{"id":207,"date":"2010-10-01T23:02:07","date_gmt":"2010-10-02T03:02:07","guid":{"rendered":"http:\/\/blogstemp3.wpengine.com\/?p=207"},"modified":"2010-10-01T23:02:07","modified_gmt":"2010-10-02T03:02:07","slug":"the-new-epidemic-narcotic-bowel-and-abdominal-pain","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/the-new-epidemic-narcotic-bowel-and-abdominal-pain\/2010\/10\/01\/","title":{"rendered":"The New Epidemic: Narcotic Bowel and Abdominal Pain"},"content":{"rendered":"<p>I remember clearly when \u201cpain\u201d became a vital sign. As I suspect most medical professionals felt, chronic pain was a serious and disabling symptom that was poorly treated for the most part. The last decade of expanding research into mechanisms and treatments of chronic pain has brought enormous relief to the millions that suffer from this symptom.<\/p>\n<p>However, it has also resulted in a growing and devastating new problem and that is visceral hyperalgesia (abdominal pain) from chronic narcotics used to treat pain. Whereas most health care professionals know that narcotics can cause alteration in bowel function (constipation from slowed colonic transit, nausea and vomiting from delayed gastric emptying, etc.), I suspect most are not aware that narcotic bowel from chronic narcotic use also includes abdominal pain arising from narcotic induced visceral hypersensitivity.<\/p>\n<p>It has been said that the most common reason for consultation to a GI doctor is for IBS, but in my practice, the most common consult is now for abdominal pain that is secondary to chronic narcotic use. This is the new GI epidemic in the U.S. in my opinion.<\/p>\n<p>Have you been seeing these patients as well? What are you telling them and the referring provider? Let us know what you think. <\/p>\n","protected":false},"excerpt":{"rendered":"<p>I remember clearly when \u201cpain\u201d became a vital sign. As I suspect most medical professionals felt, chronic pain was a serious and disabling symptom that was poorly treated for the most part. The last decade of expanding research into mechanisms and treatments of chronic pain has brought enormous relief to the millions that suffer from [&hellip;]<\/p>\n","protected":false},"author":28,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-207","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/posts\/207","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/users\/28"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/comments?post=207"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/posts\/207\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/media?parent=207"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/categories?post=207"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/tags?post=207"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}