Opioid Use Among Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-analysis

Niccum, Blake; Moninuola, Oluwatoba; Miller, Kaia C.; Khalili, Hamed

doi:10.1016/j.cgh.2020.08.041

Cited by 30 publications

(32 citation statements)

References 62 publications

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“…In addition, those with Rome IV‐type symptoms, who report more severe abdominal pain, were more likely to be prescribed opioids compared with those with Rome III IBS‐type symptoms, or those without IBS‐type symptoms at all. Chronic opioid use is common in IBD, with studies demonstrating associations with increased healthcare use, mood disorders, prior gastrointestinal surgery, IBD activity, and mortality 35,36 37 …”

Section: Discussionmentioning

confidence: 99%

“…Chronic opioid use is common in IBD, with studies demonstrating associations with increased healthcare use, mood disorders, prior gastrointestinal surgery, IBD activity, and mortality. 35,36 There is no evidence that opioids significantly improve pain or quality of life scores in patients with IBD. 37 Their association with IBS-type symptoms in the current study is therefore concerning and highlights the need for evidence-based management strategies for IBS-type symptoms in patients with IBD.…”

Section: Ta B L E 1 (Continued)mentioning

confidence: 99%

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Prevalence and impact of Rome IV versus Rome III irritable bowel syndrome in patients with inflammatory bowel disease

Fairbrass

Selinger

Gracie

et al. 2021

Neurogastroenterology Motil

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Background Irritable bowel syndrome (IBS)‐type symptoms are common in inflammatory bowel disease (IBD), but few studies have examined the prevalence and impact of IBS‐type symptoms in IBD according to Rome IV criteria. Methods We collected demographic, symptom (Rome III, Rome IV, and clinical disease activity indices), psychological (anxiety, depression, and somatization), and quality of life data from 973 IBD patients. Medical records were reviewed to document disease type, extent/location, behavior, medical therapy, and antidepressant or opioid use. We compared characteristics of individuals with no IBS‐type symptoms, Rome III IBS‐type symptoms, and Rome IV IBS‐type symptoms. Key Results In total, 302 (31.0%) patients met the Rome III criteria for IBS, and 172 (17.7%) met Rome IV criteria. Those with IBS‐type symptoms were younger, more likely to be female, and had higher rates of antidepressant (p = 0.006) or opioid use (p = 0.001). Rome IV IBS‐type symptoms were associated with symptoms of mood disorders, flare of disease activity, and lower quality of life scores (p < 0.001 for all analyses). Compared with Rome III criteria, those with Rome IV IBS‐type symptoms had significantly higher rates of anxiety (p < 0.001), depression (p = 0.002), and somatization (p < 0.001), lower quality of life scores (p < 0.001) and were more likely to have CD (p = 0.011), with ileal distribution (p = 0.006). Conclusions and Inferences Rome IV IBS‐type symptoms are associated with increased psychological co‐morbidity, lower quality of life scores, and higher rates of antidepressant or opioid use. This is a cohort potentially at risk of adverse clinical outcomes and should be a focus for future research.

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Section: Discussionmentioning

confidence: 99%

Section: Ta B L E 1 (Continued)mentioning

confidence: 99%

Prevalence and impact of Rome IV versus Rome III irritable bowel syndrome in patients with inflammatory bowel disease

Fairbrass

Selinger

Gracie

et al. 2021

Neurogastroenterology Motil

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show abstract

“…Meanwhile, chronic use of currently licensed prescription opioids is associated with poorer control of pain, 11 increased healthcare use, 65 and higher mortality in patients with IBD. 16 Long-term use of opioids therefore should, as far as possible, be avoided for pain management in these patients, and alternatives offered.…”

Section: Pharmacological Approaches To Chronic Pain In Patients With Inflammatory Bowel Diseasementioning

confidence: 99%

Chronic pain in patients with inflammatory bowel disease

Bakshi

Hart

Lee

et al. 2021

Pain

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“…In line with the global opioid epidemic, the use of opioids has increased in IBD 1 . Up to 30% of IBD outpatients and up to 70%‐90% of hospitalised patients receive opioids 2 …”

mentioning

confidence: 99%

“…More importantly, this study touches upon a relevant topic in clinical practice. Chronic opioid use is associated with numerous side effects, increased infections, and mortalty 2,4,5 . Even more worrisome, data supporting a benefit of opioids for pain control and quality of life are lacking 6,7 …”

mentioning

confidence: 99%