Q: I have pain in the left and right side of the abdomen. Initially, for one month, the pain was only on the right side, near the appendicular region. The pain was not much and was bearable. Now the pain is on both sides. I have shown to two doctors who are highly qualified and experienced gastroenterologists (one in Hyderabad and other one in Chennai). Both these doctors initially thought it may be Appendicitis and suggested some tests. I underwent endoscopy, which showed a healed ulcer. I also underwent colonoscopy, which revealed Irritable Bowel Syndrome. I also underwent an ultrasonic scan 1 month ago and the scan has ruled out formation of stones in the kidney, ureter and bladder. There is no stone formation. Now the doctors are saying it is not appendicitis. Also, as per the scan, there are no stones in the kidney, ureter and bladder. The pain is increasing slowly day by day. I am taking the following pills: Pantocid, Colospa and Spasmo-Proxyvon. What is my problem and its cure?

A:You have been to several doctors, including some of the very best. It is unlikely that I can advise you better than them without seeing you. I can tell you about some of these diseases. Appendicitis is an acute inflammation of the appendix, and causes pain in the right lower abdomen. The diagnosis is made on blood tests and ultrasonography. In an acute attack a CT scan is an excellent test, but is infrequently done. Treatment is surgical. Irritable bowel syndrome is a disorder of function, and very few tests are diagnostic. Often it is diagnosed after other diseases are ruled out. In irritable bowel syndrome the symptoms are pain, gas, diarrhea, sometimes constipation, and other features that can point to several disorders. Treatment is with medicines, and you need to be in contact with one gastroenterologist who will give you time. Diverticulitis is characterized by small diverticulae (outpouchings from the intestine) in the large intestine. These diverticulae get inflamed and may cause pain in both sides of the abdomen. Patients have pain, occasional fever, diarrhoea or constipation. Endoscopy can see these diverticulae, as can a barium If these studies were negative in your case, diverticulitis is unlikely, though still just possible. Treatment is initially medical, with drugs, then surgery is an option. All things considered, you should be in touch with one gastroenterologist, who will treat you regularly. Also ask him to rule out abdominal tuberculosis. Are or were you a habitual drinker? Ask him to rule out chronic pancreatitis.