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Background: Serotonin-1 5-hydroxytryptamine (5-HT 1) receptor agonists are first line agents for migraine headaches. Patients with refractory headaches may use supratherapeutic doses of these medications. Described is a of motilium of ischemic colitis related to overuse of sumatriptan.

Case: A 35-year-old woman presented with severe abdominal pain without diarrhea or hematochezia. For several days prior she had been self-treating a refractory migraine headache with frequent Fluoxetine Hydrochloride (Sarafem)- Multum of sumatriptan. She is a nonsmoker and took no oral contraceptives of motilium other serotonin agonists. A computed tomography scan of the abdomen revealed left-sided of motilium. A colonoscopy with biopsy confirmed ischemic colitis and excluded inflammatory bowel disease (IBD).

Discussion: Previously published case reports have suggested an association between 5-HT 1 receptor agonists and ischemic colitis. These reports have been dismissed because the patients were taking oral contraceptives, serotonin agonists, or had other comorbidities.

This healthy patient lacked risk factors for ischemia, of motilium the youngest to be reported, and is the first without hematochezia.

Conclusion: 5-HT 1 receptor agonists are generally considered safe. Ischemic colitis is a potentially serious complication of these agents. A retrospective review of 5-HT 1 receptor agonist users who have presented with acute onset abdominal pain or hematochezia is necessary to elucidate the incidence of this adverse of motilium. Migraine headaches are commonly treated by family physicians.

One exception is patients with known cardiovascular disease or significant cardiovascular risk factors because of the medication's vasoconstricting of motilium and the risk for ischemia. However, patients who experience refractory headaches may inadvertently overuse these agents in an attempt to reduce their pain and disability. The of motilium common complication of overuse of abortive medications is rebound headaches.

Described in this report is a case of ischemic colitis related to the use of supratherapeutic doses of sumatriptan in a previously healthy patient. A 35-year-old of motilium woman presented to the emergency department (ED) after enduring 6 hours of severe abdominal pain, rated as 10 out of of motilium. Her pain was nonfocal and nonradiating. She was nauseous but experienced no emesis, diarrhea, or bloody stools. During the 3 days before the of motilium of her abdominal pain she developed an intense refractory migraine headache requiring several doses of her usual abortive medications.

She estimated that during the 36 hours before the abdominal pain developed she took 300 mg of sumatriptan orally and 12 mg subcutaneously. She has a long history of migraine headaches that have been difficult to control and have required multiple doses of sumatriptan. She had never experienced similar abdominal pain during these of motilium occasions of headache. She denied of motilium of tobacco, alcohol, or illicit drugs.

Of motilium takes no oral contraceptives or other serotonin agonists. Her other medications include ibuprofen, fluticasone propionate nasal spray, and cetirizine. She had taken one 800-mg dose of ibuprofen during the 72 hours before her ED visit. At presentation our patient was afebrile and hemodynamically stable. Her abdomen was soft but linked to obesity tender to palpation.

She exhibited voluntary guarding without rebound tenderness. Her white blood cell count was elevated, 19. All other laboratory studies were normal (Table 1). Her abdominal and pelvic axial computed tomography scans with oral and intravenous contrast revealed diffuse wall thickening isolated to the left colon, consistent with acute colitis. During her colon clean in the Of motilium the patient received 2 mg of hydromorphone and 4 mg of ondansetron, which reduced her abdominal pain to 8 of 10.

She was diagnosed with colitis of undetermined etiology, discharged from the hospital, and prescribed 10 days of motilium levofloxacin and metronidazole and hydrocodone-acetaminophen for pain. Her of motilium instructions stated that she may continue to take her home medications as previously prescribed, including sumatriptan.

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