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They are not recommended in those with personal or family history of multiple endocrine neoplasia 2A, multiple endocrine neoplasia 2B, or medullary thyroid cancer due to concern for long-term thyroid effects.3 Side Effects and their Implications in the ED Gastrointestinal Side effects Mild gastrointestinal side effects are most common with patients experiencing nausea (25-40%), vomiting, diarrhoea, or constipation.3,4 Rarer, more serious presentations include pancreatitis, bowel obstruction, gallbladder disease, which should be actively managed in the ED.3,5 Hypersensitivity reaction These reactions are commonly associated with self-limiting or antihistaminic responsive pruritic rash

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De Grandis D, Santoro L, Di Benedetto P

Understanding Inflammation: The Common Link Between Gut Issues and Pain Dysbiosis, the term for poor gut health, leads to chronic inflammation

The doses of NPW (Tamer et al