GERD and severe stabbing abdominal pain

Dear Ask The Doctor: Hi, i am writing on behalf of a friend. He had been diagnosed with having IBS when he was 13, without a colonoscopy, and now he is 25. He has been having abdominal pain and interchanges of diarrhea and constipation all these years but a month ago it suddenly got really worse (after having some fish, but even if it was bad, he had never experienced such excruciating pain again), as in one day he started to ache so much he couldn't get up off the floor. It was like stabbing and ripping him apart. He went to the hospital and had blood work done and an X-ray and they said it was normal but suggested a colonoscopy but he didn't go through with it. Ever since he has been having really severe abdominal pain and interchanges of diarrhea and constipation and he has been to several doctors, one prescribing him with amitriptyline and antibiotics for the intestine, and another after that giving him mebeverine hydrochloride alone. He took the antibiotics and amitriptyline for almost a month and it helped him a bit but in the evening he would none the less have the return of the severe pain in his entire abdomen, sometimes centering on the left upper side of it. Then he went to the other doctor who perscribed mebeverine hydrochloride, telling him it would instantly help, without that being the case when he tried it. He had extensive blood work done and everything was normal, no inflammation or anemia, and the doctor said he didn't need anything else and should just take the mebeverine. But he is still in pain and i was wondering if it could be something else with these symptoms. Should he have a colonoscopy or some other less painful test? He also has Gastroesophageal Reflux Disease.

Dear Kik: I am not sure if your friend has already visited a gastroenterologist for evaluation. However, there could be a possibility of esophagitis associated with the gastroesophageal reflux disease, or even stomach ulcer, to be a cause for such an excruciating pain. In my opinion an abdominal Xray or endoscopic examination of the upper GI tract may be help diagnose the underlying condition.