Buprenorphine–Naloxone as a Novel Treatment of Narcotic Bowel Syndrome: A Case Report
Authors: Elizabeth Loomis, Jasdeep Bajwa, Sachiko Kaizuka
Journal: Annals of Internal Medicine (2020)

Letters21 July 2020Buprenorphine–Naloxone as a Novel Treatment of Narcotic Bowel Syndrome: A Case ReportElizabeth Loomis, MD, Jasdeep Bajwa, DO, and Sachiko Kaizuka, MDElizabeth Loomis, MDUniversity of Rochester, Rochester, New York (E.L., J.B., S.K.)Search for more papers by this author, Jasdeep Bajwa, DOUniversity of Rochester, Rochester, New York (E.L., J.B., S.K.)Search for more papers by this author, and Sachiko Kaizuka, MDUniversity of Rochester, Rochester, New York (E.L., J.B., S.K.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0798 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Narcotic bowel syndrome is a chronic pain syndrome that occurs with opioid use and is defined by the Rome IV criteria (Table) (1). One of its features is that abdominal pain persists as opioid treatment is continued or escalated. Information about treatment options is limited, and treatment is successful in few patients (2). For example, more than half of patients with this syndrome who undergo opioid detoxification return to opioid use within a few months because of continued pain (3).Table. Rome IV Criteria for Narcotic Bowel Syndrome (1)Objective: To ...References1. Keefer L, Drossman DA, Guthrie E, et al. Centrally mediated disorders of gastrointestinal pain. Gastroenterology. 2016;150:1408-19. [PMID: 27144628] doi:10.1053/j.gastro.2016.02.034 CrossrefMedlineGoogle Scholar2. Sandgren JE, McPhee MS, Greenberger NJ. Narcotic bowel syndrome treated with clonidine. Resolution of abdominal pain and intestinal pseudo-obstruction. Ann Intern Med. 1984;101:331-4. [PMID: 6147108] LinkGoogle Scholar3. Drossman DA, Morris CB, Edwards H, et al. Diagnosis, characterization, and 3-month outcome after detoxification of 39 patients with narcotic bowel syndrome. Am J Gastroenterol. 2012;107:1426-40. [PMID: 22710577] doi:10.1038/ajg.2012.142 CrossrefMedlineGoogle Scholar4. Ghosh SM, Klaire S, Tanguay R, et al. A review of novel methods to support the transition from methadone and other full agonist opioids to buprenorphine/naloxone sublingual in both community and acute care settings. Can J Addict. 2019;10:41-50. doi:10.1097/CXA.0000000000000072 CrossrefGoogle Scholar5. Luthra P, Burr NE, Brenner DM, et al. Efficacy of pharmacological therapies for the treatment of opioid-induced constipation: systematic review and network meta-analysis. Gut. 2018;68:434-44. [PMID: 29730600] doi:10.1136/gutjnl-2018-316001 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Rochester, Rochester, New York (E.L., J.B., S.K.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0798.This article was published at Annals.org on 12 May 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byManagement of Opioid-Induced Constipation and Bowel Dysfunction: Expert Opinion of an Italian Multidisciplinary PanelFentanyl/hydromorphone/morphine 21 July 2020Volume 173, Issue 2Page: 164-166KeywordsAbdominal painEmergency departmentGastroenteritisHospitalizationsNauseaOpioidsUltrasound imagingUrineVentricular fibrillationVomiting ePublished: 12 May 2020 Issue Published: 21 July 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...