GI

Opioids for Abdominal Pain – Are We Influencing Rate of Return?

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Patients who are discharged from the emergency department after presenting with abdominal pain and receiving opioids have 57% greater odds of return within 30 days. This population is also at higher risk for adverse effects from these medications.

Source
Return Rates for Opioid versus Nonopioid Management of Patients with Abdominal Pain in the Emergency Department. J Emerg Med. 2023 Apr;64(4):471-475. doi: 10.1016/j.jemermed.2023.01.008. Epub 2023 Mar 28.

Is It Just Me or Are We Seeing More Cannabis Hyperemesis?

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Legalization of cannabis in Ontario was not associated with an increase in ED visits for cannabis hyperemesis syndrome (CHS); however, after legislation passed allowing commercialization of cannabis, there was a large increase in visits for CHS.

Source
Changes in Emergency Department Visits for Cannabis Hyperemesis Syndrome Following Recreational Cannabis Legalization and Subsequent Commercialization in Ontario, Canada. JAMA Netw Open. 2022 Sep 16. Doi:10.1001/jamanetworkopen.2022.31937

A Spoonful of Sugar – Does Open-Label Placebo Work?

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Children with functional abdominal pain and irritable bowel syndrome taking an open-label placebo reported significantly less pain and took fewer rescue pain medications.

Source
Effect of Open-label Placebo on Children and Adolescents With Functional Abdominal Pain or Irritable Bowel Syndrome: A Randomized Clinical Trial. JAMA Pediatr. 2022 Apr 1;176(4):349-356. doi: 10.1001/jamapediatrics.2021.5750. Erratum in: doi: 10.1001/jamapediatrics.2022.0359.

New Outbreak of Acute Hepatitis in Children – Why?

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A new, rare form of acute hepatitis has been seen in children, mostly under age 5 years, that presents with vomiting, diarrhea, and abdominal pain, followed by acute hepatitis with jaundice. If you see a child with a “stomach virus” who has jaundice – check labs!

Source
Acute hepatitis is identified in more children, but cause remains elusive. BMJ. 2022 May 6;377:o1156. doi: 10.1136/bmj.o1156.

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