This topic is about someone who has been experiencing persistent, sharp pain near their ileostomy after an injury during horseplay. Despite various medical evaluations and treatments, the pain remains unresolved, and they are seeking further advice and insights. Here are some suggestions and considerations:

1. Imaging and Diagnostics
- It might be helpful to repeat imaging tests, focusing on potential musculoskeletal injuries. This could include CT scans, MRIs, or ultrasounds targeting the ribs, abdominal wall, and groin to check for issues like a cracked rib, pulled muscle, or a new hernia.
- For gallbladder issues, a special contrast CT or a HIDA scan with IV tracer and oral contrast might be necessary, as standard CT scans can sometimes miss dysfunctions.
- Consider the possibility of internal scar tissue or adhesions, which can cause constant pain that worsens with bowel movements.

2. Possible Causes
- Peripheral nerve damage or neuropathy from the lifting incident is a possibility. It might be beneficial to consult a surgeon who specializes in peripheral nerve repair.
- Multiple abdominal wall hernias can develop along incision lines and cause pain, so a thorough hernia survey is important.
- The pain could also have a muscular origin, so exploring muscle relaxants or targeted physical therapy might be worthwhile if not already tried.

3. Specialist Referrals
- Consider consulting a peripheral nerve specialist or pain neurologist. It's advisable to get at least three opinions before considering any surgical nerve repair, as success can often be a one-time opportunity.
- A pain management clinic might offer options such as nerve blocks or external/electronic nerve stimulation devices.

4. Treatment Approaches
- If the issue is nerve-related, options could include surgical repair, neuro-stimulation, or advanced pharmacologic treatments beyond pregabalin (Lyrica).
- Continue using heat and ice packs; some people find that alternating them helps with muscle spasms.
- Ensure the hernia belt is fitted correctly, as an improper fit can worsen the pain.

5. General Recommendations
- Keep a detailed record of pain patterns and triggers to assist specialists in understanding the issue.
- Advocate for timely referrals and seek second and third opinions when necessary.
- Communicate any activity limitations to avoid further injury and modify physical interactions to protect the stoma area.