Which of the following is a common gastrointestinal disturbance seen in NOWS?

Neonatal Opioid Withdrawal Syndrome (NOWS) is characterized by a range of symptoms following the withdrawal of opioids in newborns exposed in utero. One notable gastrointestinal disturbance associated with NOWS is vomiting.

This symptom occurs as a response to the rapid adjustment of the neonatal central nervous system and gastrointestinal tract to a new environment absent of opioids. The withdrawal process can lead to dysregulation of these systems, causing symptoms such as vomiting, irritability, and gastrointestinal distress. The physiological effect of opioids on the gastrointestinal system can result in an underdeveloped tolerance to normal feeding and digestion patterns due to the abrupt cessation of opioid exposure after birth.

In contrast, while constipation may occur due to an immature gastrointestinal system, it is less frequently reported compared to vomiting in the context of NOWS. Increased appetite generally does not occur during withdrawal; instead, feeding difficulties are common. Heartburn is not a typical symptom observed in this syndrome; rather, it is more associated with gastrointestinal issues unrelated to opioid withdrawal in neonates. Thus, vomiting stands out as a key and common gastrointestinal disturbance seen in NOWS.