Transdermal Buprenorphine in the Treatment of Chronic Abdominal Pain Syndrome

Centrally mediated abdominal pain syndrome (CAPS) is a condition that has traditionally been treated with first-line agents, such as tricyclic anti-depressants and serotonin and norepinephrine reuptake inhibitors. However, in the setting of pain refractory to these primary agents, there is little evidence in support of alternative regimens, especially opioid analgesics.

This case examines the utility of weekly 10 mcg transdermal buprenorphine patches as an additional treatment modality for CAPS, specifically in the setting of a 27-year-old woman with intractable abdominal pain following a cholecystectomy. In < 1 week, the patient had significant improvement in pain control without any of buprenorphine's potential side effects.

Given the debilitating pain CAPS causes alongside the widespread economic burden it puts on both patients and hospital systems, transdermal buprenorphine can be a transformative approach to mitigating the consequences of this syndrome.