Hello and welcome to XXXXXXX ma'am.

Thank you for writing to us.

I have gone through your history and query. Let me try to help you by starting from the very beginning (i.e. not taking your history into consideration yet).

In patients experiencing pain with such a description and location, the following conditions are to be first considered and further investigated:
-IBS (constipation or diarrhea; more common in constipation)
-Acid reflux disease
-Gastritis
-Urinary tract infection
-Intestinal adhesion, ulceration, obstruction etc. (intestinal problems; especially sigmoid colon and rectum; pertaining to the location)

From your history, you have four of the above mentioned possible causes to this type of pain. So let us try to narrow the cause down from your history or look for any other possible cause for the same. For this, I will require your assistance. You will need to provide some information, please bare with me.
1. As you are acquainted with how an episode of IBS feels, do you feel you are experiencing an episode now? Do you have constipation or diarrhea-related IBS?
2. Do you experience this pain after/before meals? If yes, how long after/before?
3. Do you have any additional symptoms like burning sensation while urinating, frequent urge to urinate, etc?
4. Do you experience a reflux/regurgitation of food, dry cough, chest pain/burn, difficulty swallowing food, sensation of a lump in throat, etc?
5. If you experience constipation, how long does it last? Are you constipated now?
6. You must have been informed about food that could trigger an episode of IBS, have you consumed any of those food items?
7. Are you on any medications for your IBS? If yes, could you name them for me?
8. When was the last time you passed gas or had a bowel movement?

Thank you so much for your co-operation. A patient's co-operation greatly helps in all cases.

Looking forward to your response.

Best wishes.

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Hello once again.

I am sorry, but other than the history mentioned earlier
"Medical History
IBS, dumping syndrome@ times,diverticulosis, ulcer,adhesisions involving sigmoid colon,cervical injury with repair, a 1:320 XXXXXXX diabetes,hypothyroidism," and the first query; I have not received any other details. The above mentioned details are not sufficient, which is why I asked for your co-operation in answering a few questions of mine, in my previous response.

You could reply to my questions as a response and that would help a lot.

Looking forward to this information.

Till then take care.

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Thank you for that information.

Although it would have been better if you would respond to the specific queries I asked you in my first response, I shall comment with the help of information provided by you so far.

Let me list the possible causes:
-Sluggish bowel movements and a narrowing/stricture of the sigmoid colon can cause stagnation of bowel contents and gas, this can lead to a distension and thus result in pain
-A feeling of 'never being empty' as described by you is usually seen in patients experiencing an episode of IBS, which causes distension and inflammation of the bowel. This also results in pain. Thus, requiring anti-spasmodic medication (eg. mebeverine hydrochloride, etc.)
-Constant pain experienced in that particular area could be due to partial bowel obstruction (that can be caused by the narrowing of the sigmoid, which is preventing in passing of gas or bowel contents)

In my opinion, it is best to visit a doctor and get an erect x-ray of the abdomen and an abdominal ultrasound to find the cause for this pain.

In the meantime, the best medication to relieve symptoms would be anti-spasmodic medication like mebeverine chloride, dicyclomine hydrochloride, etc.

I hope this helps. Do write back to me if you have any more queries. I would be happy to help.

Best wishes.

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