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- 저자 : ( Chandan Kakkar ) (검색결과 1 건)
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Clinical profile and outcomes of opioid abuse gastroenteropathy: an underdiagnosed disease entity
( Ramit Mahajan ),( Yogesh Gupta ),( Arshdeep Singh ),( Pulkit Dhiman ),( Vandana Midha ),( Chandan Kakkar ),( Vikram Narang ),( Varun Mehta ),( Kavita Saggar ),( Ajit Sood ) 대한장연구학회 2020 Intestinal Research Vol.18 No.2
Background/Aims: Opioid-induced bowel dysfunction includes nausea, vomiting, constipation and abdominal distension. We describe patients presenting with gastrointestinal (GI) ulcers and ulcerated strictures secondary to opioid abuse, an entity not well described in literature. Methods: This retrospective observational study included patients with opioid abuse gastro enteropathy presenting to Dayanand Medical College and Hospital, Ludhiana, India between January 2013 and December 2018. Opioid abuse gastroenteropathy was defined as gastric or small bowel ulcers and ulcerated strictures in patients abusing opioids, where all other possible etiologies of GI ulcers/strictures were excluded. Clinical, biochemical, endoscopic, radiologi cal and histological parameters as well as response to treatment were assessed. Results: During the study period, 20 patients (mean age, 38.5±14.2 years; 100% males) were diagnosed to have opioid induced GI ulcers and/or ulcerated strictures. The mean duration of opioid consumption was 6.2±3.4 years. The mean duration of symptoms at presentation was 222.1±392.3 days. Thirteen patients (65%) had gastroduodenal involvement, 6 (30%) had a jejunoileal disease and 1 (5%) had an ileocecal stricture. Two patients (10%) presented with upper GI bleeding, 11 (55%) had features of gastric outlet obstruction and 7 (35%) presented with small bowel obstruction. Abdominal pain and iron deficiency anemia were the most common presentations. Only 1 patient (5%) responded to proton pump inhibitors, 3 (15%) had a lasting response to endoscopic balloon dilatation, while all other (80%) required surgical intervention. Conclusions: Opioid abuse gastroenteropathy presents as ulcers and ul cerated strictures which respond poorly to medical management and endoscopic balloon dilatation. A majority of these cases need surgical intervention. (Intest Res 2020;18:238-244)
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