Chronic pelvic pain

A 24 year old female complaining of pain in suprapubic and inguinal region since 1.5 yrs. pain is episodic 4-5 episodes per month, self reliving. Pain is felt like heaviness assd with simultaneous low back pain. Pain feels like going for motion but even then pain doent get relieved. There is no aciditý or altered bowelbladder habits. BMI is around 26. No pain on movement or jogging etc. back exam is normal, SLRT 90 FABERS neg no tenderness abdomen No tenderness as such soft abdomen USG shown small subserosal fibroid rest NAD i made a diagnosis of chronic pelic pain with some component of IBD. gave her gabapentin Tramadol, tryptomer and normaxin RT today many gynae seen but no relief What else can be done or what treat other doctors thic

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* Irritable bowel syndrome ** Endometriosis Add stelabid 2 TDS.and hot water compression during attack Needs further investigation and evaluation to conclude and treatment plan.
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Adv urine re Cystitis Endometriosis
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Unusual presentation, please look into stress related factors, these could be related to stress component. Many patients with somatoform pain disorder present with unusual pain with multiple consultation to different specialists. Over the period of time even symptoms may change. I recommend not to give opioid analgesics.
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Marital status sexual status any dicharge pv dysmenuhhrae appendicular status tob kept in mind before starting treatment urine for E coli stool exm r also to b kept mind
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It may be Cystitis or renal stone with DD of inguinal hernia , chronic amoebiasis Adv urine exam ,usg kub, and stool examination
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May be treated as endometriosis
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