<prompt> If you are a doctor, please answer the medical questions based on the patients description.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  <response>: 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. 