The DOI matches its Crossref record; 203 of the 203 references it cites were found in a registry or an index.
Opioid misuse in gastroenterology and non-opioid management of abdominal pain
Open accessAbstract
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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In the citing paper
“the development of narcotic bowel syndrome, an opioid induced paradoxical hyperalgesia. 26”
From Rome IV Functional Gastrointestinal Disorders and Health Impairment in Subjects With Hypermobility Spectrum Disorders or Hypermobile Ehlers-Danlos Syndrome (2021) · cites this paper as [26]
In the citing paper
“This would fit with ample evidence linking opioids to compounding and deleterious gastrointestinalrelated adverse effects, collectively known as opioid -induced bowel dysfunction. 26”
From Rome IV Functional Gastrointestinal Disorders and Health Impairment in Subjects With Hypermobility Spectrum Disorders or Hypermobile Ehlers-Danlos Syndrome (2021) · cites this paper as [26]
In the citing paper
“Among the most common symptoms of opioid-induced bowel dysfunction are abdominal pain, nausea, reflux, vomiting, and constipation”
From Rome IV Functional Gastrointestinal Disorders and Health Impairment in Subjects With Hypermobility Spectrum Disorders or Hypermobile Ehlers-Danlos Syndrome (2021) · cites this paper as [26]
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Citations
Cites
CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016
Dowell, D., Haegerich, T. M., & Chou, R. (2016) · JAMA · doi:10.1001/jama.2016.1464 · Cited by 5,161
Lacy, B. E., Mearin, F., Chang, L., Chey, W. D., Lembo, A. J., Simren, M., & Spiller, R. (2016) · Gastroenterology · doi:10.1053/j.gastro.2016.02.031 · Cited by 2,866
The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems.
(2015) · PubMed Central · Cited by 2,540
Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features, and Rome IV
Drossman, D. A. (2016) · Gastroenterology · doi:10.1053/j.gastro.2016.02.032 · Cited by 2,444
Self-citationMeditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis
Goyal, M., Singh, S., Sibinga, E. M. S., Gould, N. F., Rowland-Seymour, A., Sharma, R., Berger, Z., Sleicher, D., Maron, D. D., Shihab, H. M., et al. (2014) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2013.13018 · Cited by 2,380
Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain
Chou, R., Fanciullo, G. J., Fine, P. G., Adler, J. A., Ballantyne, J. C., Davies, P., Donovan, M. I., Fishbain, D. A., Foley, K. M., Fudin, J., et al. (2009) · The Journal of Pain · doi:10.1016/j.jpain.2008.10.008 · Cited by 2,192
Increases in drug and opioid overdose deaths — United States, 2000–2014
Rudd, R. A., Aleshire, N., Zibbell, J. E., & Gladden, R. M. (2016) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6450a3 · Cited by 1,859
The Prescription Opioid and Heroin Crisis: A Public Health Approach to an Epidemic of Addiction
Kolodny, A., Courtwright, D. T., Hwang, C. S., Kreiner, P., Eadie, J. L., Clark, T. W., & Alexander, G. C. (2015) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-031914-122957 · Cited by 1,388
Rates of opioid misuse, abuse, and addiction in chronic pain
Vowles, K. E., McEntee, M. L., Julnes, P. S., Frohe, T. M., Ney, J. P., & van der Goes, D. N. (2015) · Pain · doi:10.1097/01.j.pain.0000460357.01998.f1 · Cited by 1,178
Glial activation: a driving force for pathological pain
Watkins, L. R., Milligan, E. D., & Maier, S. F. (2001) · Trends in Neurosciences · doi:10.1016/s0166-2236(00)01854-3 · Cited by 1,091
Research works printed but not linked: 2
- Leppert, W. The impact of opioid analgesics on the gastrointestinal tract function and the current management possibilities. Contemp. Oncol. 16, 125–131 (2012).
- Lacy, B. E., Chey, W. D. & Lembo, A. J. New and emerging treatment options for Irritable Bowel Syndrome. Gastroenterol. Hepatol. 11 (Suppl. 2), 1–19 (2015).
Cited by
Sorted by citations
Drossman, D. A., Tack, J., Ford, A. C., Szigethy, E., Törnblom, H., & Van Oudenhove, L. (2018) · Gastroenterology · doi:10.1053/j.gastro.2017.11.279 · Cited by 470
Self-citationDrewes, A. M., Olesen, A. E., Farmer, A. D., Szigethy, E., Rebours, V., & Olesen, S. S. (2020) · Nature Reviews Disease Primers · doi:10.1038/s41572-019-0135-7 · Cited by 280
Self-citationBharucha, A. E., Kudva, Y. C., & Prichard, D. O. (2019) · Endocrine Reviews · doi:10.1210/er.2018-00161 · Cited by 252
New concepts in opioid analgesia
Stein, C. (2018) · Expert Opinion on Investigational Drugs · doi:10.1080/13543784.2018.1516204 · Cited by 175
“epidemiological data suggest that quality of life or functional capacity are not improved [75,81,82].”
BackgroundVitamin D and Its Potential Interplay With Pain Signaling Pathways
Habib, A. M., Nagi, K., Thillaiappan, N. B., Sukumaran, V., & Akhtar, S. (2020) · Frontiers in Immunology · doi:10.3389/fimmu.2020.00820 · Cited by 127
“At present, no other oral therapeutic drug provides instant and effective relief of severe pain (151, 152).”
Background
Metadata
- Authors
- Szigethy, E., Knisely, M., & Drossman, D.
- Affiliations
- University of Pittsburgh (US)
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Szigethy, Eva
- Venue
- Nature Reviews Gastroenterology & Hepatology
- Published
- 2017-11-15
- Volume
- 15
- Issue
- 3
- Pages
- 168-180
- ISSN
- 1759-5045 (ISSN-L)
- 1759-5053
- 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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