### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
i have had abdominal pain in the upper middle part of my abdomen. it is constantly hurting at a four on the pain scale but escalates to a ten for hours. the only thing that helps the pain is percocets and vicodin. i have tried advil and tylenol but nothing seemed to help. i have had cat scans, ultrasounds, blood tests, urine tests, colonoscopy, endoscopy, m.r.i.s. eating doesnt make it worse or better. but it gets worse when i pick up something twenty pounds or more and when someone pushes on it. i have tried antacids, birth control, antidepressants, antidepressants for chronic pain, anxiety medication, muscle relaxers, but nothing seemed to help at all. im a female and i am nineteen years old.

### output:

Hi. Thanks for your query and an elucidated history. The cause of pain in the upper middle part where the ultrasonography, CT scan endoscopy and MRI, colonoscopy is normal, not responding to Advil or Tylenol, but only to percent and Vicodin can be due to :Neurological problem or an IBS. The IBS, Irritable Bowel Syn Chat Doctor.  And try to get medicines against IBS. Neurological causes can be due to compressed disc at the thoracic level or an actual problem at the spinal cord level. MRI of the spine and thoracic spine level should help to get a diagnosis. Once the diagnosis is made it is easy to take a proper treatment. IT is wonderful to know why there is no effect of anti-depressant. In selected cases I would like to go for Diagnostic Laparoscopy and try to get a diagnosis and plan a treatment if feasible.