Chronic methadone use, poor bowel visualization and failed colonoscopy: A preliminary study

Table 1 Exclusion criteria for patient enrollment

Patient with history of

Diabetes, neurological or any thyroid dysfunction

Active inflammatory bowel disease

Scleroderma

Chronic constipation

Chronic diarrhea

Any acute or chronic renal insufficient or on hemodialysis

Radiation to colon

Colectomy, or hemi-colectomy

Positive stool studies for any pathogen

Iron replacement therapy

Fentanyl, dilaudid, or any other opioids

Pancreatic insufficiency or pancreatic enzyme replacement therapy

Tricyclic antidepressants

Colonoscopy performed on emergent basis or on unstable patients

Colonoscopy report without comment on adequacy of bowel preparation or bowel images

Table 2 Clinical characteristics of the enrolled patients n (%)

	Methadone patients	Controls	P value
Number of patients	56	68
Number of colonoscopies	67	72
Average age (yr)	52.2 ± 9.2	54.6 ± 15.5	0.27
Gender			0.67
Male	46 (68.7)	47 (65.3)
Female	21 (31.3)	25 (34.7)
Indication
Bleeding	22 (32.4)	47 (40.9)
Anemia	3 (4.4)	25 (21.7)
Screening	31 (45.6)	11 (9.6)
Abdominal pain	5 (7.4)	8 (7)
Other	7 (10.3)	24 (20.9)

Table 3 Comparisons of bowel visualization, preparation assessment, and rate of repeat colonoscopy between methadone and control patients n (%)

Variables	Methadone patients (n = 67)	Control(n = 72)	P value
Bowel visualization			< 0.001
Excellent	12 (17.9)	30 (41.7)
Good	14 (20.9)	28 (38.9)
Fair	14 (20.9)	9 (12.5)
Poor	27 (40.3)	5 (6.9)
Bowel preparation assessment			< 0.001
Good	22 (32.8)	52 (72.2)
Fair	21 (31.3)	13 (18.1)
Poor	24 (35.8)	7 (9.7)
Repeat colonoscopy	22 (32.8)	9 (12.5)	0.004

Table 4 Univariate and multivariate analysis in methadone dependent patients

Variables	UnivariateOR (95% CI)	P value	MultivariateOR (95% CI)	P value
Bowel visualization
Excellent	1.00		1.00
Good	1.25 (0.50, 3.16)	0.64	1.07 (0.41, 2.80)	0.89
Fair	3.89 (1.33, 11.36)	0.01	2.51 (0.74, 8.50)	0.14
Poor	13.50 (4.21, 43.31)	< 0.001	7.77 (1.66, 36.47)	0.01
Bowel preparation assessment
Good	1.00		1.00
Fair	3.82 (1.63, 8.96)	0.002	2.29 (0.86, 6.10)	0.10
Poor	8.10 (3.05, 21.56)	< 0.001	2.61 (0.56, 12.21)	0.22
Repeat colonoscopy	3.42 (1.44, 8.13)	0.01	0.73 (0.19, 2.77)	0.64

OR: Odds ratio.