<s>[INST] I am a 24yr old female who has neurofidbramatosis type 1 (nf1). I have been having horrible pain in upper left abdomen that goes into my back between my shoulder blades. Also anytime I eat or drink anything I am either sick to my stomach in horrible pain or both. I even throw up a lot after eating. I can not live like this anymore the pain nausea and vomiting is ruining my life.  Its been going on for two weeks now the pain has been getting worse. [/INST] Hello! Thank you for the query. Such upper abdominal pain which radiates to the back is usually caused by gallstones. Sometimes pancreas inflammation can give such symptoms however the pain is usually so strong that forces patients to visit a doctor. If it is gallstone issue, your symptoms should get worse after fatty foods spicy foods or alcohol. Sometimes similar symptoms are present with stomach issues like peptic ulcer. I suggest you to do not wait any longer and visit your doctor. Abdominal ultrasound, blood work, liver tests should be done at first. If gallstones will be confirmed, laparoscopic surgery should be done. If nothing will be found, gastrostomy is necessary. In a meanwhile please avoid fatty foods, spicy foods, coffee and alcohol. Hope this will help. Regards. </s>