Table 2.

Case Summaries

Age/Gender	Symptoms (Duration)	Duration Of Narcotic Use	Dose At Presentation	Treatment For NBS	Immediate Outcome	Follow Up
#1 40 yo Female	No prior GI symptoms or narcotic use had surgery for acute pain	10 weeks during post-operative period while in hospital	40 mg/day morphine sulphate IV escalating to 80 mg/day	Narcotic withdrawal over 6 days, clonidine0.1 po tid, lorazepam01 mg tid, desipramine50 mg. qhs	75% relief by hospital discharge	Complete resolution at 1 year and no recurrence
#2 37 yo Female	abdominal pain, nausea, vomiting, diarrhea, constipation.(14 years)	2 years	Morphine Sulfate90mg/day	Narcotic reduced 33% q2days, clonidine patch 0.2 mg before stopping narcotic, desipramine 100 mg qhs, paroxetine 20 mg qd	Marked improvement	3 months: no pain; on desipramine and paroxetine with mild constipation 9 months: 3 mild episodes of pain consistent with IBS; No narcotic use
#3 42 yo Female	IBS (23 years) + chronic pain (3 years)	3 years	Oxycodone 30mg/day	Narcotic reduced 50% per week, Clonazepam 0.5 mg qd, clonidine patch 0.2 mg, paroxetine 60 mg. qd	Marked improvement	One year later, no pain. No narcotics.
#4 20 yo Female	Lower Back Pain (16 months) abdominal pain, nausea, vomiting (4 weeks); New diagnosis of CD	20 months	Methadone260mg/day	Narcotic reduced 10–20% over 11 days, Duloxetine 30–60 mg, cyclobenzaprine, clonidine 0.1 po qid, lorazepam 1 mg. po qid	Marked improvement relapse and subsequent improvement,	6 months, no pain or narcotics; 12 months relapse of narcotics, again detoxified and pain free one month later
#5 20 yo Female	Mid-abdominal pain 8 weeks (history of UC with IPAA 1 year earlier)	At least 8 weeks (uncertain if longer	90 mg. IV increased to 360 mg. morphine or equivalent/day	Narcotic reduction by 33% every two days, Duloxetine, clonidine, lorazepam	Narcotics withdrawn but patient went back on narcotics	Continued drug seeking behavior several months later