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Systematic Review With Meta-Analysis: Chronic Opioid Use Is Associated With Esophageal Dysmotility in Symptomatic
Chengu Niu1, Jing Zhang2, Jay Bapaye1
1Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA.
The American Journal of Gastroenterology
|July 18, 2023
Summary
Chronic opioid use significantly increases the risk of esophageal dysmotility disorders, including distal esophageal spasm and type III achalasia. This finding highlights the importance of considering opioid therapy as a risk factor for esophageal motor abnormalities.
Area of Science:
- Gastroenterology
- Pharmacology
- Esophageal Physiology
Background:
- Chronic opioid exposure is prevalent and may affect gastrointestinal function.
- Esophageal motility disorders can significantly impact patient quality of life.
- Understanding the link between opioids and esophageal function is crucial for clinical management.
Approach:
- A systematic review and meta-analysis were conducted.
- Nine studies comparing esophageal manometry in chronic opioid users versus non-users were included.
- Data were analyzed using random-effects models to assess outcomes.
Key Points:
- Opioid use was significantly associated with increased odds of distal esophageal spasm, esophagogastric junction outflow obstruction, and type III achalasia.
- Significant differences in basal lower esophageal sphincter pressure, integrated relaxation pressure, and distal contractile integral were observed.
- Opioid use was paradoxically linked to a lower risk of ineffective esophageal motility.
Conclusions:
- Chronic opioid exposure is linked to a higher prevalence of esophageal dysmotility disorders.
- Opioid treatment should be considered a potential risk factor when diagnosing esophageal motor abnormalities like type III achalasia.
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