Esophageal Symptoms Can Be Associated with Chronic Opioid Use

When we think about gastrointestinal side effects of opioids, we often focus on constipation or impaired gastric emptying. But opioids also have effects on esophageal motility. In this meta-analysis, researchers identified nine studies in which high-resolution esophageal manometry was performed in chronic opioid users and nonusers referred for symptoms such as dysphagia, reflux, and esophageal-related chest pain. Findings were categorized according to the Chicago Classification, an increasingly used system for describing esophageal motility disorders (Neurogastroenterol Motil 2021; 33:e14058).

Compared with opioid nonusers, opioid users had a significantly higher prevalence (odds ratios, ≈5.0) of distal esophageal spasm, esophagogastric junc…