narcotic bowel syndrome; opioid-induced gastrointestinal hyperalgesia

Introduction

unexplained abdominal pain that is treated with opioids & persists or worsens while opioid doses are maintained or increased

Etiology

• may associated with opioid-related dysmotility (i.e. constipation, gastroparesis, ileus)
• idiopathic

Pathology

• opiate-induced gastrointestinal hyperalgesia

Clinical manifestations

• paradoxical increase in abdominal pain with increasing doses of narcotics

Management

• discontinue opiates
  • may need to taper in a monitored environment
• high rate of recidivism

More general terms

• syndrome
• intestinal disease
• opioid-induced hyperalgesia

Additional terms

• opioid-induced constipation (OIC)