A recent study has learned that opioids like morphine can lead to stomach inflammation.
Nevertheless, according to experts, the condition can be treated with proton pump inhibitor drugs like omeprazole, an over-the-counter drug frequently used to lower stomach acid.
The gold standard for treating both acute and chronic pain is opioids. However, there could be severe gastrointestinal side effects such as nausea, vomiting, and constipation. Uncertainty surrounds the causes of these side effects.
According to the Centers for Disease Control and Prevention, the US has seen an increase in drug overdose deaths during the Covid-19 pandemic, accelerating significantly during the first months of the public health emergency, including deaths from opioids and counterfeit pills containing fentanyl.
Opioids Users May Experience Gastrointestinal Issues
Morphine is still regarded as one of the best pain medications despite its association with significant comorbidities because there aren't any better alternatives, according to the study's principal investigator Sabita Roy, PhD, of the Department of Surgery at the Miller School of Medicine at the University of Miami and the Sylvester Comprehensive Cancer Centre in Miami, Florida, USA.
"Several groups of researchers, including our own, have been working for a considerable time on understanding the phenomenon and deciphering the mechanism underlying the gastrointestinal adverse effects of morphine," Roy said in a Medical Xpress report.
Opioid users experience higher rates of gastric dysfunction, higher levels of gastric retention, worse quality of life, more hospitalizations, and higher antinausea and pain medication usage compared to non-users.
Opioids Caused Gastric Damage Among Mice
The researchers gave mice either morphine or a placebo to see how it affected the mice's gastric inflammation. They discovered that the accumulation of acid in the stomach results from increased gastric acid secretion and delayed gastric emptying, which lengthens the retention time of acid in the stomach, leading to morphine-mediated gastric damage.
The mice who had been given morphine had delayed gastric emptying, according to in vivo imaging. A significant disruption of the gastric mucosal cells, a smaller glandular region, and increased gastric cell death were all signs of severe gastric damage.
These effects were diminished in the morphine-treated mice when they were treated with naloxone, a synthetic drug that blocks the action of opioid receptors. It suggests that the traditional opiate receptors are at play. The lowest part of the stomach, the gastric antrum, has a lot of opioid receptors (near the small intestine).
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Can Omeprazole Cure Gastrointestinal Issues? Researchers Point Out Results
The cytokine IL-6 is thought to have a role in the control of opioid-induced delays in gastric emptying and injury to the stomach, according to Dr. Roy and his fellow researchers (per Science Daily). Mice given morphine showed higher levels of IL-6.
Morphine treatment shortened stomach emptying delays in IL-6-deficient mice. These mice showed no signs of stomach irritation, and their pH values were comparable to those of the placebo group. It reveals that an immediate rise in IL-6 following morphine therapy results in a delay in stomach emptying, which causes acid to build up and produce gastric inflammation.
The co-administration of omeprazole, a proton pump inhibitor, and morphine results in gastroprotection by inhibiting gastric acid production, directly lowering gastrointestinal delaying and inflammation, and enhancing morphine tolerance, which is a noteworthy unique finding of this study.
Pre-Treatments Needed To Reduce Morphine-Induced Pain
The study also addressed the significant question of whether omeprazole's gastroprotective function in any way interferes with morphine's analgesic effects.
The researchers discovered that pretreatment significantly reduced morphine-induced analgesic tolerance. According to earlier studies, morphine can trigger cytokines that promote inflammation and lead to morphine tolerance. They contend that by lowering the concentration of these cytokines, omeprazole interrupts the loop of chronic morphine tolerance.
Researchers published their study, "Opioid Use in Murine Model Results in Severe Gastric Pathology that May Be Attenuated by Proton Pump Inhibition," in the American Journal of Pathology.
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