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

### input:
My best friend has lower right abdominal pain . She has had a total hysterectomy . You can visually see that her lower right abdomen is swollen and gets bigger and hurts more by the end of day. She went to local ER friday and they said CAT scan was normal, blood work was normal with the exception of her liver enzymes being slightly elevated. She has had continued pain all weekend and this morning she started complaining about pain in her tailbone. It hurts so bad she can barely sit and it hurts when she stands. She doesn t have a regular family physician. She always went to OB/GYN for everything lol She had a partial hysterectomy and was left with one ovary until it caused problems and was removed this past November. Should I take her back to the ER and see what other tests or should we wait and just try to get her in to see a family physician? Thank you

### output:

Hello! According to your friends' surgery history there is a probability of post-surgery adhesions. Especially she has had two of it.  Adhesions may cause partial intestines' obstruction (called jubilees) which can reveal with intermittent abdominal pain. If your friend has also constipation, diarrheas or both associated with abdominal pain and flatulence, nausea and this symptoms may come and go, jubilees is very probable. Lower right abdominal pain is also characteristic for appendicitis (what has to be always ruled out!), right urinary tract infections/stones. Backbone diseases can also show up with symptoms mentioned by you but (backbone MRI may be required if all abdominal diseases are ruled out). To rule out intestines obstruction abdomen X-ray is necessary (abdomen CT might not visualize it). Blood tests need to be repeated as white blood count and CRP may elevate after few days of disease appearance. This tests may be negative on the beginning of pathologic process. Urine tests should be done as well. Take care