Lower prevalence of gastroesophageal reflux disease in patients with noncardiac chest pain on opiates: a cross-sectional study

Cifuentes, Juan D. Gomez; Thota, Prashanthi N.; López, Rocío

doi:10.1093/dote/doaa068

Cited by 2 publications

(11 citation statements)

References 24 publications

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“…The results showed that opioid use did not significantly increase the risk of either type I or type II achalasia (pooled OR 1.01, 95% CI 0.56-1.84, P 5 0.97, I 2 5 0% for type I; pooled OR 0.91, 95% CI 0.57-1.44, P 5 0.68, I 2 5 37% for type II) (Figures 4 and 5). Nine studies, including 1,725 opioid users and 8,243 nonopioid users, reported the relationship between opioid use and the risk of type III achalasia (4)(5)(6)(7)(8)(9)(15)(16)(17). The results showed that opioid use significantly increased the risk of type III achalasia (pooled OR 4.15, 95% CI 2.15-8.03, P , 0.0001, I 2 5 64%) (Figure 6).…”

Section: The American Journal Of Gastroenterologymentioning

confidence: 98%

“…Five studies involving a sample of 1,200 opioid users and 4,500 nonopioid users were conducted to investigate the relationship between opioid use and the distal contractile integral (4,7,9,15,17). The results showed that opioid use was significantly associated with an increased distal contractile integral (MD 640.29, 95% CI 469.56-811.03, P , 0.00001, I 2 5 91%) (Figure 10).…”

Section: Secondary Outcomesmentioning

confidence: 99%

“…To determine the effect of opioid use on EGJOO, a metaanalysis was conducted on 8 studies comprising 1,711 opioid users and 8,201 nonopioid users (4)(5)(6)(7)(8)(9)15,16). The results showed a significant increase in the risk of EGJOO in opioid users compared with nonopioid users (pooled OR 5.13, 95% CI 2.11-12.43, P 5 0.0003, I 2 5 93%) (Figure 3).…”

Section: The American Journal Of Gastroenterologymentioning

confidence: 99%

“…To evaluate the impact of opioid use on the occurrence of achalasia, we analyzed 9 studies comprising a combined sample of 1,725 opioid users and 8,243 nonopioid users (4)(5)(6)(7)(8)(9)(15)(16)(17). Seven studies that included a combined sample of 1,428 opioid users and 6,437 nonopioid users were analyzed to determine the effect of opioid use on the incidence of type I and type II achalasia (4,(7)(8)(9)(15)(16)(17).…”

Section: The American Journal Of Gastroenterologymentioning

confidence: 99%

“…Six studies comprising a total of 1,458 opioid users and 6,148 nonopioid users investigated the relationship between opioid use and the risk of IEM (4,(6)(7)(8)(9)15). The results showed that opioid use was associated with a lower risk of IEM than nonopioid use (pooled OR 0.68, 95% CI 0.49-0.95, P 5 0.02, I 2 5 53%) (Figure 7).…”

Section: Secondary Outcomesmentioning

confidence: 99%

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Systematic Review With Meta-Analysis: Chronic Opioid Use Is Associated With Esophageal Dysmotility in Symptomatic Patients

et al. 2023

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Objectives: We aimed to conduct a systematic review and meta-analysis to assess the impact of chronic opioid exposure on esophageal motility in patients undergoing manometric evaluation. Methods: Multiple databases were searched through October 2022 for original studies comparing the manometric results of patients who have used chronic opioids (for >90 days) to those who do not. The primary outcomes were esophageal dysmotility disorders. Three high-resolution manometry parameters were conducted as secondary outcomes. A random effects model was applied to calculate the odds ratio (OR) and means difference (MD) along with a 95% confidence interval. Results: Nine studies were included in this meta-analysis. Opioid use was associated with higher esophageal dysmotility disorders, including distal esophageal spasm (pooled OR 4.84, 95% CI 1.60–14.63, P = 0.005, I2=96%), esophagogastric junction outflow obstruction (pooled OR 5.13, 95% CI 2.11–12.43, P = 0.0003, I2=93%), and type III achalasia (pooled OR 4.15, 95% CI 2.15–8.03, P < 0.0001, I2=64%). No significant differences were observed for hypercontractile esophagus, type I achalasia, or type II achalasia. The basal lower esophageal sphincter pressure (MD 3.02, 95% CI 1.55–4.50, P < 0.0001, I2=90%), integrated relaxation pressure (MD 2.51, 95%CI 1.56–3.46, P < 0.00001, I2=99%), and distal contractile integral (MD 640.29, 95% CI 469.56–811.03, P < 0.00001, I2=91%) significantly differed between the opioid use and nonopioid use group. However, opioid use was associated with a lower risk of ineffective esophageal motility (pooled OR 0.68, 95% CI 0.49–0.95, P = 0.02, I2=53%). Conclusion: Chronic opioid exposure is associated with an increased frequency esophageal dysmotility disorders. Our results revealed that opioid use is significantly associated with Type III achalasia but not with Type I and II achalasia. Therefore, opioid treatment should be taken into account as a potential underlying risk factors when diagnosing these major esophageal motor abnormalities.

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Section: The American Journal Of Gastroenterologymentioning

confidence: 98%

Section: Secondary Outcomesmentioning

confidence: 99%

Section: The American Journal Of Gastroenterologymentioning

confidence: 99%

Section: The American Journal Of Gastroenterologymentioning

confidence: 99%

Section: Secondary Outcomesmentioning

confidence: 99%

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Systematic Review With Meta-Analysis: Chronic Opioid Use Is Associated With Esophageal Dysmotility in Symptomatic Patients

et al. 2023

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Esophageal Motility Abnormalities in Lung Transplant Recipients With Esophageal Acid Reflux Are Different From Matched Controls

Elsheikh,

Akanbi,

Selby

et al. 2023

J Neurogastroenterol Motil

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Background/Aims There is an increased incidence of gastroesophageal reflux disease (GERD) after lung transplantation (LT) that can be associated with graft dysfunction. It is unclear if the underlying esophageal motility changes in GERD are different following LT. This study aimed to use esophageal high-resolution manometry (HRM) to explore GERD mechanisms in LT recipients compared to matched controls. Methods This was a retrospective study including patients with pathologic acid reflux who underwent HRM and pH testing at our healthcare facility July 2012 to October 2019. The study included 12 LT recipients and 36 controls. Controls were matched in a 1:3 ratio for age, gender, and acid exposure time (AET). Results LT recipients had less hypotensive esophagogastric junction (EGJ) (mean EGJ-contractile integral 89.2 mmHg/cm in LT vs 33.9 mmHg/cm in controls, P < 0.001). AET correlated with distal contractile integral and total EGJ-contractile integral only in LT group ( r = –0.79, P = 0.002 and r = –0.57, P = 0.051, respectively). Conclusions Following LT, acid reflux is characterized by a less hypotensive EGJ compared to controls with similar AET. The strongest correlation with AET after LT was found to be esophageal peristaltic vigor. These results add to the understanding of reflux after LT and may help tailor an individualized treatment plan.

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Lower prevalence of gastroesophageal reflux disease in patients with noncardiac chest pain on opiates: a cross-sectional study

Cited by 2 publications

References 24 publications

Systematic Review With Meta-Analysis: Chronic Opioid Use Is Associated With Esophageal Dysmotility in Symptomatic Patients

Systematic Review With Meta-Analysis: Chronic Opioid Use Is Associated With Esophageal Dysmotility in Symptomatic Patients

Esophageal Motility Abnormalities in Lung Transplant Recipients With Esophageal Acid Reflux Are Different From Matched Controls

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