对疑似阿片类药物诱导的食道功能障碍患者的阿片类药物戒断的前性评估
A Ezquerra-Durán1, L Alcalá-González2,3, I K Araujo1
1Neurogastroenterology and Motility Unit, Gastroenterology Department, Institut Clínic de Malalties Digestives i Metabòliques (ICMDM), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.
The American journal of gastroenterology
|January 10, 2025
概括
慢性阿片类药物使用可能会导致食道功能障碍. 停止服用阿片类药物改善了超过一半的研究患者的症状和食道运动,这表明阿片类药物使用和食道运动障碍之间存在联系.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 慢性阿片类药物使用与食道运动功能障碍之间的联系尚不清楚.
- 症状患者经常出现非阻塞性消化障碍症.
研究的目的:
- 调查慢性阿片类药物使用和食道运动功能障碍之间的因果关系.
- 评估阿片类药物停用对食道运动性和临床症状的影响.
主要方法:
- 一个前性的,前后的,多中心研究设计.
- 包括患有慢性阿片类药物使用的患者,因缺食症而被转诊进行食道运动性测试.
- 评估食道运动功能和阿片类药物戒断前后的临床症状.
主要成果:
- 73%的评估患者符合阿片类药物诱导的食道功能障碍的标准.
- 停用阿片类药物至少7天导致食道运动障碍在52.6%的患者中得到解决.
- 在停止服用阿片类药物的患者中,64.3%的患者获得了临床成功 (埃卡德得分≤3).
结论:
- 在症状患者中,阿片类药物诱导的食道功能障碍很普遍.
- 停止服用阿片类药物可以显著改善大量患者的食道运动性和临床症状.
- 这项研究支持慢性阿片类药物使用和食道运动障碍之间的因果关系.
相关概念视频
Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
174
Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
174
Gastroesophageal Reflux Disease II: Clinical Features and Management
54
Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
54
Barrett Esophagus-II: Clinical Manifestations and Management
103
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
103
Peptic Ulcer Disease IV: Management
72
Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
72
Esophageal Strictures-II: Clinical Features and Management
45
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
45
Endoscopic Procedures I: Esophagogastroduodenoscopy
64
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
64


