1. 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

2. 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

21. 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

22. TREAT Registry
Lichtenstein et al. AJG

25. Inpatient Narcotic Use
Lichtenstein et al. IBDJ

26. Outpatient Narcotic Use
Targownik et al. AJG

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

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