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

### input:
I am a 59 year old female.  I have been having cronic pain in the upper right abdomen,  under the rib cage for approximately 3 years.  I have had many tests and doctors have been unable to diagnose.  The pain is worse when I sit for any length of time so I stand a lot or lay flat with my hands over my head to elongate my body.  The pain wakes me up from a sound sleep many times each night and is constant throughout the day.  I can only lay on my right side for a few minutes before the pain intensifies.  At times there are stabbing pains but mostly a constant dull pain, sometimes through to my back.  I have not been able to identify any association to digestion or specific foods.  I had my gall bladder removed in 1989 and tests have not revealed any stones when the tests were taken.  I have had Catscans, MRI, ultrasounds and blood and urine tests.  I need to find the cause of this pain so that I can treat it.  I dont want to live on pain medication.  Do you have any suggestions as to what can be causing this pain and possible treatments?

### output:

Hi welcome to Chat Doctor forum.  Thanks for calling Chat Doctor. Forum.  You have got a pain in upper right abdomen at rib cage, not related to food, or food timing, It is dull pain and aching when you sit or in sleep. You got operated gallbladder in 1989.  It appears to be the pain of pull, means may be due to adhesion, or herniation. For diagnosis, you may need to get leucotomy (opening abdomen and searching the cause.) as M.R.I, and C.T.scan failed to find the cause.  I advise you to consult a general surgeon for diagnosis and treatment.  Wishing you a quick and complete recovery.  Best regards.