TOPLINE:

Cannabis use in patients with gastroparesis increased and was associated with increased odds of emergency department (ED) visits and hospitalizations but reduced esophagogastroduodenoscopy rates.

METHODOLOGY:

• To manage gastroparesis symptoms, little evidence exists for the theoretical benefits of cannabinoids, and their safety has not been well established, despite increased use among patients.
• Researchers conducted a retrospective cohort study using a large US clinical dataset (TriNetX) to assess the effect of cannabis use in adult patients (≥ 18 years) with gastroparesis, comparing outcomes 1 year after diagnosis (between 2004 and 2024) with those in nonusers.
• Patients with gastroparesis were identified using International Classification of Diseases, 10th Revision (ICD-10), Clinical Modification codes and were stratified into 20,687 cannabis users’ and the same number of propensity-matched nonusers (mean age, 42 years; about 59% women).
• Primary outcomes were rates of all-cause ED visits and hospitalizations. Secondary outcomes included rates of esophagogastroduodenoscopy, abdominal CT scan, enteral feeding, and the presence of clinical malnutrition among patients with gastroparesis.
• Outcomes were observed over a 1-year follow-up period between 2004 and 2024 and adjusted for confounders, such as demographics, body mass index, comorbidities, and treatment.

TAKEAWAY:

• At the 1-year follow-up, cannabis use in patients with gastroparesis was associated with increased odds of ED visits (47% vs 34%; adjusted odds ratio [aOR], 1.73; 95% CI, 1.66-1.80) and hospitalizations (42% vs 33%; aOR, 1.44; 95% CI, 1.39-1.50) and reduced odds of undergoing esophagogastroduodenoscopy (16% vs 17%; aOR, 0.93; 95% CI, 0.88-0.98).
• Cannabis users with gastroparesis had higher rates of clinical malnutrition (67% vs 62%; aOR, 1.26; 95% CI, 1.21-1.32) but were less likely to receive enteral feeding (4% vs 7%; aOR, 0.59; 95% CI, 0.54-0.64).
• The odds of ED visits and hospitalizations significantly increased for patients who started using cannabis after a diagnosis of gastroparesis but modestly increased for those with a history of prior use. Regardless of the timing of initiation, cannabis users vs nonusers experienced higher rates of nausea or vomiting (40%-47% vs 26%) and abdominal pain (20%-21% vs 19%).
• Cannabis use in patients with gastroparesis rose from 0.7% in 2004 to 9.4% in 2024.

IN PRACTICE:

“These findings emphasize the need for caution and individualized approaches to cannabis prescribing/advocation in this population. As cannabis use continues to rise, it is imperative that clinicians remain informed, ensuring optimal care for patients with gastroparesis,” the authors wrote.

SOURCE:

The study was led by Yassine Kilani, MD, Saint Louis University School of Medicine in St. Louis. It was published online in The American Journal of Gastroenterology.

LIMITATIONS:

The retrospective design of the study limited causal inferences, and reliance on ICD-10 coding may have introduced misclassification bias. There is no validated definition of gastroparesis in large databases. The limited data on cannabis use patterns and the severity of gastroparesis restricted the interpretability of the findings. Residual confounding may persist despite adjustments. It is unclear whether cannabis use serves as a marker of symptom severity or a contributing factor.

DISCLOSURES:

The study received no financial support. One author declared being a medical advisor to a charity for patients with gastroparesis.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.