Codeine delays gastric emptying through inhibition of gastric motility as assessed with a novel diagnostic intragastric balloon catheter

Background The use of opioids as analgesic is on the rise, despite their inhibitory effect on gastric emptying. A novel feeding catheter with integrated intragastric balloon was developed to continuously assess gastric motility, enabling to investigate the effect of opioids on motility and emptying...

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Bibliographic Details
Published in:Neurogastroenterology and motility 2020-01, Vol.32 (1), p.e13733-n/a
Main Authors: Goelen, Nick, Hoon, Jan, Morales, John F., Varon, Carolina, Van Huffel, Sabine, Augustijns, Patrick, Mols, Raf, Herbots, Marissa, Verbeke, Kristin, Vanuytsel, Tim, Tack, Jan, Janssen, Pieter
Format: Article
Language:English
Subjects:
Adult
Analgesics
Analgesics, Opioid - adverse effects
Balloon catheters
Catheters
Codeine
Codeine - adverse effects
Contractility
Female
Gastric Balloon
Gastric emptying
Gastric Emptying - drug effects
Gastric motility
Humans
Intolerance
Male
Manometry - instrumentation
Manometry - methods
medical device
Monitoring systems
Monitoring, Physiologic - instrumentation
Motility
Narcotics
Nutrients
Opioids
Pressure
VIPUN GMS
Young Adult
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Summary:Background The use of opioids as analgesic is on the rise, despite their inhibitory effect on gastric emptying. A novel feeding catheter with integrated intragastric balloon was developed to continuously assess gastric motility, enabling to investigate the effect of opioids on motility and emptying simultaneously. We aimed to discriminate normal and pharmacologically impaired gastric motility and its impact on gastric emptying in healthy adults. Methods The VIPUN Gastric Monitoring System comprises a nasogastric balloon catheter and a monitoring unit. In a four‐way randomized, single‐blinded, cross‐over study, subjects received either placebo or 58.8 mg codeine phosphate in combination with either an uninflated or an inflated (180 mL) balloon catheter. Motility‐induced pressure changes were recorded for 6 hours. During the first 2 hours, nutrients were infused (225 kcal, 75 mL/h). Gastric emptying was assessed with a 13C‐octanoate breath test and expressed as gastric half‐emptying time (GET½). An algorithm, designed to detect phasic contractility, converted pressure changes to a gastric balloon motility index (GBMI). Results are presented as mean(SD). Key Results Eighteen subjects completed the investigation (32(13) years, 22(2) kg/m2). After codeine, GBMI was lower (0.31(0.16)) and GET½ was longer (233(57) minutes) compared with placebo (GBMI: 0.48(0.15), P 
ISSN:1350-1925
1365-2982
DOI:10.1111/nmo.13733