J Neurogastroenterol Motil.  2019 Apr;25(2):205-211. 10.5056/jnm18150.

Opioid Treatment and Excessive Alcohol Consumption Are Associated With Esophagogastric Junction Disorders

• Schindler
• Runggaldier D
• Bianca A
• Becker AS
• Murray F
• Savarino E
• Pohl D

• KMID: 2449092
• DOI: http://doi.org/10.5056/jnm18150

Abstract

BACKGROUND/AIMS
The influence of external factors such as opioids and alcohol has been extensively investigated for various segments of the gastrointestinal tract. However, the association between their use and the development of esophagogastric junction outflow obstruction disorders (EGJOODs) is unknown. Therefore, the aim of this study is to analyze prevalence and clinical relevance of opioids and alcohol intake in patients with EGJOODs.
METHODS
In this single-center, retrospective study, we reviewed clinical and pharmacological data of 375 consecutive patients who had undergone high resolution impedance manometry for EGJOODs. EGJOODs were classified according to the Chicago classification version 3.0 and to recently published normal values for test meals. Demographics, manometric data, and symptoms were compared between different groups using Pearson's chi-squared test, Fisher's exact test, and multivariate analysis. A P < 0.05 was considered significant.
RESULTS
EGJOOD was found in 30.7% (115/375) of all analyzed patients. The prevalence of opioids (14.8% vs 4.2%, P = 0.026) was significantly higher in patients with EGJOODs compared to patients without EGJOODs. Additionally, excessive alcohol consumption (12.2% vs 3.5%, P = 0.011) was associated with EGJOODs. Excessive alcohol consumption was especially frequent in the non-achalasia esophagogastric junction outflow obstruction subgroup (16.2%) and opioid use in the achalasia type III subgroup (20.0%).
CONCLUSIONS
We found a significant association between EGJOODs and opioid as well as excessive alcohol consumption. This underlines the importance of detailed history taking regarding medication and ethanol consumption in patients with dysphagia. Further prospective studies on mechanisms undelaying esophagogastric junction dysfunction due to opioids or alcohol are warranted.

Keyword

Alcohol drinking; Analgesics, Opioids; Esophageal achalasia; Esophagogastric junction; Manometry

MeSH Terms

Alcohol Drinking*
Analgesics, Opioid
Classification
Deglutition Disorders
Demography
Electric Impedance
Esophageal Achalasia
Esophagogastric Junction*
Ethanol
Gastrointestinal Tract
Humans
Manometry
Meals
Multivariate Analysis
Prevalence
Prospective Studies
Reference Values
Retrospective Studies
Analgesics, Opioid
Ethanol