That depends. She needs to gently palpate the abdomen knowing which organs are located in the different areas. She needs to ask when his last bowel movement was. He could be constipated or have a lot of gas. An Xray or blood work may need to be done to confirm a diagnosis like appendicitis or gallbladder issues. It could be menstrual cramps. There is no way to just look at a patient and know for sure what the problem is.