Opioid Treatment and Excessive Alcohol Consumption Are Associated With Esophagogastric Junction Disorders
Schindler Valeria, Runggaldier Daniel, Bianca Amanda, Becker Anton S., Murray Fritz, Savarino Edoardo, Pohl Daniel,
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( Schindler Valeria )
University Hospital Zurich Department of Gastroenterology and Hepatology
( Runggaldier Daniel )
University Hospital Zurich Department of Gastroenterology and Hepatology
( Bianca Amanda )
University Hospital Zurich Department of Gastroenterology and Hepatology
( Becker Anton S. )
University Hospital Zurich Institute of Diagnostic and Interventional Radiology
( Murray Fritz )
University Hospital Zurich Department of Gastroenterology and Hepatology
( Savarino Edoardo )
University of Padua Department of Surgery, Oncology and Gastroenterology
( Pohl Daniel )
University Hospital Zurich Department of Gastroenterology and Hepatology
Abstract
Background/Aims: The influence of external factors such as opioids and alcohol has been extensively investigated for various segments of the gastrointestinal tract. However, the association between their use and the development of esophagogastric junction outflow obstruction disorders (EGJOODs) is unknown. Therefore, the aim of this study is to analyze prevalence and clinical relevance of opioids and alcohol intake in patients with EGJOODs.
Methods: In this single-center, retrospective study, we reviewed clinical and pharmacological data of 375 consecutive patients who had undergone high resolution impedance manometry for EGJOODs. EGJOODs were classified according to the Chicago classification version 3.0 and to recently published normal values for test meals. Demographics, manometric data, and symptoms were compared between different groups using Pearson’s chi-squared test, Fisher’s exact test, and multivariate analysis. A P < 0.05 was considered significant.
Results: EGJOOD was found in 30.7% (115/375) of all analyzed patients. The prevalence of opioids (14.8% vs 4.2%, P = 0.026) was significantly higher in patients with EGJOODs compared to patients without EGJOODs. Additionally, excessive alcohol consumption (12.2% vs 3.5%, P = 0.011) was associated with EGJOODs. Excessive alcohol consumption was especially frequent in the non-achalasia esophagogastric junction outflow obstruction subgroup (16.2%) and opioid use in the achalasia type III subgroup (20.0%).
Conclusions : We found a significant association between EGJOODs and opioid as well as excessive alcohol consumption. This underlines the importance of detailed history taking regarding medication and ethanol consumption in patients with dysphagia. Further prospective studies on mechanisms undelaying esophagogastric junction dysfunction due to opioids or alcohol are warranted.
키워드
Alcohol drinking; Analgesics, Opioids; Esophageal achalasia; Esophagogastric junction; Manometry
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