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

### input:
Hello. Im a 41 year old female in good health. A little overweight, but dont smoke or drink. I eat well, but dont get much exercise. Back in November I was shoveling snow from the sidewalk. Later that night I had deep aching pain all over my abdomen. It was constant, but worse when leaning or bending over. Even sitting up straight was tough. In a week I felt better. Two months later after bending over sorting laundry, the pain came back.it started low in the abdomen and moved up around the belly button and a little higher. It lasted a few days and went away. Then a week later after similar movements it came back. This has been the pattern for the last couple months, it is now April. Sometimes the pain is sharp, but mostly aching. I can move into certain positions which alleviates usually. There are no outward bulges, but made appointment with a doctor thinking it could be a hernia. The discomfort moved around a little so I wasnt sure what it could be. The doctor didnt feel anything and said it wasnt a hernia unless it was really small.he told me to go home and do ab crunches to strengthen the muscles. I dont think thats a good idea, so I asked for an ultrasound. He said no, but ordered a CT Scan with oral contrast. I am scheduled for tha later this week. The last few days I have felt very good and almost forget about the discomfort. However, I know it can comeback quickly by just moving the wrong way. I havent noticed any change in digestive or bowel systems. No nausea or weight loss. I do have gerd that seems to be unresponsive to medication and have had minor gallbladder pain, but this is much different and is brought on by movement. Sorry for the super long description. Any thoughts as to what it might be or any future action I should take? Thank you. - AAA

### output:

Hi ! The symptoms you have described shows that the pain and discomfort comes whenever your intro abdominal pressure increases. The possibility of a para esophageal hernia or any other uncompleted internal hernia can not be ruled out. It is very difficult to diagnose these cases from external examination. Sometimes it may give rise to symptoms of Castro esophageal reflux disease like hyperacidity, dysphagia, etc. These can be diagnosed with the help of X-rays chest/abdomen and a CENT abdomen. An ultrasound may also be done to exclude heat biliary pathology. Till then, you can start taking some antacid liquids and a proton pump inhibitor for reducing the acid secretion in the stomach. If the pain is too severe, then one can opt for an anti-spasmodic. Hope this information will help you out.