[Case of non-cancer abdominal pain successfully treated by a large amount of oral morphine].

A 34-year-old woman, with intractable non-cancer abdominal pain was successfully treated with large amounts of oral morphine. Medical records showed that she had been suffering from severe upper right abdominal pain with nausea and vomiting for 11 years. The pain continued all day long and the breakthrough pain occurred sometimes accompanied by nausea and vomiting. Various medical examinations including psychosocial exploration had been done to explain her pain mechanism and vomiting but causes were unknown. Psychological examination revealed she had no mental problems. A year and 6 months, she felt severe pain never experienced at the same area and she was transferred and admitted to our clinic. We conducted the epidural morphine analgesia. Her pain responded to this treatment. The dose of morphine was gradually increased and she was free from pain at the dose of 30 mg x day(-1) epidural morphine. With decreasing pain, her nausea and vomiting also diminished. This epidural dose could be clinically converted into 1,440 mg oral morphine. She was seen at our clinic twice a month for her pain condition and for checking the blood morphine level. In spite of large amount of morphine intake, no accumulation of blood morphine, M-6-G, and M-3-G levels was recognized.