{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T08:17:35Z","timestamp":1778228255006,"version":"3.51.4"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,1,12]],"date-time":"2018-01-12T00:00:00Z","timestamp":1515715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K23 DK84113"],"award-info":[{"award-number":["K23 DK84113"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>While opioid prescriptions have increased alarmingly in the United States (US), their use for unexplained chronic gastrointestinal (GI) pain (eg, irritable bowel syndrome) carries an especially high risk for adverse effects and questionable benefit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To compare opioid use among US veterans with structural <jats:styled-content style=\"fixed-case\">GI<\/jats:styled-content> diagnoses (<jats:styled-content style=\"fixed-case\">SGID<\/jats:styled-content>) and those with unexplained <jats:styled-content style=\"fixed-case\">GI<\/jats:styled-content> symptoms or functional <jats:styled-content style=\"fixed-case\">GI<\/jats:styled-content> diagnoses (<jats:styled-content style=\"fixed-case\">FGID<\/jats:styled-content>), a group for whom opioids have no accepted role.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Veterans Health Administration (<jats:styled-content style=\"fixed-case\">VHA<\/jats:styled-content>) administrative data from fiscal year 2012 were used to identify veterans with diagnostic codes recorded for <jats:styled-content style=\"fixed-case\">SGID<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">FGID<\/jats:styled-content>. This cohort study examined <jats:styled-content style=\"fixed-case\">VHA<\/jats:styled-content> pharmacy data to compare groups receiving\u00a0\u2265\u00a01 opioid prescription during the year and number of prescriptions filled. Bivariate and multiple logistic regression analyses adjusted for potential confounding factors (demographics, medical diagnoses, social factors) and identified potential mediators (service use, psychiatric comorbidity) of opioid use in these groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A greater proportion of veterans with <jats:styled-content style=\"fixed-case\">FGID<\/jats:styled-content> received an opioid prescription during fiscal year 2012 (36.0% of 272\u00a0431) compared to only 28.9% of 1\u00a0223\u00a0744 in the <jats:styled-content style=\"fixed-case\">SGID<\/jats:styled-content> group (Relative Risk [<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>]\u00a0=\u00a01.25). In multivariate logistic regression, personality disorders and drug abuse (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.23 for each group), recent homelessness (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.22), psychotropic medication fills (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.55) and emergency department encounters (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.21) were independently associated with opioid prescription use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite the potential for adverse consequences, opioids more often are prescribed for veterans with chronic, unexplained <jats:styled-content style=\"fixed-case\">GI<\/jats:styled-content> symptoms compared to those with structural diagnoses. Psychiatric comorbidities and frequent healthcare encounters mediate some of the opioid use risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.14503","type":"journal-article","created":{"date-parts":[[2018,1,12]],"date-time":"2018-01-12T09:36:43Z","timestamp":1515749803000},"page":"784-791","source":"Crossref","is-referenced-by-count":22,"title":["Opioid medication use in patients with gastrointestinal diagnoses vs unexplained gastrointestinal symptoms in the US Veterans Health Administration"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1586-199X","authenticated-orcid":false,"given":"G. 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