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Pilot Study of Recurrent Abdominal Pain in the ED: Low-Risk Disease Associated with High Severity Pain and Frequent Opioid Administration

Year: 2025

Type: article

Abstract: OBJECTIVE: Abdominal pain is the most common emergency department (ED) chief complaint, with many patients experiencing recurrent episodes due to non-life-threatening etiologies such as disorders of gut-brain interaction. This pilot study aimed to characterize patients with recurrent low-risk abdominal pain, focusing on pain severity, management, biopsychosocial factors, opioid use, and 30-day return visits. METHODS: This prospective, observational pilot study enrolled adult ED patients with recurrent abdominal pain at a single academic center between July 2022 and June 2023. Inclusion required at least one similar episode in the prior year with symptom resolution between episodes. Exclusions included unstable clinical status or high-risk conditions. Patient-reported outcomes, social determinants of health, and clinical data were collected. Primary outcomes included pain severity, opioid use, and 30-day return visit rates. RESULTS: A total of 101 participants were enrolled (mean age, 43.7 years; 65.3% female; 69.3% Black). Pain severity was high (triage pain score, 7.1±2.6). Frequent prior computed tomography imaging was noted in 56.4% of participants. Opioids were administered in 50 participants (49.5%), while Patient-Reported Outcomes Measurement Information System (PROMIS)-29 scores highlighted risks of anxiety (T-score, 56.0±11.1) and pain interference (T-score, 60.8±8.2). Return visits occurred in 11 participants (10.9%) within 30 days. CONCLUSION: In this pilot study, patients with recurrent low-risk abdominal pain showed high symptom burden and healthcare utilization. Targeted interventions addressing biopsychosocial factors and improving pain management are needed to reduce ED revisits and improve outcomes.

Source: Clinical and Experimental Emergency Medicine

DOI: 10.15441/ceem.25.036