ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2007
The narcotic bowel syndrome: clinical features, pathophysiology, and management.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 98 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
98 citing papers in PubMed, 1 synthesis or guideline pooled it, 241 citations in OpenAlex.
- A meta-analysis of the long-term outcomes following surgery or endoscopic therapy for chronic pancreatitis.Langenbeck's archives of surgery · 2022Pooled it
- Patients With Short Bowel on Narcotics During 2 Randomized Trials Have Abdominal Complaints Independent of Teduglutide.JPEN. Journal of parenteral and enteral nutrition · 2017Trial
- Narcotic bowel syndrome misdiagnosed as somatoform pain disorder and presenting with opioid use disorder - A case report.Indian journal of psychiatry · 2026Article
- Mechanisms of chronic abdominal pain in inflammatory bowel disease and implications for treatment.Nature reviews. Gastroenterology & hepatology · 2026Review
- An examination of the interaction between the interoceptive and reinforcing properties of morphine: a self-administration study in male and female rats.Psychopharmacology · 2026Article
- Evaluating the analgesic effect of metamizole in the mouse model for DSS-induced acute colitis.Frontiers in physiology · 2026Article
- Pain management in a patient with intestinal failure in the palliative care setting: case report.BMC palliative care · 2025Article
- Microbiome-derived metabolites in substance use disorders: Mechanisms and implications.Annals of the New York Academy of Sciences · 2025Review
- The use of transcutaneous electrical acupoint stimulation to reduce opioid consumption in patients undergoing off-pump CABG: a randomized controlled trial.Perioperative medicine (London, England) · 2024Article
- Predictive Scores for Identifying Chronic Opioid Dependence After General Anesthesia Surgery.Journal of pain research · 2024Article
- Lifestyle Factors and Silent Inflammatory Bowel Disease.Inflammatory intestinal diseases · 2023Article
- Abdominal Pain in Inflammatory Bowel Disease: An Evidence-Based, Multidisciplinary Review.Crohn's & colitis 360 · 2023Article
- Opioid use in children with inflammatory bowel disease-related arthritis.Clinical and experimental rheumatology · 2023Article
- Irritable Bowel Syndrome Is an Independent Risk Factor for Developing Opioid Use Disorder in Patients with Inflammatory Bowel Disease.Journal of personalized medicine · 2023Article
- Management of Pelvic Pain in Patients with Crohn's Disease-Current Overview.Journal of clinical medicine · 2023Review
- Gastrointestinal symptoms and nutritional issues in patients with hypermobility disorders: assessment, diagnosis and management.Frontline gastroenterology · 2023Article
- Pharmacological and non-pharmacological therapeutic interventions for the treatment of spinal cord injury-induced pain.Frontiers in pain research (Lausanne, Switzerland) · 2022Review
- Less Well-Known Consequences of the Long-Term Use of Opioid Analgesics: A Comprehensive Literature Review.Drug design, development and therapy · 2022Review
- High-Dose Opioid Use Among Veterans with Unexplained Gastrointestinal Symptoms Versus Structural Gastrointestinal Diagnoses.Digestive diseases and sciences · 2021Article
- Article
38 more citing papers are in PubMed but not listed here.
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
Narcotic bowel syndrome (NBS) is a subset of opioid bowel dysfunction that is characterized by chronic or frequently recurring abdominal pain that worsens with continued or escalating dosages of narcotics. This syndrome is underrecognized and may be becoming more prevalent. In the United States this may be the result of increases in using narcotics for chronic nonmalignant painful disorders, and the development of maladaptive therapeutic interactions around its use. NBS can occur in patients with no prior gastrointestinal disorder who receive high dosages of narcotics after surgery or acute painful problems, and among patients with functional gastrointestinal disorders or other chronic gastrointestinal diseases who are managed by physicians who are unaware of the hyperalgesic effects of chronic opioids. The evidence for the enhanced pain perception is based on the following: (1) activation of excitatory antianalgesic pathways within a bimodal opioid regulation system, (2) descending facilitation of pain at the rostral ventral medulla and pain facilitation via dynorphin and cholecystokinin activation, and (3) glial cell activation that produces morphine tolerance and enhances opioid-induced pain. Treatment involves early recognition of the syndrome, an effective physician-patient relationship, graded withdrawal of the narcotic according to a specified withdrawal program, and the institution of medications to reduce withdrawal effects.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.