Based on the detailed description provided, it sounds like the individual is experiencing a chronic abdominal issue that has been ongoing since 2019. Here is a summary and analysis of the symptoms described:
Symptoms:
- Pain Location and Nature:
- Pain in the right side of the abdomen.
- Persistent pain that worsens periodically, making it very difficult to bear.
- Physical Sensations:
- Sensation of a wound inside the abdomen.
- A feeling of something spreading like a fluid, similar to the sensation of an injection spreading.
- Additional Symptoms During Flare-Ups:
- Vomiting.
- Feverish feelings.
- Pain that sometimes subsides suddenly but leaves lingering pain when walking.
- Frequency and Duration:
- The pain and discomfort seem to occur at least once every year and last for several days.
- Associated Issues:
- Feeling of burning and redness in the ears.
- Excessive thirst, drinking around four liters of water daily.
- Restlessness.
- Pain in the soles of the feet.
- Physical Changes:
- Persistent small lump on the right side of the abdomen.
- Audible sounds from the abdomen, especially noticeable when the stomach is empty.
Diagnostic Efforts:
- Multiple scans (including those at major hospitals like Kalubowila and Colombo General Hospital) showed no significant abnormalities.
- Received medication for suspected internal injuries, but no surgical intervention.
Potential Conditions:
- Chronic Appendicitis: Chronic inflammation of the appendix can cause intermittent pain in the lower right abdomen, nausea, and fever.
- Irritable Bowel Syndrome (IBS): This can cause abdominal pain, bloating, and changes in bowel habits, though it typically doesn't cause fever or the sensation of internal injury.
- Kidney Stones or Gallstones: Stones can cause intermittent severe pain, especially if they move or cause blockages.
- Hernia: A hernia could cause a lump and pain, particularly if it becomes incarcerated or strangulated.
- Gastrointestinal Disorders: Conditions like Crohn's disease or ulcerative colitis could explain some symptoms but typically involve more obvious changes in bowel habits and more visible inflammation on scans.
- Interstitial Cystitis: This bladder condition could cause abdominal pain, burning sensation, and increased frequency of urination.
- Neurological Causes: Nerve entrapment or damage could cause referred pain, burning sensations, and other neurological symptoms.
- Adhesions or Scar Tissue: Post-inflammatory or post-surgical adhesions can cause intermittent pain and sensations of internal pulling.
Recommendations:
Given the chronic nature and the complexity of the symptoms, it is advisable to consult a specialist who can conduct a thorough examination and possibly provide a fresh perspective. The following specialists could be consulted:
- Gastroenterologist: For comprehensive evaluation of the gastrointestinal tract.
- Neurologist: To investigate any neurological causes of pain and sensations.
- Urologist: Given the frequency of urination and burning sensations.
- General Surgeon: To rule out any hernias or other surgical issues.
- Pain Specialist: To manage chronic pain and explore pain relief options.
Since the person is located around Maharagama, Pannipitiya, Thalawathugoda, or Kottawa, finding a reputable hospital or clinic in these areas with specialists in these fields would be beneficial. It may also be useful to gather all previous medical records and test results for the specialist to review comprehensively.