Chronic continuous abdominal pain: evaluation of diagnostic features, iatrogenesis and drug treatments in a cohort of 103 patients

Autor:	Darren Green, Shaheen Hamdy, Eleesia Kilgallon, Peter Paine, Simon Lal, Philip L. Shields, Dipesh H. Vasant
Rok vydání:	2019
Předmět:	Adult Male medicine.medical_specialty Abdominal pain Cohort Studies Iatrogenesis 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine medicine Humans Duloxetine Pharmacology (medical) 030212 general & internal medicine Hepatology business.industry Gastroenterology Middle Aged Neurogastroenterology medicine.disease Abdominal Pain Analgesics Opioid Gastrointestinal Pain Allodynia chemistry Chronic Disease Neuropathic pain Female 030211 gastroenterology & hepatology medicine.symptom business Cohort study
Zdroj:	Alimentary Pharmacology & Therapeutics. 49:1282-1292
ISSN:	0269-2813 2009-2016
DOI:	10.1111/apt.15241
Popis:	BACKGROUND Chronic continuous abdominal pain (CCAP) is characteristic of centrally mediated gastrointestinal pain disorders. It consumes significant healthcare resources yet is poorly understood, with minimal cohort-specific data in the literature. AIMS To examine in a large cohort of CCAP patients, (a) diagnostic features, (b) iatrogenic impact of opioids and surgery, (c) drug treatment effects and tolerance. METHODS Consecutive tertiary CCAP referrals to a neurogastroenterology clinic (2009-2016) were reviewed for Rome IV and neuropathic pain criteria. Medical, surgical and drug histories, interventions and outcomes were correlated with clinical diagnosis and associated opioid use. RESULTS Of 103 CCAP patients (mean age 40 ± 14, 85% female), 50% had physiological exacerbations precluding full Rome IV Centrally Mediated Abdominal Pain Syndrome criteria. However, there were no significant differences between patients who satisfied Rome IV criteria and those who did not. Overall, 81% had allodynia (a nonpainful stimulus evoking pain sensation). Opioid use was associated with allodynia (P = 0.003). Prior surgery was associated with further operations post CCAP onset (P
Databáze:	OpenAIRE
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