Implications of the Opioid Epidemic for the Clinical Gastroenterology Practice

Namisha Thapa, Matthew Kappus, Ryan Hurt, Sarah Diamond

Research output: Contribution to journalReview article

1 Scopus citations

Abstract

Purpose of Review: The opioid epidemic in the USA has led to a rise in opioid-related gastrointestinal (GI) side effects that are often difficult to diagnose and treat. The aim of this report is to discuss opioid pathophysiology, opioid-related GI side effects, clinical presentation, and diagnostic criteria and to review the current pharmacotherapy available. Recent Findings: Opioid-related GI disorders are increasingly recognized and include, but are not limited to, opioid-induced esophageal dysfunction (OIED), gastroparesis, opioid-induced constipation (OIC), narcotic bowel syndrome (NBS), acute post-operative ileus, and anal sphincter dysfunction. Treatment of these conditions is challenging. OIC has the most available pharmacotherapy for treatment, including classical laxatives, peripherally acting μ-receptor antagonists (PAMORAs), novel therapies (lubiprostone, prucalopride- 5-HT agonist), and preventative therapies (PR oxycodone/naloxone). Summary: The gastrointestinal effects of opioid therapy are variable and often debilitating. While medical management for some opioid-related GI side effects exists, limiting or completely avoiding opioid use for chronic non-cancer pain will mitigate these effects most effectively.

Original languageEnglish (US)
Article number44
JournalCurrent gastroenterology reports
Volume21
Issue number9
DOIs
Publication statusPublished - Sep 1 2019

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Keywords

  • Chronic narcotics
  • Clinical gastroenterology
  • Gastrointestinal dysmotility
  • Narcotic bowel syndrome
  • Opioid epidemic

ASJC Scopus subject areas

  • Gastroenterology

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