"K Cramps," Recurrent Abdominal Pain in a Patient with Chronic Ketamine Use: A Case Report.
Tucker Avra, Jesus Torres, Kumar Felipe Vasudevan, Elizabeth A Samuels
Clinical practice and cases in emergency medicine August 1, 2024 DOI: 10.5811/cpcem.19431 via PubMed
Summary
AI-generated from the abstractA 31-year-old man with a three-year history of using ketamine by inhalation, injection, and intravenously visited the emergency department twice in one week with severe back and abdominal pain and indigestion. Standard tests and advanced imaging found no clear cause. The patient identified from Reddit that his symptoms likely stemmed from chronic ketamine use; after stopping ketamine, his pain improved within 24 hours. He then sought addiction treatment on his own. Emergency physicians should consider chronic ketamine use as a possible cause for gastrointestinal and urinary symptoms, and offer education, symptom relief, and links to substance use treatment.
Study at a glance
| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 31-year-old male with chronic nonmedical ketamine use |
| Keywords | Ketamine abuse Chronic pain Drug-induced illness Emergency medicine Self-diagnosis |
| Citations | 2 |
| Key finding | Chronic ketamine use can cause severe atraumatic back and abdominal pain that resolves upon discontinuation, and patients may self-diagnose via online forums. |
Abstract
Medical and nonmedical ketamine use is increasing in the United States. This will likely lead to an increase in emergency department (ED) visits in individuals experiencing associated side effects. Physicians will need to be able to effectively recognize and manage ketamine-related complications. A 31-year-old male with a three-year history of inhalational, intramuscular, and intravenous nonmedical ketamine use presented to the ED twice within a week with symptoms of severe atraumatic back pain, abdominal pain, and dyspepsia. A comprehensive workup, including advanced imaging, was unrevealing for identifiable causes, and the patient was discharged with instructions for primary care follow-up for further evaluation. The patient used information shared on Reddit, an online forum and social network, to identify that the cause of his pain was related to chronic ketamine use. Subsequently, upon discontinuation of ketamine, the pain improved in 24 hours. The patient self-navigated to addiction treatment. Emergency physicians should consider sequelae of chronic ketamine use as a possible cause for gastrointestinal and urologic symptoms in the ED. In addition to thorough examination and assessment for other acute medical problems, patients should be offered education, symptomatic treatment, and linkage to harm reduction and substance use disorder treatment services.