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

### input:
I have been experiencing what feels like muscle spasms & twitching under my left breast/rib cage area. I also have IBS and have been having diarrhea off and on more so for the past month. (Appendix removed October 2012) I have a doctor appt next week, but I am looking to ask the right questions. I have also recently went off the Depo Provera shot (last one was January) after being on it for about 15 years. I haven t gotten my period, but was wondering what kind of withdrawal symptoms I may feel. I have gotten crampy feelings and spotted very little in April. I also have tenderness in the upper areas of both breasts (not pregnant). I had a full exam in January and was ok. I had hematuria (large amounts in November 13 and trace amounts Jan. 14). Nobody could really tell me anything (I thought passed kidney stones) which I ve had before. CT scan did show 2 small ones in left kidney.

### output:

Hi, Thanks for your query. From the description provided it seems that you have muscle twitches or articulations. These are small, local, involuntary muscle contraction and relaxation visible under the skin arising from the spontaneous discharge of a bundle of skeletal muscle fibers. Articulations have a variety of causes, the majority of which are benign. The most likely and common causes for these are1... High levels of stress, anxiety,nervousness or excitement or anger.2... Consumption of excess of alcohol or caffeine.3...low levels of calcium, potassium,magnesium etc4... Low levels of IT B125... Use of medicines like anti asthmatics, anti seizure, weight loss medicines etc6. Certain disorders like hyperthyroidism or hyperparathyroidism. I would advise you to get tested for above-mentioned causes, stop alcohol and caffeine, do regular stress buster exercises like breathing exercises and yoga and taking good nutritious diet. Taking methylcobalamin supplements and electrolyte fluids will be helpful. If some deficiency comes in your tests, then take those supplements. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care