Principal Investigator: Dustin Carlson, MD; Co-Principal Investigator: Erica Donnan, MD In 2017, more than 191 million opioid prescriptions were dispensed in the United States. Opioids frequently cause many gastrointestinal side effects such as bloating, reflux and constipation, yet not much is known about how opioids affect the esophagus and swallowing. Opioids can lead to symptoms that mimic esophageal disorders such as achalasia that could result in unnecessary invasive procedures including surgery. The largest study of its kind, this project will look into how opioids affect esophageal motility. Using the Esophageal Center of Northwestern’s motility registry, Drs. Carlson and Donnan have access to some 4,000 patients who have undergone high-resolution manometries to assess esophageal function. The team will look at patients who have had motility studies at Northwestern while on opioids and evaluate volunteer patients on opioids without swallowing symptoms. Given the widespread use of opioids, patients with opioid- induced swallowing problems will become more common. This study is essential in determining how opioids affect the esophagus so that clinicians can correctly evaluate and treat these...
Gastroesophageal reflux disease (GERD) is a common condition that often involves heartburn and/or regurgitation. If left untreated, scarring of the esophagus or “food pipe” may result. GERD leads to millions of outpatient visits annually. For some individuals, increased laxity at the end of the muscular esophagus may contribute to GERD. Assessing the extent of this laxity helps to determine the most appropriate strategies for treating the disease and preventing further damage to the esophagus. The motility of the esophagus—a tube that moves food from the throat to the stomach via muscular movement—can reveal much about its function and well-being. Manometry tests are currently used to measure the strength and muscle coordination of a patient’s esophagus while swallowing. During the manometry test, a thin, pressure-sensitive tube is passed through the nose and down the esophagus. While effective, manometry sometimes causes significant discomfort for the patient, which could hinder the diagnostic evaluation. Funded by the Digestive Health Foundation, researchers in Northwestern Medicine’s Division of Gastroenterology and Hepatology are investigating the expanded use of a new device, the functional lumen imaging probe (FLIP). Already commercially available and FDA-approved, the FLIP offers a promising alternative to manometry. Because it can be quickly performed during a sedated upper endoscopy, FLIP is much more comfortable for patients than previous techniques. Led by Dustin Carlson, MD, the Northwestern team recently developed a novel, customized, patent-pending FLIP analysis technique. Dubbed FLIP topography, it allows for the assessment of esophageal motility. To further evaluate and substantiate FLIP’s clinical viability, the investigators will use the device and new technique in 40 patients with GERD during standard-of-care endoscopy procedures. In...
