An Unrecognized Cause of Chronic Diarrhea: Opioid-Induced Adrenal Insufficiency - A Case Report.

Authors

David Kweku Aseda Donkor, Rejoice Abiodun, Parth Adrejiya, Winston Ugbajah, Cyril Anara

Published in

Journal of pain & palliative care pharmacotherapy. Pages 1-5. Aug 31, 2026. Epub Aug 31, 2026.

Abstract

Opioid-induced adrenal insufficiency is an underrecognized form of secondary adrenal insufficiency caused by hypothalamic-pituitary-adrenal axis suppression and a potential but overlooked cause of chronic diarrhea. We describe a 59-year-old woman with six months of diarrhea, abdominal pain, weight loss, hypotension, and hyponatremia extensively evaluated but unrevealing for gastrointestinal etiology. Biochemical testing confirmed secondary adrenal insufficiency. Medication review revealed prior buprenorphine-naloxone exposure. Hydrocortisone therapy resulted in rapid hemodynamic improvement and resolution of gastrointestinal symptoms. Chronic gastrointestinal complaints are not always gastrointestinal in origin and should prompt consideration of endocrine etiologies, particularly in patients with opioid exposure.

PMID:
42671789
Bibliographic data and abstract were imported from PubMed on 01 Sep 2026.

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