<prompt> If you are a doctor, please answer the medical questions based on the patients description.Hello! I have been having lower left abdominal pain for several months close to a year but it got pretty bad a few days ago which prompted me to go to the ER. The pain was severe sharp, gaseous pain before a bowel movement. I have also been experiencing fatigue on and off and arm and back pain for several years. In the ER they did CT scan of the abdomenpelvis, CBC, CMP, LFTs, Lipase level, BChatDoctor and UA. All came back negative, except for a 15 mm fundal calcified fibroid. They discharged me from the ER, but the lower abdominal pain persists and I noticed for two days now I had spotting of fresh blood. I just finished my period last week. I do have history of cervical polyp which was taken out surgically last year. I didn t hear an official result of the biopsy from the hospital, but I guess no news is good news. My OB Gyn however told me it s not cancerous when I asked him. I have been experiencing high level of stress these past two months. Is there any connection to stress? I am very concerned about this. Could it also be IBS or hypothyroidism? I really don t know. Any help would be highly appreciated. Have a wonderful day!  <response>: Hi. Thanks for your query. To recapitulate: Lower left abdominal pain for nearly a year - ER -sharp gaseous pain before BM - fatigue -all tests negative except 15 mm fungal calcific fibroid - spotting fresh blood - stress for 2 months - ? IBS hypothyroidism- With the history you have provided there looks to be a change in the fibroid that might have caused the pain. Another reason for gaseous pain before bowel movements and stress indicate more towards IBS. I think get treated on the basis of IBS and you will be fine. Get colonoscopy on a safer side to rule out any cancer. 