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Hi Dr. Robert,

First take my cordial greetings. I know that you give free advice, really so great you are! I feel really happy to find doctor like you.

I am Shapla Yasmin, Female, 23 years old, Student of LLB. I come from Chittagon, Bangladesh. Please advise me in that matter whatever I describe in the below:

Problems: My mother is 39 years old. Since 3/4 years my mother feeling pain on womb and full of abdomen. When pain starts she feel ache with her full abdomen. And that time my mother feel Influenza and my mother's whole belly and abdomen become hot. That time she never moved.

We viewed my mother so many doctors. But nobody can find out how can these pain starts, why this pain starts. We done all X- rays, Blood test, Urine test, Ultrasonography, so many things whatever doctors are given to us. But in report doctors nothing find out, everything is all right to my mother's health. And no doctor finds out the Disease, why that pain starts.

Dr. Robert, Please help me in this matter. How can stop that pain? And what medicine my mother should take for this pain?

Thanks & Regards

Shapla Yasmin

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© 2006 Robert Saltzman

Hello, Shapla Yasmin--

Thank you for your greetings and kind words. I appreciate hearing from you.

Back in the twentieth century, following Sigmund Freud's and Carl Jung's new understandings of the human psyche in which it was demonstrated that various bodily symptoms could be caused by inner emotional conflicts, medical doctors began to divide the causes of physical complaints into two categories. On the one hand, there were the "organic" ailments, meaning disease complaints which had an obvious physical cause (such as a wound, infection by harmful bacteria, poison, etc.), and on the other hand there were "psychosomatic" ailments, which had real physical symptoms (headaches, rashes, abdominal pains, etc.), but had no identifiable physical cause. These were called "psychosomatic" to indicate that the flesh (the soma) was being affected by the mind (the psyche).

In these twenty-first century days of computer aided brain scans separating "mind" (whatever that is) from body (especially the physical organ called "the brain") does not seem quite so clear cut as I imagine it did to Freud or Jung, but the basic distinction still seems useful. When a patient, such as your mother presents to a doctor with serious symptoms such as the ones she has, the doctor tries in every way to find a physical cause for the illness, because medical doctors specialize in finding physical causes, and then intervening with drugs, surgery, and other means in order either to remove or neutralize the causes or else to help the patient better to deal with the physical causes. I could give countless examples of this, but I am sure that you get the picture.

If the doctor tries many examinations and tests and still cannot find any physical cause for the illness, then there is a real problem because this could mean one of two things: either there is a physical cause of the illness, but that the doctor for one reason or another has not been able to find it, or there is no physical cause at all, the disease is psychosomatic, that is. I call this a problem because choosing between those two explanations is not always easy. Perhaps the patient really has a physical problem, but the doctor lacks access to tests which could reveal it, or the doctor lacks knowledge of that particular disease and so misses the diagnosis that a better informed physician would make. Since it is impossible completely to prove a negative (that a disease absolutely has no physical cause, for example), some doubt must always exist.

That said, the usual procedure when facing illness is to get a good physical exam and needed subsequent tests administered by a competent physician. If these prove negative, perhaps more tests will be tried. Eventually, however, if no examination or test can point to a physical cause for the complaint, the doctors will run out of resources, and will begin to assume that the problem probably is psychosomatic. Judging from what you have written, I think this is the situation regarding your mother's symptoms; the doctor's seem to have run out of resources. In other words, possibly the next thing to try is not further medical tests, but an examination by a psychologist who can begin to look for emotional conflicts which may be producing your mother's symptoms. I do want to emphasize, however, that I have not met your mother, nor had an opportunity to read her medical records, so I am only speaking here in general, not specifically about your mother.

I hope this will help, Yasmin.

Be well.

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