Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Neurogastroenterol Motil. 2024 Dec;36(12):e14941. doi: 10.1111/nmo.14941. Epub 2024 Oct 7.
Opioids inhibit motility and secretion of the gut and have been used for antidiarrheal treatment for centuries. However, the underlying mechanisms of opium tincture are not evident.
To investigate the effects of opium tincture on gastrointestinal motility, intestinal volumes, and water content of different gut segments assessed by magnetic resonance imaging (MRI).
Twenty healthy volunteers were included in a randomized, placebo-controlled, crossover study of 9 days of treatment with 30 drops of opium tincture per day. MRI was performed on day 1 (before treatment) and day 9 (during treatment). Measurements included assessments of gastric volume, gastric emptying, gastric motility, small bowel volume, small bowel water content, small bowel motility, colon volume, colon water content, and whole gut transit.
Opium tincture delayed gastric emptying by a mean difference of 5.6 min [95% CI: 1.8-9.4], p = 0.004, and increased postprandial gastric meal volume (17-21%, p = 0.02). Small bowel endpoints did not change. Opium tincture delayed whole gut transit time (p = 0.027) and increased ascending colon volume by 59 mL [95% CI: 15-103], p = 0.004, and transverse colon volume by 48 mL [95% CI: 4-92], p = 0.027. T1-relaxation time of the descending colon chyme was decreased during opium treatment, indicating dryer feces (difference: -173 ms [95% CI: -336 -11], p = 0.03).
Opium tincture induced changes in the stomach and colon in healthy volunteers. An improved understanding of how opioids affect gut functions may lead to a better understanding and optimized management of diarrhea.
阿片类药物抑制肠道的运动和分泌，已被用于抗腹泻治疗数百年。然而，鸦片酊的潜在机制尚不清楚。
通过磁共振成像（MRI）评估鸦片酊对胃肠道运动、肠道容积和不同肠道段含水量的影响。
20 名健康志愿者参与了一项为期 9 天的随机、安慰剂对照、交叉研究，每天服用 30 滴鸦片酊。在第 1 天（治疗前）和第 9 天（治疗期间）进行 MRI 检查。测量包括胃容量、胃排空、胃动力、小肠容量、小肠含水量、小肠动力、结肠容量、结肠含水量和全肠道转运时间。
鸦片酊使胃排空平均延迟 5.6 分钟[95%置信区间：1.8-9.4]，p=0.004，并增加餐后胃容量（17-21%，p=0.02）。小肠终点无变化。鸦片酊使全肠道转运时间延长（p=0.027），升结肠容量增加 59 毫升[95%置信区间：15-103]，p=0.004，横结肠容量增加 48 毫升[95%置信区间：4-92]，p=0.027。阿片治疗期间降结肠食糜的 T1 弛豫时间缩短，表明粪便更干燥（差异：-173 毫秒[95%置信区间：-336-11]，p=0.03）。
鸦片酊在健康志愿者中引起胃和结肠的变化。更好地了解阿片类药物如何影响肠道功能，可能会更好地理解和优化腹泻的管理。
