Opioid-Induced Esophageal Dysmotility (OIED) – A Case Report

Abstract

Recent studies have shown that chronic opioid use is associated with an increased risk of symptomatic esophageal motility disorders. Opioid-induced esophageal dysfunction (OIED) is most often identified in patients taking high doses of opioids. This condition is associated with poorer treatment outcomes than primary motility disorders and management of these cases is further complicated by the presence of chronic pain, opioid addiction, and physical and psychological comorbidity.

We present the case of a 68-year-old Caucasian woman with OIED, induced by the chronic intake of low-dose Fentanyl and Tramadol prescribed to treat severe back pain. The clinical course highlights the sometimes difficult diagnosis and management of this recently recognized condition.

Zusammenfassung

Jüngste Studien haben gezeigt, dass chronischer Opioidkonsum mit einem erhöhten Risiko für symptomatische Ösophagusmotilitätsstörungen verbunden ist. Eine opioidinduzierte ösophageale Dysfunktion (OIED) wird am häufigsten bei Patienten festgestellt, welche hochdosierte Opioide einnehmen. Diese Erkrankung ist mit schlechteren Behandlungsergebnissen verbunden als bei primären Motilitätsstörungen, und die Behandlung dieser Fälle wird durch das Vorhandensein von chronischen Schmerzen, Opioidabhängigkeit sowie physischer und psychischer Komorbiditäten zusätzlich erschwert.

Wir präsentieren den Fall einer 68-jährigen kaukasischen Frau mit OIED, aufgrund von chronischer Einnahme von niedrig dosiertem Fentanyl und Tramadol zur Behandlung starker Rückenschmerzen. Der klinische Verlauf soll die manchmal schwierige Diagnosestellung und Behandlung dieser erst kürzlich anerkannten Erkrankung verdeutlichen.

Schlüsselwörter

OIED - Opioid-induzierte ösophageale Dysfunktion - ösophageale Motilitätsstörung - Achalasie - Dysphagie - Opioid - Fentanyl

Keywords

OIED - Opioid Induced Esophageal Dysfunction - esophageal motility disorder - achalasia - dysphagia - opioid - fentanyl

Publication History

Received: 17 August 2022

Article published online:
14 December 2022

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