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Completed

NCT Number: NCT06385561

The Influence of Tramadol on Opioid-induced Bowel Dysfunction

Tramadol is a weak opioid and widely used to treat moderate to severe pain. Stronger opioids are known to inhibit gastrointestinal motility and secretion, however the effects of tramadol on gastrointestinal function remains less understood. The aim of this study was to determine to what degree tramadol causes opioid-induced bowel dysfunction by using an objective design to explore gastrointestinal transit, motility pattern, secretion, and colonic volume, in a group of healthy male volunteers.

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Key information

Age range

20 year–40 year

Sex eligibility

Male

Study type

Interventional

Phase

Phase 2

Primary location

Aalborg University Hospital

Aalborg, 9000, Denmark

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Healthy (assessed by a study-affiliated medical doctor.)
  • Signed informed consent.
  • Able to read and understand Danish.
  • Male (to avoid influence of menstrual cycles)
  • Northern European descent (to minimize genetic variance influences on drug metabolism).
  • The researcher believes that the participant understands the study details, is compliant and is expected to complete the study.
  • Opioid naïve* (who have not taken prescription opioid for one week or longer and at least a year have passed since completion of a previous opioid study.)
  • Between 20 and 40 years of age.
  • A State Trait Anxiety Inventory (STAI) score in the range of 20-37 i.e., classified as "no or low anxiety" at inclusion.

Exclusion criteria

  • Known hypersensitivity or allergy towards the used pharmaceutical compounds or pharmaceutical compounds similar to those used in the study.
  • Less than three spontaneous bowel movements per week.
  • Participation in other studies within 14 days prior to first visit.
  • Expected need of medical/surgical treatment during the study.
  • Any diagnosed disease, which investigator concludes will affect the trial (including all contraindicated complications: severe chronic obstructive pulmonary disease, pulmonary heart disease, severe bronchial asthma, paralytic ileus, hypercapnia, serious respiratory depression with hypoxia, moderate to severe decreased liver function, gastrointestinal obstruction or perforation, acute surgical abdominal complications such as appendicitis, Mb. Crohn's, ulcerative colitis, and toxic mega colon).
  • History of substance abuse (alcohol, tetrahydrocannabinol (THC), benzodiazepine, central stimulants and/or opioids, urine drug test will be performed prior to treatment start). ¹
  • History of major mental disorders (e.g., major anxiety, major depression or treatment with psychoactive medications etc.) ²
  • Metal implants or pacemaker.
  • Daily use of prescription only medicine
  • Daily alcohol consumption
  • Participation motivated by "wrongful" reasons such as poor economy, or psychosocial issues e.g., problems in the family, loneliness, sadness. People with such problems may be more likely to develop substance dependence.1
  • Intake of alcohol within 48 hours before start of study period or any alcohol consumption during each study period. If consumption takes place during the study the participant will be excluded.
  • Use of any analgesic medication within 48 hours before start as well as for the duration of the study. If consumption takes place during the study the participant will be excluded.
  • Nicotine use

Treatment and study plan

Tramadol

Drug

Tramadol is administered orally twice daily in a dosage of 100 mg (daily total of 200 mg)

Placebo

Drug

Placebo is administered orally twice daily.

Primary outcomes

  1. Total gastrointestinal transit time

    Time frame: From day 4 to day 8

    Difference in hours from ingestion of a 3D Transit Capsule to expulsion of the capsule during active and placebo treatment

  2. Colorectal transit time

    Time frame: From day 4 to day 8

    Difference in hours from the entering in the colon of a 3D Transit Capsule to expulsion of the capsule during active and placebo treatment

Secondary outcomes

  1. Constipation symptoms

    Time frame: From day 1 to day 10

    Measured on the Patient Assessment of Constipation Symptoms (PAC-SYM) questionnaire (ranging from 0 (symptom absent) to 4 (very severe).

  2. Bowel movement frequency

    Time frame: From day 1 to day 10

    Number of spontaneous bowel movements per day

  3. Stool consistency

    Time frame: From day 1 to day 10

    Rated on the Bristol Stool Form Scale (ranging from type 1 (constipation) - type 7 (diarrhea))

  4. Gastrointestinal symptoms

    Time frame: Day 1 and day 10

    Measured on the Gastrointestinal Symptom Rating Score (GSRS) questionnaire (ranging from 0 (no discomfort) to 6 (very severe discomfort)

  5. Opioid-induced constipation

    Time frame: Day 1 and day 10

    Measured by the Bowel Function Index (BFI) questionnaire (ranging from 0 (not at all) to 100 (very strong).

  6. Diagnostic evaluation of opioid-induced constipation

    Time frame: Day 10

    Assessed using the Rome IV C6 criteria consisting of 7 items rated as either true or false. 2 or more items rated as "true" indicates functional constipation

  7. Colonic motility patterns

    Time frame: From day 4 to day 8

    Number of motility patterns in the colon measured by the 3D Transit Capsule

  8. Opiate withdrawal symptoms

    Time frame: Day 13, 14 or 15

    Measured by the Subjective Opiate Withdrawal Scale (ranging from 0 (not at all) to 4 /extremely)

  9. Colon volume

    Time frame: Day 10

    Volumetric quantification of the colon measured using T2-weighted MRI images

  10. Colonic water content

    Time frame: Day 10

    Analysis of colonic water content measured using heavily T2-weighted MRI images

  11. Gastric half emptying time

    Time frame: Day 1 and day 10

    Analysis of gastric half emptying time after ingestion of a standardized meal measured by MRI

  12. Gastric contraction assessment

    Time frame: Day 1 and day 10

    Analysis of gastric contraction amplitude after ingestion of a standardized meal measured by MRI

  13. Gastric contraction assessment

    Time frame: Day 1 and day 10

    Analysis of gastric contraction frequency after ingestion of a standardized meal measured by MRI

  14. Small bowel motility assessment

    Time frame: Day 1 and day 10

    Analysis of small bowel motility after ingestion of a standardized meal measured using dynamic MRI images. A semi-automated analysis software enables registration of small bowel motility with the calculation of regional motility maps and quantification of motility indices.

  15. Small bowel water content

    Time frame: Day 1 and day 10

    Analysis of small bowel water content measured using heavily T2-weighted MRI images

Sponsors and collaborators

Lead sponsor

Asbjørn Mohr Drewes

Other

Registry information

Official study title

The Influence of Tramadol on Opioid-induced Bowel Dysfunction - An Investigator Initiated, Randomized, Double-blinded, Placebo-controlled, Cross-over Clinical Trial

Important dates

Study start
2022
Primary completion
2023
Study completion
2023
First posted
Apr 26, 2024
Registry last updated
Apr 26, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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