Yikes! Well a biopsy would be definitive. I'm not sure if I was born with it, but I have heard that symptoms can present themselves in three different circumstances, which are: underlying condition of lymphoma (not me thankfully), abdominal surgeries (I have had several), or severe back trauma. My symptoms came on two weeks to the day of a horrible fall on black ice. My specialist believes 100% that my symptoms were brought on by the fall. For pain management, I am on CBD oil, Targin (oxybased, mild slow release that does not constipate) and percocet for breakthrough pain. I hope this helps you.