Jehangir A, et al. - This study was performed to investigate the relationship of chronic scheduled opioid use on symptoms, health care utilization and employment in patients referred for gastroparesis (Gp). Compared to gastroparesis patients not taking opiates (GpNO), gastroparesis patients those on chronic scheduled opiates (GpCO) had a higher severity of many gastrointestinal symptoms. In GpCO, hospitalization rates were more than 2-fold higher than GpNO. Furthermore, when compared to GpNO, GpCO had lower employment rate and working hours.

• From May 2016 to July 2017, patients referred to the tertiary care academic center, with established diagnosis or symptoms suggestive of Gp filled out the Patient Assessment of Upper GI Symptoms, abdominal pain and demographics questionnaires.
• They underwent gastric emptying and blood tests.
• For this study, they were asked about taking pain medicines and the types, doses, and duration.
• Mann Whitney U test, Analysis of Variance, Student’s t test and Χ² tests were used where appropriate for data analyses.

• One hundred fifty-eight (70.9%) patients were not taking opioids (GpNO), 22 (9.9%) were taking opioids only as needed, while 43 (19.3%) were on chronic (> 1 mo) scheduled opioids (GpCO), of which 18 were taking opioids for reasons that included gastroparesis and/or stomach pain among 223 patients with delayed gastric emptying.
• Median morphine equivalent use was 60 mg per day.
• Compared to GpNO, GpCO reported higher severities of many gastrointestinal symptoms including nausea (mean ± SE of mean of 4.09 ± 0.12 vs 3.41 ± 0.12, P=0.011), retching (2.86 ± 0.25 vs 1.98 ± 0.14, P=0.003), vomiting (2.93 ± 0.24 vs 2.07 ± 0.15, P=0.011), early satiety (4.17 ± 0.19 vs 3.57 ± 0.12, P=0.004), post-prandial fullness (4.14 ± 0.18 vs 3.63 ± 0.11, P=0.022), loss of appetite (3.64 ± 0.21 vs 3.04 ± 0.13, P=0.039), upper abdominal pain (3.86 ± 0.20 vs 2.93 ± 0.13, P=0.001), upper abdominal discomfort (3.74 ± 0.19 vs 3.09 ± 0.13, P=0.031), heartburn during day (2.55 ± 0.27 vs 1.89 ± 0.13, P=0.032), heartburn on lying down (2.76 ± 0.28 vs 1.94 ± 0.14, P = 0.008), chest discomfort during day (2.42 ± 0.20 vs 1.83 ± 0.12, P=0.018), chest discomfort at night (2.40 ± 0.23 vs 1.61 ± 0.13, P=0.003), regurgitation/reflux during day (2.77 ± 0.25 vs 2.18 ± 0.13, P=0.040) and bitter/acid/sour taste in the mouth (2.79 ± 0.27 vs 2.11 ± 0.14, P=0.028).
• A longer duration of nausea per day (median of 7 h vs 4 h for GpNO, P=0.037), and a higher number of vomiting episodes per day (median of 3 vs 2 for GpNO, P=0.002) were observed in GpCO.
• At night, their abdominal pain more frequently woke them up (78.1% vs 57.3%, P=0.031).
• They had a lower employment rate (33.3% vs 54.2%, P=0.016) and amongst those who were employed less number of working hours per week (median of 23 vs 40, P=0.005).
• In the last 1 year, they reported higher number of hospitalizations (mean ± SE of mean of 2.90 ± 0.77 vs 1.26 ± 0.23, P=0.047).