Usually, a doctor can determine whether a person has a digestive disorder based on the medical history and a physical examination. The doctor can then select appropriate procedures that help confirm the diagnosis, determine the extent and severity of the disorder, and aid in planning treatment.
A doctor identifies symptoms by interviewing a person to obtain their medical history and asking specific questions to gain additional information. For example, in speaking with a person who has abdominal pain, the doctor might first ask, “What is the pain like?” This question might be followed by questions such as, “Does the pain get better after you eat?” or “Does the pain get worse with movement?”
First, the doctor observes the abdomen from different angles, looking for swelling (distention) of the abdominal wall that might accompany abnormal growth or enlargement of an organ. A stethoscope is placed on the abdomen, through which the doctor listens for sounds that normally accompany the movement of material through the intestines and for any abnormal sounds. The doctor feels for tenderness and any abnormal masses or enlarged organs. Pain that is caused by gentle pressure on the abdomen and that is increased when the pressure is released (rebound tenderness) may indicate inflammation and sometimes infection of the lining of the abdominal cavity ( peritonitis Peritonitis Abdominal pain is common and often minor. Severe abdominal pain that comes on quickly, however, almost always indicates a significant problem. The pain may be the only sign of the need for surgery... read more ).
If the person has certain symptoms, the anus and rectum may be examined with a gloved finger, and a small sample of stool is sometimes tested for hidden (occult) blood (see Stool Occult Blood Tests Stool Occult Blood Tests Bleeding in the digestive system can be caused by something as insignificant as a little irritation or as serious as cancer. Chemicals can be used to detect small amounts of blood in the stool... read more ). In women, a pelvic examination Pelvic Examination For gynecologic care, a woman should choose a health care practitioner with whom she can comfortably discuss sensitive topics, such as sex, birth control, pregnancy, and problems related to... read more often helps distinguish digestive problems from gynecologic ones.
Because the digestive system and the brain are highly interactive ( see Mind-Body Interactions Mind-Body Interactions The mind and body interact in powerful ways that affect a person's health. The digestive system is profoundly controlled by the mind (brain), and anxiety, depression, and fear dramatically affect... read more ), a psychologic evaluation is sometimes needed in the assessment of digestive problems. In such cases, doctors are not implying that the digestive problems are made up or imagined. Rather, the digestive problems may be the result of anxiety, depression, or other treatable psychologic disorders. Such disorders can affect how active digestive tract contractions are and/or how sensitive people are to these sensations.