Opioid Withdrawal Misdiagnosed as a Crohn's Flare

There is an increased incidence of opioid use disorder (OUD) originating from prescription misuse. Diagnosing OUD remains challenging, particularly in patients with multiple medical comorbidities where other potential etiologies may cause overlapping symptoms.

This report highlights a 28-year-old male with Crohn's disease (CD) with recurrent hospitalizations of abdominal pain, hematuria, nausea, vomiting, and diarrhea. An extensive workup was negative for a Crohn's flare; however, the patient's symptoms improved within 48 h of admission, coinciding with opioid administration for pain management. Subsequently, the patient was diagnosed with opioid withdrawal and discharged with a buprenorphine clinic appointment to initiate medications for OUD.

This case highlights the complexity of diagnosing opioid withdrawal in a patient with CD and the persistent stigma in the healthcare community regarding persons who use opioids.