Article
Oncology
Antoine Lemaire, Yoann Pointreau, Berengere Narciso, Francois-Xavier Piloquet, Viorica Braniste, Jean-Marc Sabate
Summary: This study demonstrates that naloxegol is effective and well-tolerated in cancer pain patients with OIC, leading to an improvement in their quality of life.
SUPPORTIVE CARE IN CANCER
(2021)
Review
Medicine, General & Internal
Nabil ALMouaalamy
Summary: This study discusses opioid-induced constipation (OIC) in advanced cancer patients, focusing on the definition, pathophysiology, and treatment. OIC is common in these patients and is often associated with severe distress and reduced quality of life.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2021)
Article
Clinical Neurology
Giustino Varrassi, Vivek Banerji, Walter Gianni, Franco Marinangeli, Carmine Pinto
Summary: OIC is a significant limitation of opioid treatment, impacting patients' quality of life, especially for younger patients and those who have been on opioids for a shorter period of time. The management of constipation is inadequate in many cases and there is a definite need for better education among healthcare providers about OIC.
Article
Gastroenterology & Hepatology
You-Min Lin, Yanbo Tang, Yu Fu, Shrilakshmi Hegde, W. Daniel Shi, M. Li-Yen Huang, Xuan-Zheng Shi
Summary: Constipation and abdominal pain in opioid-induced bowel dysfunction may be caused by fecal retention, which leads to changes in smooth muscle function and neuronal excitability. Prevention of fecal retention through liquid diet can potentially improve symptoms by regulating the expression of COX-2 and NGF.
AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY
(2021)
Article
Gastroenterology & Hepatology
Nayna A. Lodhia, Laura Horton, Thapa Namisha, Alison H. Goldin, Walter W. Chan
Summary: This retrospective cohort study analyzed the relationship between recent opioid use in constipated patients and anorectal sensation, defecatory function, and balloon expulsion. Results showed that recent opioid use was associated with anorectal dysfunction and difficulty in passing stools.
DIGESTIVE DISEASES AND SCIENCES
(2022)
Review
Pharmacology & Pharmacy
Rob Hill, Meritxell Canals
Summary: Morphine and other opioids are widely used for pain treatment, but their side effects limit their use. Developing opioids with fewer side effects is a major research focus, but translating promising candidates from the lab to the clinic remains challenging.
PHARMACOLOGY & THERAPEUTICS
(2022)
Article
Gastroenterology & Hepatology
Jeff Liang, Christopher V. Almario, William D. Chey, Carolyn S. Higgins, Brennan M. R. Spiegel
Summary: In this study of a nationally representative data set in the United States, the prevalence, symptom severity, and medication use in individuals with Rome IV chronic idiopathic constipation (CIC), opioid-induced constipation (OIC), and opioid-exacerbated constipation (OEC) were assessed. The results showed that OIC and OEC were less prevalent than CIC, but individuals with OIC and OEC had more severe constipation symptoms and were more likely to use prescription medication.
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2023)
Article
Multidisciplinary Sciences
Ernest Mas-Herrero, Laura Ferreri, Gemma Cardona, Robert J. Zatorre, Francesc Pla-Junca, Rosa Maria Antonijoan, Jordi Riba, Marta Valle, Antoni Rodriguez-Fornells
Summary: Studies in rodents show that the opioid circuit plays an important role in mediating objective hedonic reactions to basic rewards. However, it is still unclear whether opioid transmission is crucial for experiencing pleasure with more abstract rewards, such as music. This study used a double-blind within-subject pharmacological design and found that while opioid levels did not affect subjective pleasure or chills, they bidirectionally modulated objective emotional arousal measures during reward consumption.
ANNALS OF THE NEW YORK ACADEMY OF SCIENCES
(2023)
Article
Biochemistry & Molecular Biology
Agata Szymaszkiewicz, Marcin Talar, Jakub Wlodarczyk, Mikolaj Swierczynski, Adrian Bartoszek, Julia Krajewska, Anna Mokrowiecka, Ewa Malecka-Wojciesko, Jakub Fichna, Marta Zielinska
Summary: Nearly 20% of elderly patients suffer from constipation, but the age-related changes in the gastrointestinal (GI) tract remain insufficiently elucidated. This study evaluated the alterations within the endogenous opioid system (EOS) as a potential cause of constipation in the elderly. The results showed that the age-related impairment of GI peristalsis may result from reduced MOP and DOP response to opioid agonists or alterations in EOS expression.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Review
Chemistry, Medicinal
Alok K. Paul, Craig M. Smith, Mohammed Rahmatullah, Veeranoot Nissapatorn, Polrat Wilairatana, Mariana Spetea, Nuri Gueven, Nikolas Dietis
Summary: Opioids are commonly used for pain management but have numerous adverse effects, particularly in older adults. Understanding the mechanisms of opioid-induced adverse reactions can aid in improving pain management strategies.
