Jeff Gudin, MD: Treating Pain Management as a Symptom


How issues with pain in patients with Lyme disease or opioid-induced constipation can be managed in a timely, efficient manner.

By the time a patient with Lyme disease is meeting with a pain specialist for their symptoms, they’re dealing with a chronic disease. It’s most important in this moment for specialists to remember that the chronic issues from the tick-borne disease are not just pain-related.

In an interview with MD Magazine®, Jeff Gudin, MD, director of Pain Management and Palliative Care at the Englewood Hospital & Medical Center in Englewood, NJ, explained that neurological symptoms are frequently reported by patients with Lyme disease seeking pain management care.

“A lot of times, patients will say, ‘I have this weird tingling or this weakness, or this fog’,” Gudin said. “In the early stages, you can have focal pain, but in the later stages, it’s really a neurological disease.”

Balancing the appropriate treatment regimen, for both pain management in Lyme disease and in patients with opioid-induced constipation, require an understanding of the most commonly-reported symptoms in patients, Gudin said. Sometimes the treatment is modernized—other times, it is the same as always.

“Twenty years ago in my training, I was taught to use over-the-counter stool softeners and laxatives,” Gudin said. “This week, I prescribed opioid to a patient and used stool softeners and laxatives.”

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