Brief Answer: Mutidimensional suspicions, needs workup Detailed Answer: Good day XXXX! My name is Dr S Khan and i would like to help you with your pain in left hypochondriac region. Miss XXXXXXX providing the history and comorbidities this pain has multidirectional etiology. These sharp pains could be the flaring of interstitial lung disease which you already have involving pleural layers. Or this could be pulmonary manifestation of rheumatoid arthritis you have. It could be gastro intestinal discomfort like Ulcer or reflux as you have lupus which is a very common part of this disease. and it could be simple NSAIDs and other pain medicines induced gastric ulcer you take from such a long time. And it could be pancreatic gallbladder profile derangement as age of 43 with a transition of menstrual life predisposes to such troubles like pancreatitis or cholelithiasis (gall stone). I hope you see the dimensions in which a single pain of left hypochondriac region is going. SO i advise miss XXXXXXX to seek the help of nearby physician and have some work up. Ultrasound abdomen and pancreatic profile with liver function profile would be a good start. Once ruled out then your morbidities would be looked for as a reason for this pain . to me it looks like gastric ulcer as most of the dots are connected with this suspicion. But its too early to say what it is. Seek the help and do as directed and keep me posted on the updates. Hope this answer finds you in good faith. Kindly do ask the follow up if any thing needs more explanation. i would be happy to explain. other wise i request you to please close the discussion and rate the answer as per your experience. Have a very good rest of the day XXXXXXX and may the odds be ever in your favour. Regards Dr S Khan

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