Melchior Chloé, Desprez Charlotte, Wuestenberghs Fabien, Leroi Anne-Marie, Lemaire Antoine, Goucerol Guillaume
INSERM UMR 1073, Institute for Research and Innovation in Biomedicine, Normandy University, Rouen, France.
Gastroenterology Department, Rouen University Hospital, Rouen, France.
Front Pharmacol. 2020 Dec 21;11:596467. doi: 10.3389/fphar.2020.596467. eCollection 2020.
We aimed to determine the burden of opioid consumption in a cohort of patients with functional gastrointestinal disorders. All patients diagnosed with functional gastrointestinal disorders and referred to our university hospital were evaluated from 2013 to the beginning of 2019. Irritable bowel syndrome and functional dyspepsia diagnoses were determined according to Rome criteria and severity according to irritable bowel syndrome severity scoring system. Vomiting was quantified using a 5-point Likert scale, and constipation severity was measured using the Knowles-Eccersley-Scott-Symptom questionnaires. Quality of life was quantified by the GastroIntestinal Quality of Life Index. Patients were categorized as being treated on a chronic basis with either tramadol, step II opioids, step III opioids or as being opioid-free. 2933 consecutive patients were included. In our cohort, 12.5% had only irritable bowel syndrome, 39.3% had only functional dyspepsia, 24.9% had a combination of both, and 23.4% had other functional gastrointestinal disorders. Among them, the consumption of tramadol, step II (tramadol excluded) and step III opioids was 1.8, 1.3 and 0.3 % respectively in 2013 and 4.3, 3.4 and 1.9% in 2018 ( < 0.03). Opioid consumption was associated with increased vomiting ( = 0.0168), constipation ( < 0.0001), symptom severity ( < 0.001), more altered quality of life ( < 0.0001) and higher depression score ( = 0.0045). In functional gastrointestinal disorders, opioid consumption has increased in the last years and is associated with more GI symptoms (vomiting, constipation and GI severity), higher depression and more altered quality of life.
我们旨在确定一组功能性胃肠疾病患者的阿片类药物使用负担。2013年至2019年初，对所有被诊断为功能性胃肠疾病并转诊至我们大学医院的患者进行了评估。根据罗马标准确定肠易激综合征和功能性消化不良的诊断，并根据肠易激综合征严重程度评分系统确定严重程度。呕吐采用5级李克特量表进行量化，便秘严重程度采用诺尔斯-埃克斯利-斯科特症状问卷进行测量。生活质量通过胃肠道生活质量指数进行量化。患者被分类为长期接受曲马多、II级阿片类药物、III级阿片类药物治疗或未使用阿片类药物。纳入了2933例连续患者。在我们的队列中，12.5%仅患有肠易激综合征，39.3%仅患有功能性消化不良，24.9%同时患有两者，23.4%患有其他功能性胃肠疾病。其中，2013年曲马多、II级（不包括曲马多）和III级阿片类药物的使用率分别为1.8%、1.3%和0.3%，2018年分别为4.3%、3.4%和1.9%（<0.03）。阿片类药物的使用与呕吐增加（=0.0168）、便秘（<0.0001）、症状严重程度（<0.001）、生活质量改变更大（<0.0001）和抑郁评分更高（=0.0045）相关。在功能性胃肠疾病中，近年来阿片类药物的使用有所增加，并且与更多的胃肠道症状（呕吐、便秘和胃肠道严重程度）、更高的抑郁程度以及更大的生活质量改变相关。
