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

### input:
Hello Dr Vashistha I started having abdominal pains about 9 months ago, brought on by sitting in the leaned forward position. An ultrasound of the gall bladder revealed only a possible small polyp but a HIDA scan showed 5% ejection fraction so it was removed. The pains continued intermittently but constantly increasing in severity and occurrence. Initially the pain was about 2-5 lasting for a few minutes 1 or 2x per day, now it goes up to 4-6 with pulses to perhaps 7 and multiple times a day, again associated with sharp bending at the waist (the pain appears a few minutes after I bend). After the gall blader removal I also had a double contrast ct performed, which revealed no major problems including nothing post operative, and no appendix problems. There was only some mild perinephric inflammation. During this scan I placed a marker on my abdomen where the pains are present and the ct report stated that the marker was above the cecum. I also had a colonoscopy as a 50th birthday check after the pains started and while they found and removed 4 polyps, they saw nothing that would cause the pain. Any suggestions?

### output:

Hi and thank you so much for this follow-up precision. I am so sorry to hear about these symptoms that you have reported. It is not uncommon to have a long-standing pain in the abdomen with no apparent cause after multiple investigations. I will suggest that this pain should be considered as part of dyspepsia and managed as such. Even without an established cause, pain medications to control the pain and improve your quality of life should be strongly considered. I feel comfortable doing so because beyond the symptoms, there seems to be nothing grossly wrong going on that may compromise your health status. I hope this helps. Furthermore, I wish you well. Feel free to ask for more information should need to be.