Opiate‐induced oesophageal dysmotility

Aliment Pharmacol Ther 31, 601–606 Summary Background Opiates have well characterized (troublesome) untoward effects on the gastrointestinal tract. Opioid bowel dysfunction has been a subject of research and even drug design, but surprisingly little is known with regard to clinical effects of opiat...

Full description

Saved in:

Bibliographic Details
Published in:	Alimentary pharmacology & therapeutics 2010-03, Vol.31 (5), p.601-606
Main Authors:	KRAICHELY, R. E., ARORA, A. S., MURRAY, J. A.
Format:	Article
Language:	eng
Subjects:	Analgesics, Opioid - adverse effects Biological and medical sciences Deglutition - drug effects Digestive system Esophageal Achalasia - chemically induced Esophageal Motility Disorders - chemically induced Esophageal Motility Disorders - physiopathology Esophageal Sphincter, Lower - drug effects Esophageal Sphincter, Lower - physiopathology Esophagus - drug effects Esophagus - physiopathology Gastroenterology. Liver. Pancreas. Abdomen Humans Manometry - statistics & numerical data Medical sciences Peristalsis - drug effects Pharmacology. Drug treatments Pressure Retrospective Studies
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Aliment Pharmacol Ther 31, 601–606 Summary Background Opiates have well characterized (troublesome) untoward effects on the gastrointestinal tract. Opioid bowel dysfunction has been a subject of research and even drug design, but surprisingly little is known with regard to clinical effects of opiates on the oesophagus. Aim To characterize opiate effects on motor function of the oesophagus in patients presenting with dysphagia. Methods Retrospective review of 15 patients with dysphagia referred for oesophageal manometry while on chronic opiates. Manometry was completed during opiate use and in three cases, after opiates were discontinued. Results All patients demonstrated motility abnormalities. Incomplete lower oesophageal sphincter (LOS) relaxation (11.5 ± 1.6 mmHg) was seen in most cases. Ten patients demonstrated nonperistaltic contractions in ≥3 of 10 swallows. Additional abnormalities included high amplitude contractions; triple peaked contractions; and increased velocity. The average resting lower oesophageal sphincter (LOSP) met criteria for hypertensive LOS in three patients. These features were suggestive of spasm or achalasia. Repeat manometry off opiates was performed in three cases. LOS relaxation was noted to be complete upon repeat manometry in these cases. There was also improved peristalsis and normal velocity. Conclusions A range of manometric abnormalities were seen in patients with dysphagia in the setting of opiate use: impaired LOS relaxation, high amplitude/velocity and simultaneous oesophageal waves. These data suggest that the oesophagus is susceptible to the effects of opiates and care must be taken before ascribing dysphagia to a primary oesophageal motility disorder in patients taking opiates.
ISSN:	0269-2813 1365-2036