Opioids play a major role in management of pain and inflammation in peripheral and central nervous system. The endogenous ligands-opioid peptides (endorphins) are expressed by resident immune cells in peripheral tissues. Depriving the patient of proper pain medication can aggravate the immune system dysfunction. The selection of proper opiates for treatment of CRPS is quite critical. Both opioi...

BACKGROUND Increases in prescriptions of opioid medications for chronic pain have been accompanied by increases in opioid overdoses, abuse, and other harms and uncertainty about long-term effectiveness. PURPOSE To evaluate evidence on the effectiveness and harms of long-term (>3 months) opioid therapy for chronic pain in adults. DATA SOURCES MEDLINE, the Cochrane Central Register of Control...

Chronic intestinal pseudo-obstruction (CIPO) is a rare gastrointestinal motility disorder that presents with symptoms, physical exam, and imaging findings of mechanical bowel obstruction without an anatomical obstruction. Multiple etiologies, including enteric or extrinsic neuropathic dysfunction, myopathic dysfunction the interstitial cells Cajal, cause CIPO’s pathogenesis. The presentation CI...