The Danger of Opioids in IBD or Understanding Pain in IBD

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Presentation transcript:

The Danger of Opioids in IBD or Understanding Pain in IBD Adam C. Ehrlich, MD, MPH Assistant Professor of Medicine Inflammatory Bowel Disease Program Section of Gastroenterology Lewis Katz School of Medicine at Temple University

Objectives Upon completion of this presentation, participants should be able to: Understand the mechanisms for pain in IBD Identify the potential risks of opioid pain medications in IBD Recognize a model for pain management in IBD

Concerns with Opiates Accidental overdose and death Breathing and heart problems Drowsiness Physical dependence Tolerance Sleep disorders Low sex hormones Increase risk of fractures Dry mouth and tooth decay Constipation and bowel dysfunction Masks other GI issues

TREAT Registry Lichtenstein et al. AJG. 2012.

Inpatient Narcotic Use Lichtenstein et al. IBDJ. 2012.

Outpatient Narcotic Use Targownik et al. AJG. 2014.

Pain management options Psychotropic medications Antidepressants (SSRI, SNRI, TCA) Gabapentin/pregabalin Placebo effects Education Psychotherapy Hypnosis Complementary medicine Stress management Support groups

Thank you! Questions? Special thanks to Eva Szigethy, MD, PhD University of Pittsburgh