The Impact of Antispasmodic Use on Abdominal Pain and Opioid Use in Inflammatory Bowel Disease: A Population-Based Study.

BACKGROUND

Patients with inflammatory bowel disease (IBD) are often prescribed antispasmodics for chronic abdominal pain. Large-scale data regarding efficacy and impact on clinical outcomes are lacking.

AIM: To examine the association between antispasmodic use and outcomes of abdominal pain and opioid use before and after propensity matching key demographic and clinical characteristics.

METHODS

We used TriNetX Diamond Network, a medical and claims database. Patients were stratified by baseline abdominal pain and opioid use. Secondary outcomes were corticosteroid use, IBD-related complications and surgeries, emergency room (ER) visits, hospitalisation and mortality.

RESULTS

We included 85,859 patients (median age 50; 53.8% female) with IBD; 5661 used antispasmodics. On follow-up, those with antispasmodic use had higher rates of abdominal pain and opioid use (p < 0.001) regardless of baseline abdominal pain or opioid use. After matching, 5629 patients remained per group. Patients who used antispasmodics had higher rates of abdominal pain at 1 month, regardless of baseline abdominal pain. Opioid-naïve patients who used antispasmodics had higher rates of opioid use at follow-up (1.1% vs. 0.2%; p < 0.001). The likelihood of corticosteroid use, clinic visits, ER visits and hospitalisation were higher in those with antispasmodic use. No differences in IBD-related complications, surgery or mortality were observed.

CONCLUSIONS

Antispasmodic use in patients with IBD was associated with increased abdominal pain and opioid use in opioid-naïve patients. Antispasmodic use was associated with increased likelihood of corticosteroid use, clinic and ER visits and hospitalisation.