Wellness: Today's Medicine
Why the Doctor Presses Your Abdomen
For those trained in examining the body, pressing on your abdomen can provide significant clues to potential problems.
The external examination with the hands gives doctors information about such important structures as the liver, spleen, kidneys, intestines, pancreas, bladder, gallbladder, appendix, abdominal aorta (the major blood vessel from your heart to your legs), and in females, the uterus and ovaries.
When the doctor presses on your abdomen, he or she is feeling to see if any of these are enlarged or tender, making them painful to touch, which could indicate disease.
Doctors use two different techniques to examine your abdomen: palpation and percussion.
A diagnosis is rarely made from only a manual examination of the abdomen, but this procedure can turn up abnormalities, leading to further examination or testing.
Palpation means pushing down to see if the organs can be felt. For example, the aorta that supplies blood to the lower extremities runs directly beneath the navel and should be only an inch wide; if it is wider than that, there could be a problem such as an aneurysm.
The doctor also looks for tenderness, or pain, that you might experience when he or she briefly pushes in and then quickly lifts his or her hands off your stomach (rebound tenderness). Such pain indicates that the peritoneum, or the membrane that lines the abdominal cavity, is inflamed — as often happens when the appendix becomes diseased, the bowel is perforated, or there is peritonitis.
The doctor can often feel whether certain internal organs (such as the liver, spleen, or uterus) are enlarged. The next step is finding the reason for the enlargement — possibly disease, such as infectious mononucleosis or leukemia.
Percussion means tapping the abdomen and listening to the sounds. It's similar to the tapping done by shoppers who know a ripe watermelon sounds different from an unripe one. When a doctor taps just below the rib cage, he or she can hear the sounds made by a normal liver. Similar sounds heard when tapping beyond where the liver should extend could indicate an enlarged liver. Fluid in the abdominal cavity (ascites), a result of heart, liver, or kidney disease, can also sometimes be detected by percussion.