Opium tincture has anti-propulsive effects in patients with chronic diarrhea: a randomized, placebo-controlled, and cross-over trial

Chronic diarrhea affects approximately 5% of the population. Opioids inhibit gastrointestinal motility, and opium tincture has shown anti-propulsive effects in healthy, but no controlled studies of its clinical efficacy exist. We aimed to investigate the anti-propulsive and central nervous system (C...

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Published in:Scandinavian journal of gastroenterology 2024-09, Vol.59 (9), p.1023-1034
Main Authors: Okdahl, Tina, Høyer, Katrine Lundby, Knoph, Cecilie Siggaard, Davidsen, Line, Larsen, Isabelle Myriam, Mark, Esben Bolvig, Hvas, Christian Lodberg, Krogh, Klaus, Drewes, Asbjørn Mohr
Format: Article
Language:English
Subjects:
Adult
Aged
Analgesics, Opioid - therapeutic use
Chronic Disease
Cross-Over Studies
Defecation - drug effects
Diarrhea - drug therapy
Double-Blind Method
Female
Gastrointestinal Motility - drug effects
Gastrointestinal Transit - drug effects
Humans
Male
Middle Aged
Opium - therapeutic use
Quality of Life
Treatment Outcome
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Summary:Chronic diarrhea affects approximately 5% of the population. Opioids inhibit gastrointestinal motility, and opium tincture has shown anti-propulsive effects in healthy, but no controlled studies of its clinical efficacy exist. We aimed to investigate the anti-propulsive and central nervous system (CNS) effects of opium tincture in patients with chronic diarrhea. The study was a randomized, double-blinded, placebo-controlled, cross-over trial in subjects with chronic diarrhea refractory to standard treatment. Participants received opium tincture or placebo during two intervention periods, each lasting seven days. Bowel movements were recorded daily, and gastrointestinal transit time was investigated with the wireless motility capsule system. Gastrointestinal symptoms, health-related quality of life, and CNS effects (pupil size, reaction time, memory, and general cognition) were also investigated, along with signs of addiction. Eleven subjects (mean age: 45 ± 17 years, 46% males) with a median of 4.7 daily bowel movements were included. The number of daily bowel movements was reduced during opium tincture treatment to 2.3 (  = 0.045), but not placebo (3.0,  = 0.09). Opium tincture prolonged the colonic transit time compared to placebo (17 h vs. 12 h,  
ISSN:0036-5521
1502-7708
1502-7708
DOI:10.1080/00365521.2024.2381694