{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T04:56:48Z","timestamp":1780376208691,"version":"3.54.1"},"reference-count":60,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,3,13]],"date-time":"2020-03-13T00:00:00Z","timestamp":1584057600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Opioid use has reached epidemic proportions. In contrast to the known effect of opioids on gut transit, the effect on rectal sensorimotor function has not been comprehensively investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cross\u2010sectional (hypothesis\u2010generating) study of anorectal physiology studies in 2754 adult patients referred to a tertiary unit (2004\u20102016) for investigation of functional constipation (defined by \u201cderived\u201d Rome IV core criteria). Statistical associations between opioid usage, symptoms, and anorectal physiological variables were investigated. Opioids were sub\u2010classified as prescriptions for mild\u2010moderate or moderate\u2010severe pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>A total of 2354 patients (85.5%) were classified as non\u2010opioid users, 162 (5.9%) as opioid users for mild\u2010moderate pain, and 238 (8.6%) for moderate\u2010severe pain. Opioids for moderate\u2010severe pain were associated with increased symptomatic severity (Cleveland Clinic constipation score 18.5 vs 15.1; mean difference 2.9 [95%\u2010CI 2.3\u20103.6]; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), rectal hyposensitivity (odds ratio 1.74 [95%\u2010CI 1.23\u20102.46]; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.002), functional evacuation disorders (odds ratio 1.73 [95%\u2010CI 1.28\u20102.34]; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), and delayed whole\u2010gut transit (odds ratio 1.68 [95%\u2010CI 1.19\u20102.37]; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.003). Differences in anorectal variables between opioid users for mild\u2010moderate pain and non\u2010opioid users were not statistically significant. Hierarchical opioid use (non vs mild\u2010moderate vs moderate\u2010severe) was associated with decreasing proportions of patients with no physiological abnormality on testing (40.2% vs 38.1% vs 29.2%) and increasing proportions with both delayed whole\u2010gut transit and rectal sensorimotor dysfunction (16.6% vs 17.5% vs 28.5%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>Opioid use is over\u2010represented in patients referred for investigation of constipation. Opioids for moderate\u2010severe pain are associated with rectal sensorimotor abnormalities. Further studies are required to determine whether this association indicates causation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13839","type":"journal-article","created":{"date-parts":[[2020,3,13]],"date-time":"2020-03-13T15:47:35Z","timestamp":1584114455000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Association between opioid usage and rectal dysfunction in constipation: A cross\u2010sectional study of 2754 patients"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3158-6652","authenticated-orcid":false,"given":"Paul F.","family":"Vollebregt","sequence":"first","affiliation":[{"name":"National Bowel Research Centre and GI Physiology Unit Blizard Institute Centre for Neuroscience, Surgery &amp; Trauma Queen Mary University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard L.","family":"Hooper","sequence":"additional","affiliation":[{"name":"Pragmatic Clinical Trials Unit Centre for Primary Care and Public Health Queen Mary University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1902-2640","authenticated-orcid":false,"given":"Adam D.","family":"Farmer","sequence":"additional","affiliation":[{"name":"National Bowel Research Centre and GI Physiology Unit Blizard Institute Centre for Neuroscience, Surgery &amp; Trauma Queen Mary University of London London UK"},{"name":"Institute of Applied Clinical Science University of Keele Keele UK"},{"name":"Department of Gastroenterology University Hospitals of North Midlands Stoke on Trent UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonjo","family":"Miller","sequence":"additional","affiliation":[{"name":"National Bowel Research Centre and GI Physiology Unit Blizard Institute Centre for Neuroscience, Surgery &amp; Trauma Queen Mary University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles H.","family":"Knowles","sequence":"additional","affiliation":[{"name":"National Bowel Research Centre and GI Physiology Unit Blizard Institute Centre for Neuroscience, Surgery &amp; Trauma Queen Mary University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7997-1533","authenticated-orcid":false,"given":"S. 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