Implications of the Opioid Epidemic for the Clinical Gastroenterology Practice.

Journal Article (Journal Article;Review)

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). 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.

Full Text

Duke Authors

Cited Authors

  • Thapa, N; Kappus, M; Hurt, R; Diamond, S

Published Date

  • July 25, 2019

Published In

Volume / Issue

  • 21 / 9

Start / End Page

  • 44 -

PubMed ID

  • 31346779

Electronic International Standard Serial Number (EISSN)

  • 1534-312X

Digital Object Identifier (DOI)

  • 10.1007/s11894-019-0712-7


  • eng

Conference Location

  • United States