Conversation: The conversation between human and AI assistant.
[|Human|] I am now experiencing severe cramping (lower abdomen the spreads through my entire stomach up to my diaphragm. stomach pain. Started last night. The pain comes and goes but when I feel it, it is the most painful feeling I felt. Lasts for a few seconds. Pain also radiates on my left shoulder. Feels like. I need to pass air but I can t. Please help. Thanks
[|AI|]  Hi. With the history you have provided the spasmodic pain in the abdomen with a referred pain to shoulder is suggestive of the peritonitis part also. I would advise you to go to ER/ Hospital immediately. Be nil orally, do not take anything orally. You need the investigations of :: X-ray of the abdomen in the standing position to see for the gas under the diaphragm. X-ray of the chest. Ultrasonography for fluid in the peritoneal cavity. If you have a perforation you may need urgent surgery. If there is obstruction and causing secondary peritonitis, conservative treatment can be tried.