Abdominal pain in the primary care setting

The characteristics of and final diagnoses for patients presenting with abdominal pain were investigated. This retrospective study examined 556 charts of patients 18 years of age and older who presented over a two-year period to three family practice offices. The charts were abstracted for demographic factors, symptoms, physical findings, laboratory data, final diagnosis, and number of visits for abdominal pain. The final diagnosis was documented by radiologic, laboratory, surgical, or pathologic specimen confirmation except for the following diagnoses: acute gastroenteritis, pelvic inflammatory disease, irritable bowel syndrome, and abdominal pain, etiology undetermined. No cause for the abdominal pain was found for approximately one half of the cases. Most patients were female even when gynecologic problems were excluded. Nine percent of abdominal pain patients were admitted to the hospital for evaluation or surgery. An average of 1.8 tests were ordered per patient. Almost one half of the patients were seen only once for the problem. The results suggest that a large percentage of the patients who present with abdominal pain have a self-limited illness for which no definitive diagnosis is found.