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

### input:
Hi, may I answer your health queries right now ?  Please type your query here... dear doctor my diet is normal but for past 4 years i have been having severe stomach pains- it is a stabbing pain. the pain usally starts at night and it will go on for good 6 hours approximatley. i cannot sleep noramally- i have to curl myself to reduce the pain. i vomit during that pain . yesterday was worse i tried some painkillers but the pain was still there. the pain is just on one spot of my stomach ......

### output:

Hi. Thanks for your query. Read the history and understood the problem. I am sorry to know that you are suffering from such a severe stabbing pain with vomiting for the last 4 years. It is difficult to understand why have you not investigated or consulted a Gastroenterologist. This is occurring only during nighttime and makes you curl on, meaning it is so severe. The most probable causes are:Vascular insufficiency to the intestines after the dinner-the requirement of blood supply increases many folds. Internal hernia, again very difficult to diagnose. Volvulus of some part of the intestinal tract. To get a proper diagnosis you should be seen by a Doctor / Gastroenterologist- preferably - during the attack. The investigations done when not in attack may turn out to be normal. I would advise the following investigations strictly to be done during the attack of pain. -X-ray of the whole abdomen in standing position, this helps to have a suspicion about the intestinal obstruction and the cause of it. This is followed by CT scan next time to confirm the diagnosis. Exploratory Laparoscopy or Laparotomy. This helps tremendously for the diagnosis and treatment too.