Published online Oct 28, 2017. doi: 10.3748/wjg.v23.i40.7310
Peer-review started: August 1, 2017
First decision: August 30, 2017
Revised: September 8, 2017
Accepted: September 19, 2017
Article in press: September 19, 2017
Published online: October 28, 2017
Processing time: 90 Days and 4.9 Hours
Despite the gastrointestinal side effects associated with opioid use, they are used in some patients with gastroparesis. The relationship of opioid use to the gastrointestinal symptoms, healthcare utilization and employment is not known.
As opioid use had become a healthcare epidemic in United States, studies on opioid use in gastroparesis would be useful for clinicians and researchers.
This objective was to study the relationship of chronic scheduled opioid use to gastrointestinal symptoms, healthcare utilization and employment in gastroparesis patients.
The authors used Mann Whitney U Test, Student’s t-test, Analysis of Variance, and χ2 test as appropriate for data analysis.
This study shows higher severity of many gastrointestinal symptoms, and more frequent hospitalizations in gastroparesis patients on chronic scheduled opioids, compared to gastroparesis patients not using opioids. Chronic opioid using patients also reported their work being effected more frequently by their gastrointestinal symptoms. The prevalence of chronic pancreatitis is also higher in opioid using gastroparesis patients.
This study confirmed the hypothesis that chronic opioid use in gastroparesis is related with more severe gastrointestinal symptoms, and hospitalizations. Whether opioid use is to manage a higher severity of gastroparesis symptoms, or is responsible for the higher severity of symptoms is not clear as we did not have symptoms of patients prior to starting opioids. In clinical practice, this study implicates that the opioids may need to be used with caution in gastroparesis patients.
Opioid use is quite prevalent in patients with gastroparesis. Opioid-using gastroparesis patients have more severe gastrointestinal symptoms. These opioid-using patients are more frequently hospitalized, compared to the patients without opioid use. They also more commonly report their employment being affected due to their gastrointestinal symptoms. Patients with gastroparesis may have chronic pancreatitis, possibly contributing to their gastrointestinal symptoms.
Future studies can look into the trends of laxative-use in opioid-using gastroparesis patients. The noticeable prevalence of chronic pancreatitis in gastroparesis patients in this study can be further confirmed in studies with larger sample size. This study found more frequent hospitalizations in gastroparesis patients; future studies to evaluate opioid use during hospitalizations in gastroparesis patients will add useful information to the current literature on gastroparesis.
Future research can look into opioid use in gastroparesis through different perspectives, this could be not only in the tertiary care centers, but also in smaller community settings so that the results more accurately reflect the generalized population. Moreover, bigger databases using diagnosis codes and medication-lists can be used to get a larger sample size.