Increased Sedation Requirements During Endoscopy in Patients with Celiac Disease

Abstract

Patients with CD require higher doses of sedation during upper and lower endoscopy compared to age and gender-matched controls. Putative explanations, such as visceral hypersensitivity, chronic opioid/anxiolytic use, or underlying neuropsychiatric illness, should be evaluated prospectively.

Development and validation of a clinical prediction score (the SCOPE score) to predict sedation outcomes in patients undergoing endoscopic procedures

“…An additional study ( n = 773) investigated BMI, age and gender in relation to CRC screening colonoscopy preparation quality, sedation use, and procedure time and found that decreasing age and female sex were associated with higher doses of sedative medications . A previous study by our group showed that patients with coeliac disease have higher sedative dose requirements during OGD and colonoscopy than those without coeliac disease . The present study is the largest study to date investigating risk factors for difficult‐to‐sedate patients during endoscopic procedures, and we have used the results of this analysis to develop and validate a clinical prediction score to assist providers in risk‐stratifying patients.…”

Up-to-date literature review and issues of sedation during digestive endoscopy.

“…For instance, some sedative considerations should also be made for patients with coeliac disease, who are at increased risk of visceral hypersensitivity and neuropsychiatric disorders [ 111 ]. A previous retrospective investigation demonstrated that higher amounts of midazolam and opioids were required in 26% of patients with coeliac disease compared to their matched controls [ 112 ]. This has been attributed to the underlying neuropsychiatric conditions in these patients, chronic anxiolytic/opioid use, and increased visceral hypersensitivity.…”