Hello - I ve had a two major episodes now in the middle of the night that involved waking up with extreme pain and unbelievable flatulence (both ends). In both cases there was a pain, best described as gnawing, in my Epigestric region and extending upwards between and BEHIND both shoulder blades. In both cases I had to manipulate my torso in various ways to assist with the removal of the flatulence. The first time I assumed it was bad heartburn - my mother has GERD and I thought perhaps I was developing it. But it didn t return until a few months later and this time it was worse. It lasted longer and this time I threw up (nothing had digested from dinner... 6-7 hours prior). In both cases I tried Apple Cider vinegar and later, baking soda with water. Both assisted with belching which brought temporary relief. The vomiting also brought a measure of relief, though I still have a nagging pain in between and behind my shoulder blades (12 hours later) which may simply be the result of the heaving. There doesn t appear to be a connection between fatty foods or even caffeine. The only possible one I came up with was chocolate and in this last case I had only a little - I m not even positive I ate chocolate the time before though it is possible. I eat fatty foods and chocolate on a regular basis, however, without these side effects. Upon doing some research, my first consideration was some sort of gall bladder issue. But I don t remember feeling more significant pain on the right side or at the bottom of my ribs, other than the uncomfortable gas feeling. For full disclosure, I have always had cases of painful gas (though never with the pain up so high in my back and never with vomiting). Also, I was diagnosed with Irritable Bowel Syndrome about a decade ago though it doesn t appear to affect me much except for being more gassy than the average bear. Any opinions?