Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse, Treatment and Research, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse, Treatment and Research, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Drug Alcohol Depend. 2021 Aug 1;225:108836. doi: 10.1016/j.drugalcdep.2021.108836. Epub 2021 Jun 24.
Preference for sweet-tasting foods, weight gain, and constipation characterize patients receiving methadone maintenance treatment (MMT). The prevalence of constipation in MMT and its relation to preference for sweet taste and body mass index (BMI) are undetermined.
A random sample of 83 patients was interviewed for constipation with the Patient Assessment Constipation Quality of Life (PAC-QOL) questionnaire. They rated taste intensity and reward of sweet, salty, and sour solutions by means of a nine-point Likert scale. Data on their BMI, drugs in urine, methadone dose, and serum levels were analyzed.
Forty-two patients reported minimum to severe constipation. They characterized as having longer durations of opioid usage before MMT and worse sleep quality than non-constipated patients (logistic regression). Constipation intensity was inversely correlated with duration in MMT and linearly correlated with the Patient Assessment Constipation Quality of Life score. Patients with constipation rated reward to sweet taste significantly higher with no differences in taste intensity compared to non-constipated patients. Patients with high methadone serum levels (≥750 ng/mL) rated taste intensity significantly lower compared to those with normal methadone serum levels (<750 ng/mL), and the lowest rates were reported among patients with no constipation and high methadone serum levels.
Constipation was highly prevalent among MMT patients and associated with poor sleep and lower quality of life. The relation to preference for sweets, as reflected by higher reward rating, strongly supports the need for nutritional intervention to alleviate constipation symptoms and improve quality of life and sleep.
接受美沙酮维持治疗（MMT）的患者的特征是喜欢吃甜食、体重增加和便秘。MMT 中便秘的患病率及其与对甜味的偏好和体重指数（BMI）的关系尚不确定。
对 83 名随机患者进行了便秘问卷调查，使用患者评估便秘生活质量问卷（PAC-QOL）。他们通过九点李克特量表对甜味、咸味和酸味溶液的味觉强度和奖赏进行评分。分析了他们的 BMI、尿液中的药物、美沙酮剂量和血清水平的数据。
42 名患者报告了轻度至重度便秘。与非便秘患者相比，他们具有更长的阿片类药物使用时间和更差的睡眠质量（逻辑回归）。便秘的严重程度与 MMT 的持续时间呈负相关，与患者评估便秘生活质量评分呈线性相关。便秘患者对甜味的奖赏评价明显高于非便秘患者，但味觉强度没有差异。与正常美沙酮血清水平（<750ng/ml）相比，高美沙酮血清水平（≥750ng/ml）的患者味觉强度明显较低，而无便秘和高美沙酮血清水平的患者报告的味觉强度最低。
MMT 患者中便秘的患病率很高，与睡眠质量差和生活质量低有关。与对甜食的偏好的关系，反映在更高的奖励评价上，强烈支持需要营养干预来缓解便秘症状，改善生活质量和睡眠。
