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

### input:
hello sir my name is XXXXX i m suffering from a pain more then 4 years ago....pain starts only when i lay down....it awakes me at night just after 4 to 5 hours i could not sleep 8 hours straight...the pain is in the abdomen i cannot localize it it seems like in the whole abdomen but most in the lower i guess.... help me out with this is really uncomfortable

### output:

Hello, Thanks for posting your worry. I assume you have been to many consultations and have not had any favorable management plan for your answer? You are suffering from either chronic functional abdominal pain or chronic irritable bowel diseases that if investigated clinically and para-clinically (i.e. laboratory tests, radiology e.g. endoscopy, colonoscopy, abdominopelvic ultrasound, abdominal CT or MRI etc.) we shall probably find no cause such as an infection or tumor etc. This means your problem might be of nervous or genetic origin and will need specialist doctors on the domain of chronic abdominal pain. In the meantime, the pain could be controlled by using low dose antidepressants such as amitriptyline + anti-spasmodic at time of crisis. If you are a female, you will need to visit a globs for evaluation of your pelvis (reproductive structures). If you are fortunate and a cause of your problem can be identified by the doctors, then you will probably get a cure. Also, you will probably need to check on the meals you eat and see if there is any particular dish or food type which when eaten has a greater tendency of causing the pain. Also, peptic ulcer disease/gastritis needs to be investigated. A stool exams and culture will be paramount to rule out any infections. Hope this helps