A 32-year-old woman with a 10-year history of abdominal pain presented to the gastroenterology clinic for evaluation of abdominal pain. She reported episodes of severe, diffuse abdominal pain, which she rated at 10 on a scale of 0 to 10, with 10 representing the worst pain imaginable. These episodes occurred every month or two and usually lasted for several days. They were unrelated to her menstrual cycles and occurred without an apparent precipitant. Between episodes, she reported having mild, cramping midabdominal pain almost every day, with the pain fluctuating in severity throughout the day. The pain was not associated with food intake but was aggravated by running. She had been hospitalized three times for episodes of severe pain.
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