Cited by 118Opioid Use Disorder TreatmentPain Management and Opioid UseAnesthesia and Pain Management

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Opioid misuse in gastroenterology and non-opioid management of abdominal pain

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Szigethy, Eva, Knisely, Mitchell, Drossman, Douglas·2018·Nature Reviews Gastroenterology & Hepatology

DOI 10.1038/nrgastro.2017.141PMC PMC6421506

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Abstract

Opioids were one of the earliest classes of medications used for pain across a variety of conditions, but morbidity and mortality have been increasingly associated with their chronic use. Despite these negative consequences, chronic opioid use is increasing worldwide, with the USA and Canada having the highest rates. Chronic opioid use for noncancer pain can have particularly negative effects in the gastrointestinal and central nervous systems, including opioid-induced constipation, narcotic bowel syndrome, worsening psychopathology and addiction. This Review summarizes the evidence of opioid misuse in gastroenterology, including the lack of evidence of a benefit from these drugs, as well as the risk of harm and negative consequences of opioid use relative to the brain-gut axis. Guidelines for opioid management and alternative pharmacological and nonpharmacological strategies for pain management in patients with gastrointestinal disorders are also discussed. As chronic pain is complex and involves emotional and social factors, a multimodal approach targeting both pain intensity and quality of life is best.

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Neuromodulators for Functional Gastrointestinal Disorders (Disorders of Gut−Brain Interaction): A Rome Foundation Working Team Report
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See all 118

Authors: Szigethy, E., Knisely, M., & Drossman, D.
Affiliations: University of Pittsburgh (US)
University of North Carolina at Chapel Hill (US)
Corresponding author: Szigethy, Eva
ORCID: Szigethy, Eva
Knisely, Mitchell
Drossman, Douglas
Venue: Nature Reviews Gastroenterology & Hepatology
Publisher: Springer Science and Business Media LLC
Published: 2017-11-15
Volume: 15
Issue: 3
Pages: 168-180
ISSN: 1759-5045 (ISSN-L)
1759-5053
DOI: 10.1038/nrgastro.2017.141
PMC: PMC6421506
OpenAlex: W2768878405
Cited by: 117
References: 202
Citations by year: 2026: 6 · 2025: 8 · 2024: 10 · 2023: 14 · 2022: 15 · 2021: 23 · 2020: 17 · 2019: 15 · 2018: 7 · 2017: 1
FWCI: 1.78
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springer.com/tdm (tdm)
Locations: Nature Reviews Gastroenterology & Hepatology (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: American Psychiatric Publishing
American Academy of Child and Adolescent Psychiatry
Shionogi
National Institutes of Health
National Institute of Nursing Research (T32NR009759)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Pain Management
Keywords: opioid misuse, chronic opioid use, abdominal pain, gastrointestinal diseases, opioid-induced constipation, narcotic bowel syndrome, opioid use disorder, gut-brain axis, non-pharmacological pain management, multimodal pain management, chronic non-cancer pain
MeSH terms: Analgesics, Analgesics, Opioid, Gastroenterology, Humans, Abdominal Pain, Inappropriate Prescribing, Pain Management

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Opioid misuse in gastroenterology and non-opioid management of abdominal pain

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