Narcotic Bowel Syndrome

Grover, Casey A.; Wiele, Erik D.; Close, Reb J.H.

doi:10.1016/j.jemermed.2011.05.025

Cited by 8 publications

(5 citation statements)

References 13 publications

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“…In contrast, opioids might pose problems due to their inhibitory effect on bowel motility and problems concerning dependence upon long-term use. 6,7 Cohort-based analyses of the use of pain medication in IBD patients and their efficacy for treatment of IBD-associated pain have been published. 9,16,34 Nevertheless, the effect of analgesics on IBD-related pain and its effect on intestinal inflammation on a molecular level is still insufficient, and experimental work, which allows unbiased assessment of the impact of analgesics on the induction of colitis, is very scarce.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, our experiments do not provide evidence for or against the use of this particular opioid for the treatment of IBD-associated pain, or whether it should be used with care in IBD patients. However, given the potential to induce constipation, bloating and narcotic bowel syndrome, 6,22,38 evidence from patient-based studies clearly indicate that opioids should be used with caution. Also, the use of opioids in IBD patients with severe pain over-proportionally results in dependence, 37 and while being effective in relieving pain on a short term, 11 there is evidence that long-term opioid use might increase sensitivity to gastrointestinal pain.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, in murine DSS-induced colitis, the current state of the art is still to refrain from the use of analgesics due to their possible interaction with the model (i.e., anti-inflammatory effects and negative impact on intestinal motility). 6,7 Since intestinal inflammation might cause pain during colitis experiments, the use of analgesics would be beneficial to reduce the overall constraint imposed on the animals.…”

Section: Introductionmentioning

confidence: 99%

“…22 Major side effects of opioids are gastrointestinal symptoms, including constipation, nausea and bloating, and the long-term benefit of opioid use in non-cancer patients, and especially in IBD, is debated. 6,7,18 Thus, experimental evidence is needed to provide rationales for or against the use of specific analgesics in IBD.…”

Section: Introductionmentioning

confidence: 99%

“…Many commonly used analgesics might impact gut health, 6,7 and might therefore on one hand interfere with the disease in human patients, and on the other hand also be unsuitable for use in mouse models of IBD. However, some analgesics are reported to have a relatively low impact on gut physiology and intestinal inflammation.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the effect of tramadol, paracetamol and metamizole on the severity of experimental colitis

et al. 2023

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Application of dextran sodium sulfate (DSS) is often used to induce experimental colitis. Current state of the art is to refrain from the use of analgesics due to their possible interaction with the model. However, the use of analgesics would be beneficial to reduce the overall constraint imposed on the animals. Here, we analyzed the effect of the analgesics Dafalgan (paracetamol), Tramal (tramadol) and Novalgin (metamizole) on DSS-induced colitis. To study the effect of those analgesics in colitis mouse models, acute and chronic colitis was induced in female C57BL6 mice by DSS administration in the drinking water. Analgesics were added to the drinking water on days four to seven (acute colitis) or on days six to nine of each DSS cycle (chronic colitis). Tramadol and paracetamol had minor effects on colitis severity. Tramadol reduced water uptake and activity levels slightly, while mice receiving paracetamol presented with a better overall appearance. Metamizole, however, significantly reduced water uptake, resulting in pronounced weight loss. In conclusion, our experiments show that tramadol and paracetamol are viable options for the use in DSS-induced colitis models. However, paracetamol seems to be slightly more favorable since it promoted the overall wellbeing of the animals upon DSS administration without interfering with typical readouts of colitis severity.

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