Bibliographic Details
| Title: |
Association between opioid usage and rectal dysfunction in constipation: A cross‐sectional study of 2754 patients. |
| Authors: |
Vollebregt, Paul F.1 (AUTHOR) p.vollebregt@qmul.ac.uk, Hooper, Richard L.2 (AUTHOR), Farmer, Adam D.1,3,4 (AUTHOR), Miller, Jonjo1 (AUTHOR), Knowles, Charles H.1 (AUTHOR), Scott, S. Mark1 (AUTHOR) |
| Source: |
Neurogastroenterology & Motility. Jul2020, Vol. 32 Issue 7, p1-11. 11p. |
| Subject Terms: |
*DEFECATION disorders, *CONSTIPATION, *CROSS-sectional method, *ODDS ratio, *STATISTICAL association, *CONTRAST effect |
| Company/Entity: |
CLEVELAND Clinic Foundation |
| Abstract: |
Background: Opioid use has reached epidemic proportions. In contrast to the known effect of opioids on gut transit, the effect on rectal sensorimotor function has not been comprehensively investigated. Methods: Cross‐sectional (hypothesis‐generating) study of anorectal physiology studies in 2754 adult patients referred to a tertiary unit (2004‐2016) for investigation of functional constipation (defined by "derived" Rome IV core criteria). Statistical associations between opioid usage, symptoms, and anorectal physiological variables were investigated. Opioids were sub‐classified as prescriptions for mild‐moderate or moderate‐severe pain. Key Results: A total of 2354 patients (85.5%) were classified as non‐opioid users, 162 (5.9%) as opioid users for mild‐moderate pain, and 238 (8.6%) for moderate‐severe pain. Opioids for moderate‐severe pain were associated with increased symptomatic severity (Cleveland Clinic constipation score 18.5 vs 15.1; mean difference 2.9 [95%‐CI 2.3‐3.6]; P <.001), rectal hyposensitivity (odds ratio 1.74 [95%‐CI 1.23‐2.46]; P =.002), functional evacuation disorders (odds ratio 1.73 [95%‐CI 1.28‐2.34]; P <.001), and delayed whole‐gut transit (odds ratio 1.68 [95%‐CI 1.19‐2.37]; P =.003). Differences in anorectal variables between opioid users for mild‐moderate pain and non‐opioid users were not statistically significant. Hierarchical opioid use (non vs mild‐moderate vs moderate‐severe) was associated with decreasing proportions of patients with no physiological abnormality on testing (40.2% vs 38.1% vs 29.2%) and increasing proportions with both delayed whole‐gut transit and rectal sensorimotor dysfunction (16.6% vs 17.5% vs 28.5%). Conclusions and Inferences: Opioid use is over‐represented in patients referred for investigation of constipation. Opioids for moderate‐severe pain are associated with rectal sensorimotor abnormalities. Further studies are required to determine whether this association indicates causation. [ABSTRACT FROM AUTHOR] |
|
Copyright of Neurogastroenterology & Motility is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| Database: |
Academic Search Complete |
|
Full text is not displayed to guests. |
Login for full access.
|
