Prevalence of Narcotic Bowel Syndrome in Opioid Abusers in Iran

Bizhan Ahmadi, Peyman Arab, Mohammad Javad Zahedi, Sara Shafieipour, Douglas A. Drossman, Ghodseyeh Banivaheb, Ghodseyeh Banivaheb



In spite of the increasing trend in opioid abusers worldwide, the prevalence of narcotic bowel syndrome (NBS) is undetermined. We aimed to estimate the prevalence of NBS and other opioid bowel dysfunction (OBD) in opioid abusers in Kerman, southeast Iran. According to the best of our knowledge, this is the first study to assess the prevalence of NBS in opioid abusers.


By referring to addiction treatment centers in Kerman city and in a cross-sectional study, 577 subjects with opium or opioid subtracts abuse were included in our study. A validated questionnaire was used for OBD assessment and diagnosis of NBS was made according to both the presence of chronic abdominal pain despite increasing the opioid dose and ruling out other causes of abdominal pain. SPSS software version 16 was used for data analysis.  p value<0.05 was considered as statistically significant.



Constipation, regurgitation, and heartburn were the most gastrointestinal complaints that were found in 132(22.9%), 123(21.3%) and 91(15.8%) subjects, respectively. Only 16(2.8%) participants fulfilled all the NBS criteria. Simultaneous use of non-narcotic sedative drugs increased the risk of NBS significantly (the odds ratio 3:1 and p=0.049).


NBS is not rare among opioid abusers and should be considered as a cause of chronic abdominal pain in this group.


Opioid bowel dysfunction, Narcotic bowel syndrome, Prevalence, Opioid abuser, Iran

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