Objective
Abdominal pain is the most common emergency department (ED) chief complaint, with many patients experiencing recurrent episodes due to non–life-threatening etiologies such as disorders of gut-brain interaction. This pilot study aimed to characterize patients with recurrent low-risk abdominal pain, focusing on pain severity, management, biopsychosocial factors, opioid use, and 30-day return visits. Methods This prospective, observational pilot study enrolled adult ED patients with recurrent abdominal pain at a single academic center between July 2022 and June 2023. Inclusion required at least one similar episode in the prior year with symptom resolution between episodes. Exclusions included unstable clinical status or high-risk conditions. Patient-reported outcomes, social determinants of health, and clinical data were collected. Primary outcomes included pain severity, opioid use, and 30-day return visit rates. Results A total of 101 participants were enrolled (mean age, 43.7 years; 65.3% female; 69.3% Black). Pain severity was high (triage pain score, 7.1±2.6). Frequent prior computed tomography imaging was noted in 56.4% of participants. Opioids were administered in 50 participants (49.5%), while Patient-Reported Outcomes Measurement Information System (PROMIS)-29 scores highlighted risks of anxiety (T-score, 56.0±11.1) and pain interference (T-score, 60.8±8.2). Return visits occurred in 11 participants (10.9%) within 30 days. Conclusion In this pilot study, patients with recurrent low-risk abdominal pain showed high symptom burden and healthcare utilization. Targeted interventions addressing biopsychosocial factors and improving pain management are needed to reduce ED revisits and improve outcomes.

Objective
Abdominal pain is one of the most common emergency department (ED) complaints, with many patients experiencing recurrent episodes due to cannabinoid hyperemesis syndrome (CHS), a syndrome characterized by pain and vomiting in the setting of chronic cannabis use. This pilot study aimed to demonstrate the ability to enroll patients with CHS, characterize patient-reported outcomes (PROs), and estimate 30-day revisit rates. Methods This prospective observational study enrolled adult ED patients with CHS at an academic center and community affiliate. The inclusion required a prior diagnosis of CHS and ED clinician judgment that symptoms at time of enrollment were likely due to CHS. Exclusions included unstable clinical status or other high-risk conditions. Primary outcomes included characterization of symptoms, assessment of multiple domains of PROs, measurement of the use of both computed tomography (CT) scans and opioid analgesia, and frequency of 30-day ED return visits. Results A total of 18 participants were enrolled (mean age, 34 years; 10 female patients, 55.6%). Automated chart reviews were completed for each outcome of interest at 30 days and at 12 months. Pain severity was high (mean triage pain score, 6.2±4.3) and prior CT imaging was noted in 13 patients (72.2%) in the past 5 years. Opioids were administered in four patients (22.2%), while the 29-Item Patient-Reported Outcome Measurement Information System (PROMIS-29) scores highlighted high risk of anxiety (mean T-score, 56.11±11.45) and how pain interfered with normal activities of living (mean T-score, 62.24±11.11). Return visits occurred in three patients (16.7%) within 30 days. Conclusion ED patients with CHS show a significant burden on PROs and high 30-day revisit rates. Future studies should consider interventions that address PROs and reduce ED revisits.