Article
Anesthesiology
Claudius E. Degro, Nestor Nivardo Jimenez-Vargas, Quentin Tsang, Yang Yu, Mabel Guzman-Rodriguez, Elahe Alizadeh, David Hurlbut, David E. Reed, Alan E. Lomax, Christoph Stein, Nigel W. Bunnett, Stephen J. Vanner
Summary: This study found that repeated dosing of N-(3-fluoro-1-phenethylpiperidine-4-yl)-N-phenyl propionamide can provide safe and effective analgesia for colitis by targeting the acidified layers of the inflamed colon. The drug is able to inhibit human colonic nociceptors and has minimal side effects.
Review
Gastroenterology & Hepatology
Jamie Horrigan, Sriya Bhumi, David Miller, Mikram Jafri, Micheal Tadros
Summary: Opioid-induced constipation is a common condition in older adults, and traditional laxative therapy may not be effective. Nonpharmacologic interventions and over-the-counter laxatives are recommended as initial treatment options, followed by prescription opioid receptor antagonists if necessary. Other medications like probiotics and promotility agents can be considered, but their effectiveness in older adults is not well-studied. Due to the complexity of drug metabolism in the aging population, individual evaluation and reevaluation of treatment options is important.
JOURNAL OF CLINICAL GASTROENTEROLOGY
(2023)
Article
Gastroenterology & Hepatology
Adam Truong, Lucille Yao, Phillip R. Fleshner, Karen N. Zaghiyan
Summary: This study aimed to explore the possibility of perioperative opioid avoidance in patients undergoing colorectal surgery or those with inflammatory bowel disease (IBD). The research conducted a retrospective analysis of patients from two prospective studies and found that early postoperative opioid avoidance is feasible in a limited number of IBD patients after colorectal surgery.
COLORECTAL DISEASE
(2023)
Article
Pediatrics
Denise D. Tran, Patrick C. M. Brown, Corrin Murphy, Diana Ho, Karen A. Hudson, Anna C. Wilson, Sarah W. Feldstein Ewing
Summary: Receiving an opioid prescription during childhood increases the risk of hazardous prescription opioid use during emerging adulthood. Efforts are needed to improve pediatric opioid label instructions in order to enhance patient comprehension of medication use.
Article
Medicine, General & Internal
Pilar Carrasco-Garrido, Domingo Palacios-Cena, Valentin Hernandez-Barrera, Isabel Jimenez-Trujillo, Carmen Gallardo-Pino, Cesar Fernandez-de-las-Penas
Summary: The study describes the prevalence and associated factors of opioid and non-opioid analgesic usage in patients with post-COVID-19 condition. The findings show that the prevalence of opioid analgesic consumption is 24.1%, while non-opioid analgesic consumption is 82.3%. Females are more likely to consume non-opioid analgesics, and factors such as marital status, monthly income, number of post-COVID symptoms, and anxiolytic consumption are associated with opioid analgesic usage. Older age and anxiolytic consumption are predictors of non-opioid analgesic consumption.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Gastroenterology & Hepatology
Marco B. Mahdi, Emily Steinkohl, Vikesh K. Singh, Asbjorn M. Drewes, Jens B. Frokjaer, Soren S. Olesen
Summary: In medically managed patients with chronic pancreatitis, those with large duct CP have a higher prevalence of diabetes and exocrine insufficiency compared to small duct CP. There is also an increased risk of new-onset exocrine insufficiency and higher rates of pancreatic atrophy in patients with large duct CP.
CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY
(2023)
Review
Anesthesiology
Kristian D. Lyng, Chris Djurtoft, Malene K. Bruun, Mads N. Christensen, Rikke E. Lauritsen, Jesper B. Larsen, Kathryn A. Birnie, Jennifer Stinson, Morten S. Hoegh, Thorvaldur S. Palsson, Anne E. Olesen, Lars Arendt-Nielsen, Lars H. Ehlers, Kirsten Fonager, Martin B. Jensen, Hanne Wurtzen, Patricia A. Poulin, Gitte Handberg, Connie Ziegler, Lars B. Moeller, Judi Olsen, Lotte Heise, Michael S. Rathleff
Summary: This study aimed to create a contemporary evidence and gap map (EGM) of interventions and outcomes used for research investigating chronic musculoskeletal (MSK) pain. The results revealed a low proportion of high-quality evidence within chronic MSK pain and a lack of interventions encompassing the entire biopsychosocial perspective.
