BACKGROUND: The role of narcotic use in patients with inflammatory bowel disease (IBD) is poorly defined. We sought to determine the clinical features of patients with IBD who use narcotics and factors associated with the discontinuation of narcotics. METHODS: A centralized index was used to identify 100 cases (patients with IBD receiving narcotics) and 100 matched controls evaluated in an IBD clinic between 1999 and 2002. Associations of clinical factors with case or control status were summarized as overall percentages and assessed using conditional logistic regression. Associations within cases were assessed using Fisher's exact test. RESULTS: Review of 361 charts identified 100 patients with IBD receiving narcotics (cases). One hundred matched controls were then identified. Cases were significantly associated with: female gender (64% cases versus 45% controls, P = 0.01), >or=2 IBD-related surgeries (42% versus 17%, P < 0.001), moderate-to-severe pain (93% versus 20%, P < 0.001), and moderate-to-severe symptoms (83% versus 33%, P < 0.001). Significant associations were detected for depression (42% versus 19%, P < 0.001), anxiety (19% versus 7%, P = 0.02), history of abuse (sexual, emotional, or physical, 17% versus 3%, P = 0.006), and for substance abuse (excluding alcohol) (14% versus 1%, P = 0.01). Of 39 cases that returned for follow-up, 22 (56%) had discontinued narcotics. Discontinuing narcotics was associated with medical treatment adherence (100% versus 53%), none-to-mild pain (73% versus 18%), and none-to-mild clinical activity (80% versus 24%). CONCLUSIONS: Narcotic use in IBD patients is associated with female gender, >or=2 previous surgeries, moderate to severe pain, and clinical disease activity, depression, anxiety, sexual, emotional and physical abuse, and substance abuse.
BACKGROUND: The role of narcotic use in patients with inflammatory bowel disease (IBD) is poorly defined. We sought to determine the clinical features of patients with IBD who use narcotics and factors associated with the discontinuation of narcotics. METHODS: A centralized index was used to identify 100 cases (patients with IBD receiving narcotics) and 100 matched controls evaluated in an IBD clinic between 1999 and 2002. Associations of clinical factors with case or control status were summarized as overall percentages and assessed using conditional logistic regression. Associations within cases were assessed using Fisher's exact test. RESULTS: Review of 361 charts identified 100 patients with IBD receiving narcotics (cases). One hundred matched controls were then identified. Cases were significantly associated with: female gender (64% cases versus 45% controls, P = 0.01), >or=2 IBD-related surgeries (42% versus 17%, P < 0.001), moderate-to-severe pain (93% versus 20%, P < 0.001), and moderate-to-severe symptoms (83% versus 33%, P < 0.001). Significant associations were detected for depression (42% versus 19%, P < 0.001), anxiety (19% versus 7%, P = 0.02), history of abuse (sexual, emotional, or physical, 17% versus 3%, P = 0.006), and for substance abuse (excluding alcohol) (14% versus 1%, P = 0.01). Of 39 cases that returned for follow-up, 22 (56%) had discontinued narcotics. Discontinuing narcotics was associated with medical treatment adherence (100% versus 53%), none-to-mild pain (73% versus 18%), and none-to-mild clinical activity (80% versus 24%). CONCLUSIONS: Narcotic use in IBD patients is associated with female gender, >or=2 previous surgeries, moderate to severe pain, and clinical disease activity, depression, anxiety, sexual, emotional and physical abuse, and substance abuse.
Authors: Salva N Balbale; Itishree Trivedi; Linda C O'Dwyer; Megan C McHugh; Charlesnika T Evans; Neil Jordan; Laurie A Keefer Journal: Dig Dis Sci Date: 2017-08-05 Impact factor: 3.199
Authors: Mohamed Noureldin; Peter D R Higgins; Shail M Govani; Shirley Cohen-Mekelburg; Brooke C Kenney; Ryan W Stidham; Jennifer F Waljee; Akbar K Waljee Journal: Aliment Pharmacol Ther Date: 2018-11-14 Impact factor: 8.171
Authors: Christopher Andrew Lamb; Nicholas A Kennedy; Tim Raine; Philip Anthony Hendy; Philip J Smith; Jimmy K Limdi; Bu'Hussain Hayee; Miranda C E Lomer; Gareth C Parkes; Christian Selinger; Kevin J Barrett; R Justin Davies; Cathy Bennett; Stuart Gittens; Malcolm G Dunlop; Omar Faiz; Aileen Fraser; Vikki Garrick; Paul D Johnston; Miles Parkes; Jeremy Sanderson; Helen Terry; Daniel R Gaya; Tariq H Iqbal; Stuart A Taylor; Melissa Smith; Matthew Brookes; Richard Hansen; A Barney Hawthorne Journal: Gut Date: 2019-09-27 Impact factor: 23.059
Authors: Raquel Guerrero-Alba; Eduardo Emmanuel Valdez-Morales; Nestor Nivardo Jiménez-Vargas; Romke Bron; Daniel Poole; David Reed; Joel Castro; Melissa Campaniello; Patrick A Hughes; Stuart M Brierley; Nigel Bunnett; Alan E Lomax; Stephen Vanner Journal: Br J Pharmacol Date: 2018-05-22 Impact factor: 8.739