Ulcers, irritation of the stomach lining, and most problems inside the bowel are not well assessed with ultrasound. Gas inside the bowel also blocks sound waves. Tests such as endoscopy are used for those questions.
2. Functional conditions. Irritable bowel syndrome, indigestion without an obvious structural cause, and similar conditions do not usually change how organs look. A normal scan is expected.
3. Areas hidden behind gas or bone. Parts of the pancreas, and organs tucked behind the ribs, can be partly hidden on some days and clear on others.
4. Problems that come and go. If the cause of the pain is not present on the day of the scan, it may not be seen.

None of this means the scan was wasted. Ruling out gallstones, kidney swelling, an enlarged organ or fluid where it should not be is valuable information that helps your provider decide what comes next.

Keeping track of your pain before the appointment

There is often a gap of days or weeks between seeing your provider and having the scan. Using that time to keep simple notes can help everyone involved, including you. A few lines in a notebook or on your phone each day is enough. Try to record:

• Where the pain is, and whether it stays in one place or moves
• What it feels like: dull, cramping, sharp, burning or pressure
• When it happens: after meals, at night, with movement, or at random
• How long it lasts, from a few minutes to most of the day
• What seems to help or worsen it, such as eating, lying down or passing urine
• Anything else that comes with it, such as nausea, fever, changes in bowel habits or changes in urine

These notes are mainly for your provider, who can use them alongside the scan result. They are also handy at check-in, when a quick summary helps the sonographer focus on the right area. If the diary shows the pain getting steadily worse, or new warning symptoms appear, contact your provider or seek urgent care rather than waiting for the scan date. Patients in Ajax often find that the act of writing things down also makes the follow-up conversation feel more organized.

Helping the scan answer the question

Good preparation and good information make a real difference to the quality of the images.

Follow the preparation exactly

Most abdominal scans need fasting so that the gallbladder is full and the bowel is quieter. The details are covered in our abdominal ultrasound preparation guide, so we will not repeat them here, but the short version is: follow the instructions you receive when you book, and call if anything is unclear.

Tell the sonographer where it hurts

Point to the spot. If the pain moves, or is worse at certain times, mention it. The sonographer can press gently over the tender area and note whether the pain is directly over a particular organ, which can be useful for the radiologist.

Mention relevant history

Previous abdominal surgery, a known gallbladder removal, kidney stones in the past, or a pregnancy are all worth mentioning at check-in. They help the sonographer interpret what they see on the screen and avoid searching for an organ that is no longer there.

Bring a list of medications

It is a simple habit that helps any health-care visit, and it can be useful context for the report.

Reading the result with your provider

The report from an abdominal ultrasound goes to the provider who ordered it, who will discuss it with you. It may describe findings that clearly explain your pain, findings that are incidental and unrelated, or no abnormality at all.

Each of those outcomes is useful:

• A clear finding gives your provider something specific to act on.
• An incidental finding, such as a small simple cyst on a kidney, is common and often needs no action, but your provider will tell you if it does.
• A normal scan narrows the list of possible causes and points toward other tests or approaches.

It is worth asking your provider what they were looking for with the scan, what the result means for that question, and what should prompt you to get back in touch. If your pain changes, becomes severe, or new symptoms appear, seek care rather than waiting for a scheduled follow-up.

Abdominal ultrasound in Ajax

Rossland Diagnostic Clinic performs general ultrasound, including abdominal and pelvic scans, at Unit 102, 300 Rossland Road East, Ajax. Patients from Ajax, Pickering, Whitby and surrounding areas use our free parking and ground-floor entrance, and we see patients Monday to Friday from 9:00am to 5:00pm and Saturday from 8:00am to 3:30pm.

Once your provider has given you a requisition, call 905-426-3111 or request an appointment. We will go over your preparation instructions when you book.