Article
Gastroenterology & Hepatology
Tiago Bouca-Machado, Stefan A. W. Bouwense, Martin Brand, Ihsan Ekin Demir, Jens Brondum Frokjaer, Pramod Garg, Peter Hegyi, J. -Matthias Lohr, Enrique de-Madaria, Soren Schou Olesen, Sanjay Pandanaboyana, Jan Bech Pedersen, Vinciane Rebours, Andrea Sheel, Vikesh Singh, Martin Smith, John A. Windsor, Dhiraj Yadav, Asbjorn Mohr Drewes
Summary: Acute on chronic pancreatitis (ACP) is a common condition, but there are significant gaps in our knowledge about it. Through a systematic review and expert consensus, a new definition of ACP was reached. Despite the poor evidence base, this position statement provides a foundation for the management of ACP.
Article
Gastroenterology & Hepatology
Mikael Parhiala, Anne Waage, Povilas Ignatavicus, Jakob L. Poulsen, Engjom Trond, Georg Dimcevski, Ingrid Nordaas, Amer Hadi, Evangelos Kalaitzakis, Asbjorn M. Drewes, Camilla Nojgaard, Johanna Laukkarinen
Summary: This study aimed to determine the surgical treatment strategies for chronic pancreatitis (CP) in the Scandinavian and Baltic countries. The results showed that only 7% of CP patients underwent pancreatic surgery, with 51% of them undergoing surgery for chronic pain. After surgery, 47% of the patients were pain-free and half of the patients reported no pain.
Article
Substance Abuse
Ulrik Becker, Amalie Timmermann, Ola Ekholm, Morten Gronbaek, Asbjorn Mohr Drewes, Srdan Novovic, Camilla Nojgaard, Soren Schou Olesen, Janne Schurmann Tolstrup
Summary: This study analyzed the effects of drinking pattern and type of alcohol on the risk of acute and chronic pancreatitis. The results showed that increased alcohol intake was associated with increased development of pancreatitis. Frequent binge drinking and long-term drinking (daily drinking) were associated with the development of pancreatitis. The intake of large amounts of spirits and beer was associated with the development of acute and chronic pancreatitis, while the consumption of wine was not associated with the development of pancreatitis.
ALCOHOL AND ALCOHOLISM
(2023)
Article
Pharmacology & Pharmacy
Tina Okdahl, Esben Bolvig Mark, Rasmus Bach Nedergaard, Cecilie Siggaard Knoph, Mathias Ellgaard Cook, Klaus Krogh, Asbjorn Mohr Drewes
Summary: Opium tincture, traditionally used for chronic diarrhea, has been found to decrease bowel movements and increase stool consistency without causing sedation. This controlled trial demonstrates that opium tincture has anti-propulsive properties in the healthy gut, making it a relevant and safe treatment option for chronic diarrhea.
BASIC & CLINICAL PHARMACOLOGY & TOXICOLOGY
(2023)
Article
Toxicology
Charlotte Uggerhoj Andersen, Steffen Hansen, Kim Peder Dalhoff, Lars Peter Nielsen, Jorn Munkhof Moller, Anne Estrup Olesen
Summary: This study investigated the effects of a regulation in Denmark that limited the amount of paracetamol available without a prescription. The results showed a decrease in the number of paracetamol poisonings and cases involving ingestion of more than 20 g of paracetamol, as well as a lower occurrence of liver toxicity after the regulation. Other factors, such as increased public awareness, may also contribute to these changes. Additionally, the study found distinct differences between females and males in terms of age and intentional poisoning.
CLINICAL TOXICOLOGY
(2023)
Article
Public, Environmental & Occupational Health
Maja Thaarup, Peter Bronnum Nielsen, Anne Estrup Olesen, Maria Bitsch Poulsen, Torben Bjerregaard Larsen, Felix Wittstrom, Thure Filskov Overvad
Summary: This study examined the positive predictive value (PPV) of non-traumatic bleeding diagnoses in the Danish National Patient Registry. The overall validity of non-traumatic bleeding diagnoses was high, but there was a significant difference in PPVs between primary and secondary diagnoses.
