What can an abdominal X-ray diagnose?

Overview

An abdominal X-ray is a quick, non-invasive imaging test used to detect issues such as bowel obstructions, kidney stones, and swallowed objects. It involves low levels of radiation and helps doctors assess abdominal pain, bloating, or unexplained symptoms.

Although generally safe, precautions may be required for pregnant women. In some cases, alternatives such as ultrasound or CT scans may be recommended depending on your symptoms and clinical findings.

An abdominal X-ray allows doctors to assess organs, bones, and soft tissues within the abdomen and is commonly used to diagnose:

1. Bowel obstructions – Blockages in the intestines that can cause pain, bloating, and vomiting.
2. Kidney stones – Hard mineral deposits in the kidneys that may cause severe pain.
3. Gallstones – Hardened deposits in the gallbladder, although these are often better detected using ultrasound.
4. Perforations – Holes in the stomach or intestines that allow air to escape into the abdomen (a medical emergency).
5. Swallowed objects – Common in children who accidentally ingest coins, batteries, or small toys.
6. Abnormal masses or tumours – While an X-ray alone cannot confirm cancer, it may show abnormalities that need further investigation.

What Is an Abdominal X-ray?

An abdominal X-ray is a simple imaging test that uses a small amount of radiation to capture images of structures inside the abdomen, including the stomach, intestines, kidneys, liver, and spleen.

These images help doctors detect abnormalities that may be causing pain, discomfort, or other digestive and urinary symptoms.

Abdominal X-Ray: When It’s Needed

Doctors usually order an abdominal X-ray to investigate sudden symptoms or rule out urgent surgical conditions.

Sudden or Severe Abdominal Pain

An abdominal X-ray provides a rapid assessment to rule out life-threatening problems such as bowel perforation and helps determine whether hospital admission is required.

Constipation

The scan can show the volume and location of stool buildup, helping doctors decide whether medical treatment or hospital care is needed.

Vomiting

Ongoing vomiting may indicate a blockage in the digestive tract. An X-ray helps identify whether food or gas is unable to pass normally.

Suspected Bowel Obstruction

This test looks for twisted intestines or blockages preventing the movement of gas and fluid, which is considered a medical emergency.

Unexplained Bloating

Severe abdominal distension is often caused by trapped gas. X-rays clearly show air pockets and their location within the bowel.

Swallowed Foreign Objects (Common in Children)

Metal objects such as coins and batteries appear clearly on X-ray, making this the preferred test for locating foreign bodies before removal.

Kidney Stones (Initial Screening)

While less detailed than CT imaging, an abdominal X-ray is a useful first step to identify large, calcium-based kidney stones.

Pre-surgery Assessment

Surgeons may request a baseline abdominal X-ray before certain procedures to help plan surgery safely.

What an Abdominal X-ray Can Diagnose

Although it cannot detect every condition, an abdominal X-ray is highly effective for identifying specific abnormalities.

Bowel Obstruction

The scan may show dilated bowel loops and air–fluid levels, confirming that contents are unable to move through the intestines.

Severe Constipation / Faecal Loading

A mottled appearance in the colon can indicate faecal impaction and severe constipation.

Kidney Stones

X-rays can detect calcium-containing stones but may miss other types such as uric acid stones, which are not visible.

Foreign Objects

Dense objects are easily identified. Button batteries require urgent removal due to their potential to cause severe internal burns.

Abnormal Gas Patterns

Free air within the abdominal cavity suggests bowel perforation and requires immediate surgical attention.

Calcifications

The test may reveal calcified blood vessels or signs of chronic pancreatitis, often found incidentally during imaging.

Other Recognisable Conditions

Occasionally, an abdominal X-ray may identify issues outside the abdomen, such as lower lung infections or spinal fractures.

Abdominal X-ray: Can and Can’t Detect

X-rays are excellent for visualising bones, gas, and dense objects, but they are limited when it comes to soft tissue detail.

Note: If your abdominal X-ray is normal but symptoms persist, your doctor may recommend a CT scan or ultrasound for further evaluation.

What Happens During an Abdominal X-ray in Australia?

The procedure is quick, painless, and usually completed within minutes.

1. Check-in: Present your Medicare card and referral at reception.
2. Preparation: You may change into a gown and remove metal items.
3. Positioning: You will stand or lie against the imaging plate.
4. Imaging: You may be asked to hold your breath briefly.
5. Completion: Once images are confirmed, you can leave immediately.

Abdominal X-ray vs Other Scans (CT, Ultrasound)

Different imaging tests are used depending on what your doctor needs to assess. The table below compares an abdominal X-ray with CT scans and ultrasound to help understand when each is most appropriate.

Risks of an abdominal X-ray

Abdominal X-rays are generally safe, but they do involve a small dose of radiation.

1. Radiation exposure – The amount is low, but frequent exposure over time could increase the risk of cancer.
2. Pregnancy concerns – Radiation can be harmful to a developing baby, so pregnant women should inform their doctor before undergoing the test.
3. Allergic reactions – If contrast dye is used (rare for a basic X-ray), some people may experience allergic reactions.

When Should You See a Doctor?

You should seek medical attention urgently if you experience any of the following symptoms:

• Severe, sharp pain that does not improve.
• Blood in your stool or vomit.
• Inability to pass gas or stool combined with vomiting.
• High fever with abdominal tenderness.

How Hola Health Can Help

Hola Health connects you with Australian-registered online GPs within 15 minutes, 24/7.

• Telehealth Consults: Doctors assess your symptoms via video or phone.
• Referrals: We can email X-ray or imaging referrals instantly for you to take to a local clinic.

Conclusion

An abdominal X-ray is a valuable tool for diagnosing various conditions affecting the digestive and urinary systems. While it’s a simple and low-risk procedure, always follow your doctor’s guidance on when and why you might need one. If you have any concerns, don’t hesitate to ask your healthcare provider for more details.

FAQ

Do I need to fast before an abdominal X-ray?

Yes, fasting is usually required for 6–12 hours prior to the abdominal X-ray to help clear the stomach and intestines if possible.

Can I get an X-ray referral through telehealth?

Yes. If clinically necessary, telehealth doctors can email you a valid referral immediately.

Will an X-ray show appendicitis?

No. An abdominal X-ray cannot visualise the appendix well. An ultrasound or CT scan is required.

How do I get ready for an abdominal X-ray?

Preparation for an abdominal X-ray is minimal. You may be asked to:

• Remove jewellery, belts, or metal objects that could interfere with the image.
• Wear a hospital gown to avoid clothing obstructing the scan.
• Avoid eating or drinking for a few hours if instructed by your doctor.
• Inform your doctor if you’re pregnant or have had recent imaging tests using contrast.

How does the procedure work?

X-rays pass a controlled amount of radiation through the body. Dense structures like bones appear white, soft tissues appear grey, and air-filled spaces appear darker. Doctors analyse these images to identify blockages, stones, or abnormal growths.

What happens during an abdominal X-ray?

The procedure is quick and painless. Here’s what to expect:

1. Positioning – You may be asked to lie down, stand, or sit for different image angles.
2. Holding still – You may need to hold your breath briefly to prevent blurring.
3. Image capture – The X-ray machine sends a short burst of radiation.
4. Completion – The process usually takes 5–10 minutes.

Is an Abdominal X-ray Safe?

Yes. For most people, abdominal X-rays are safe. The radiation dose is very low—roughly equivalent to a few months of natural background radiation.

• Pregnancy warning: Always inform staff if you may be pregnant, as X-rays are generally avoided during pregnancy.