Methadone ileus syndrome

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Abstract
A case is presented of a 24 yr old man [a former heroin addict] undergoing methadone maintainance who developed massive abdominal distention. Respiratory compromise was indicated from diaphragmatic elevation observed on X-rays. Methadone and other morphine congeners cause slower fecal passage leading to increased water absorption, producing hardened feces and intestinal obstruction. Abdominal distention and tenderness are symptomatic and treatment is non-surgical including i.v. administration of fluids, nasogastric suction and repetitive high colonic enemas. Laxatives may be given after some stool is passed.

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