CLINICAL EPIDEMIOLOGY
(2023)
Review
Medicine, General & Internal
Christoffer S. Graven-Nielsen, Cecilie S. Knoph, Tina Okdahl, Katrine L. Hoyer, Klaus Krogh, Per M. Hellstroem, Asbjorn M. Drewes
Summary: In patients with chronic idiopathic diarrhea resistant to standard treatment, opioids are often used as rescue therapy. This systematic review investigated the effects of opioid agonists on gut function in chronic diarrhea. The review found that opioid receptor agonists such as loperamide, asimadoline, casokefamide, and codeine reduced stool frequency and increased transit time compared with placebo, while loperamide and diphenoxylate significantly improved stool consistency. However, the evidence from clinical trials is limited and more research is needed to establish standardized endpoints and larger prospective studies.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Pharmacology & Pharmacy
Anne Estrup Olesen, Tanja Joest Vaever, Martin Simonsen, Peter Gaardbo Simonsen, Kirsten Hoj
Summary: Medication reviews focusing on deprescribing can reduce potentially inappropriate medication, but there is limited evidence on health-related outcomes. In a real-life quality improvement project, a general practitioner-led medication review intervention focusing on deprescribing was associated with increased self-reported health status without deterioration in general condition or functional level. The small sample size and lack of control group should be considered when interpreting the results.
BASIC & CLINICAL PHARMACOLOGY & TOXICOLOGY
(2023)
Article
Clinical Neurology
Rasmus Bach Nedergaard, Matthew Scott, Anne-Marie Wegeberg, Tina Okdahl, Joachim Starling, Birgitte Brock, Asbjarn Mohr Drewes, Christina Brock
Summary: This study used supervised machine learning to classify the severity of cardiovascular autonomic neuropathy (CAN). The results showed that beat-to-beat measures, inflammation markers, disease-duration, and age were the most important features for characterizing CAN. It was suggested that monitoring cardiac reflex responses closely and targeting systemic low-grade inflammation could help diagnose and prevent the development of CAN.
CLINICAL NEUROPHYSIOLOGY
(2023)
Review
Anesthesiology
Anne-Marie Wegeberg, Trine Hyttel Sejersgaard-Jacobsen, Christina Brock, Asbjorn Mohr Drewes
Summary: Pain is a major clinical challenge, and understanding its pathophysiology is critical for optimal management. This systematic review investigates the ability of electrocardiographic-derived measures to predict pain, and finds that increased parasympathetic activity can predict pain reduction in different types of pain.
EUROPEAN JOURNAL OF PAIN
(2023)
Review
Biochemistry & Molecular Biology
Samuel Azuz, Jakob Lykke Poulsen, Lars Vinter-Jensen, Anne Estrup Olesen
Summary: This article focuses on the absorption of various drugs in patients with short bowel syndrome, including the characteristics of the drugs and the pharmacokinetic findings. Understanding the patient's gastrointestinal anatomy, the absorptive capacity of the remaining bowel, and the physicochemical properties of the drugs is crucial for optimizing oral pharmacotherapy.
EXPERT OPINION ON DRUG METABOLISM & TOXICOLOGY
(2023)
Article
Gastroenterology & Hepatology
Mikael Parhiala, Camilla Nojgaard, Andreas Bartholdy, Anne Waage, Povilas Ignatavicius, Trond Engjom, Georg Dimcevski, Ingrid Kvale Nordaas, Evangelos Kalaitzakis, Asbjorn M. Drewes, Amer Hadi, Soren S. Olesen, Jakob L. Poulsen, Johanna Laukkarinen, Scandinavian Baltic Pancreatic Club
Summary: This study aimed to determine the frequency of endoscopic procedures (EP) in chronic pancreatitis (CP) patients and analyze their pain and quality of life (QoL) after the procedures. The study found that 20% of CP patients underwent EP, and these patients had higher QoL scores and improved symptoms. Patients who had pancreatic stenting had similar pain patterns to the reference population.
UNITED EUROPEAN GASTROENTEROLOGY JOURNAL
(2023)
Article
Clinical Neurology
Cecilie Siggaard Knoph, Rasmus Bach Nedergaard, Soren Schou Olesen, Louise Kuhlmann, Asbjorn Mohr Drewes
Summary: Abdominal pain is common in patients with chronic pancreatitis and is difficult to manage due to altered pain processing in the central nervous system. We hypothesized that patients with painful chronic pancreatitis have generalized hyperalgesia and increased central neuronal excitability. Our study confirmed somatic hyperalgesia in these patients, highlighting the importance of targeting central mechanisms for management.
JOURNAL OF PAIN RESEARCH
(2023)
