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Chronic Drug Use and Abdominal Pain
Alexis L Cates1, Brenna Farmer2
1Division of Medical Toxicology, Department of Emergency Medicine, Einstein Healthcare Network, Korman B-14, 5501 Old York Road, Philadelphia, PA 19141, USA.
Emergency Medicine Clinics of North America
|October 3, 2021
Summary
Chronic alcohol and substance abuse can cause a range of gastrointestinal issues, from mild discomfort to life-threatening emergencies. Emergency departments see patients with diverse abdominal complaints linked to substance use.
Area of Science:
- Gastroenterology
- Toxicology
- Emergency Medicine
Background:
- Chronic alcohol and substance abuse are prevalent, often leading to significant health complications.
- Gastrointestinal (GI) pathologies are frequently encountered in patients with a history of substance use.
- Abdominal complaints in these patients can range widely in severity.
Purpose of the Study:
- To review the spectrum of gastrointestinal pathologies associated with chronic alcohol and substance abuse.
- To highlight the role of ethanol, opioids, and other substances in causing emergent GI symptoms.
- To inform emergency department (ED) physicians about substance-induced GI presentations.
Main Methods:
- Literature review of studies focusing on substance abuse and gastrointestinal complications.
- Analysis of clinical presentations of patients in the emergency department with abdominal complaints and substance use history.
- Categorization of GI pathologies based on the type of substance used (ethanol, opioids, etc.).
Main Results:
- Ethanol abuse is linked to conditions like alcoholic gastritis, pancreatitis, and liver disease.
- Opioid use can result in constipation, bowel obstruction, and ischemic colitis.
- Other substances may precipitate diverse GI issues, including nausea, vomiting, and abdominal pain, some requiring urgent intervention.
Conclusions:
- Substance abuse significantly contributes to a wide array of gastrointestinal emergencies.
- Recognition of substance-induced GI pathologies is crucial for timely and appropriate emergency care.
- Understanding these associations aids in managing patients presenting with abdominal complaints in the ED.
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