Rising Concerns: Surge in Gastric Outlet Obstruction Cases Linked to Drug Abuse

In a stark and alarming trend, a medical center in India has witnessed a significant upswing in cases of gastric outlet obstruction (GOO) with drug abuse, emerging as a prominent contributing factor. The urgency to address this concerning surge prompted an observational study, conducted from September 2017 to February 2019, to delve into the incidence of abuse involving nonsteroidal anti-inflammatory drugs (NSAIDs) and synthetic opioids among individuals diagnosed with GOO.

The study was published in the Journal of the Association of Physicians of India. 

The research, involving consecutive cases of GOO, aimed to comprehensively understand the extent of drug abuse's role in this debilitating condition. Each case underwent a thorough examination, including detailed drug addiction histories and clinical assessments. Diagnostic investigations spanned routine biochemical and hematological tests, upper gastrointestinal endoscopy (UGIE), ultrasonography, rapid urease test (RUT), and meticulous histopathological analysis of the affected areas.

Findings:

• Out of the 102 diagnosed cases of GOO, a staggering 60.78% (62 cases) had a documented history of drug addiction.
• Further breaking down the drug addiction patterns revealed a prevalence of combined NSAIDs and opioid abuse in 56 cases, opioids alone in four cases, and NSAIDs alone in two cases.
• Intriguingly, the second part of the duodenum emerged as the most commonly affected site, underscoring the severity and complexity of these cases.
• Histopathological examinations offered deeper insights, uncovering mucosal ulcerations infiltrated by eosinophils, plasma cells, and lymphocytes.

The study's revelations point towards a pressing issue within our community – the growing incidence of GOO linked to the abuse of NSAIDs and opioids. It is not merely a statistical concern but a human concern, reflecting the real impact on individuals' lives. The high prevalence of drug addiction histories among diagnosed cases raises urgent red flags, prompting healthcare professionals and policymakers alike to consider immediate and targeted interventions.