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VIDEO: Opioids lead to dyssynergic defecation
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SAN DIEGO — In this exclusive video from Digestive Disease Week, William Chey, MD, professor of medicine, and director of the GI Physiology Laboratory at University of Michigan Health System, discusses two studies from his team that were presented at the meeting.
In the first, researchers explored the role of the sucrase-isomaltase gene in patients with irritable bowel syndrome who do not get better once they begin a low-FODMAP diet.
“Individuals who don’t get better are more likely to have mutations to the sucrase-isomaltase gene,” Chey told Healio Gastroenterology and Liver Disease. “Remember that sucrase-isomaltase is the primary enzyme in the brush boarder epithelium that is responsible for sucrose and maltose, two really important disaccharides that aren’t excluded by the low-FODMAP diet.”
Chey and colleagues found that patients with two copies of mutated genes were significantly more likely to not respond to the low-FODMAP diet compared with patients with no mutations. Chey said physicians might want to pursue testing in patients who do not respond to the low-FODMAP diet to see if they have this mutation or consider trying them on a sucrose-restricted diet or sucrase enzyme supplement.
In the second study, researchers found that patients with constipation who are on an opioid analgesic are more likely to have dyssynergic defecation than patients with constipation who are not on opioids.
“We’ve known for years that opioids slow the transit of the colon, but what we haven’t known is whether opioids affect pelvic floor function and lead to a higher rate of dyssynergic defecation,” Chey said. “in your patients with constipation on an opioid that isn’t getting better with usual laxative therapy, please think about the possibility of pelvic floor disfunction and dyssynergic defecation, because they may benefit from physical therapy and biofeedback training.”
Disclosures: Chey reports financial ties to Allergan, Conti, IM Health, Ironwood, MyGiHealth, Nestle, QOL Medical, Ritter, Salix, Shire, True Self Foods, Volcant and Zespori.
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