Opioid-induced esophageal dysfunction - Prevalence and manometric findings

Area of Science:

• Gastroenterology
• Pharmacology

Background:

• Prescription opioid use is increasing globally.
• Chronic opioid consumption is increasingly recognized as a cause of esophageal motility disorders, termed opioid-induced esophageal dysfunction (OIED).

Purpose of the Study:

• To determine the prevalence of chronic opioid use in patients referred for esophageal motility testing.
• To characterize the clinical features of these patients and investigate the association between opioid consumption and esophageal motility disorders.

Main Methods:

• A retrospective, descriptive study was conducted.
• Data were collected from electronic medical records of patients who underwent high-resolution manometry (HRM) at a single European center.

Main Results:

• 10.1% of patients used opioids, with 4.8% being chronic active opioid users (CAOU).
• OIED prevalence was 32%. CAOU patients with OIED were more likely to be male (43.8% vs 8.8%) and had higher daily opioid doses (125.2 MME vs 33.4 MME).
• Dysphagia was the primary indication for HRM in 60% of CAOU patients and was more frequent in those with OIED (87.5% vs 47.0%).

Conclusions:

• Opioid-induced esophageal dysfunction (OIED) is prevalent in chronic opioid users referred for esophageal testing.
• Dysphagia is the predominant symptom in CAOU patients with OIED.
• Male sex and higher opioid dosage are associated with esophageal motility disorders in chronic opioid users.