<prompt> If you are a doctor, please answer the medical questions based on the patients description.How do I determine when abdominal pain is emergency room worthy? I am having constant upper abdominal pain just under the breast bone. I am also bloated, having some back pain. I can not sleep due to being uncomfortable and the pain. My last labs showed elevated liver enzymes and positive IGG for B19 Q-Parvovirus.  <response>: Hello, Constant abdominal pain with bloating for a long period of time should warrant a visit to the doctor. Elevated liver enzymes and positive EGG for arbovirus may correlate to Inflammatory bowel disease or other bowel pathology. I suggest you visit the clinic: sonography of abdomen to rule out intestinal pathology. Based on sonographic findings - further evaluation with Endoscopy and Colonoscopy advised if required. Hope I have answered your query. Let me know if I can assist you further. 