Wong V, Sobala G, Losowsky M
Academic Unit of Medicine, St James's University Hospital, Leeds, UK.
Postgrad Med J. 1994 Feb;70(820):138-40. doi: 10.1136/pgmj.70.820.138.
Patients with chronic abdominal pain without an organic basis present a difficult management problem. Some of these patients may be prescribed opiates initially which may result in requiring progressively higher doses for pain relief. In this clinical setting, the suspicion of narcotic bowel syndrome should be borne in mind. With appropriate treatment and counselling, further invasive investigations including laparotomy may be avoided and resolution of symptoms can be achieved with clonidine. This case report demonstrates such a typical clinical scenario and discusses the possible aetiology and pathophysiology of narcotic bowel syndrome as well as the role of clonidine in controlling opiate withdrawal symptoms.
患有无器质性基础的慢性腹痛患者面临着棘手的管理问题。这些患者中的一些人最初可能会被开具阿片类药物,这可能导致为缓解疼痛而需要逐渐增加剂量。在这种临床情况下,应考虑到麻醉性肠道综合征的可能性。通过适当的治疗和咨询,可以避免包括剖腹手术在内的进一步侵入性检查,使用可乐定可实现症状缓解。本病例报告展示了这样一个典型的临床场景,并讨论了麻醉性肠道综合征可能的病因和病理生理学,以及可乐定在控制阿片类药物戒断症状中的作用。