The Impact of Cannabis Use in Gastroparesis: A Propensity-Matched Analysis of 41,374 Gastroparesis Patients

Cannabinoids are being explored as potential treatments for gastroparesis due to their anti-emetic, gastric motility modulation, appetite stimulation, and analgesic properties coupled with their increasing use due to legalization in many states. Although these theoretical benefits are promising, clinical evidence remains limited. This study aimed to evaluate the effects of cannabis use on clinical outcomes and healthcare utilization in patients with gastroparesis using large-scale real-world data.

We conducted a cohort study using the TriNetX research network to identify US adults (≥18 years) with gastroparesis. From an initial cohort of 119 million individuals patients were stratified into cannabis users and non-users (controls). Propensity score matching (1:1) accounted for demographics, body mass index, comorbidities, laboratory parameters, and treatments. Primary outcomes included emergency department visits, hospitalizations, and esophagogastroduodenoscopy rates.

Among 41,374 patients with gastroparesis, cannabis users (n = 20,687) and non-users (n = 20,687) were propensity-matched. Cannabis users were younger with higher rates of diabetes, mood/anxiety disorders, elevated hemoglobin A1c, and opioid use ( P < 0.001). Cannabis use was associated with increased emergency department visits (adjusted odds ratio [aOR] = 1.73, 95% confidence interval [CI]: 1.66-1.80) and hospitalizations (aOR = 1.44, 95% CI: 1.39-1.50) but reduced esophagogastroduodenoscopy utilization (aOR = 0.93, 95% CI: 0.88-0.98).

Cannabis use in patients with gastroparesis seems to increase healthcare utilization. These findings underscore the need to carefully assess the risks and benefits of cannabis in gastroparesis management. Prospective studies are essential to evaluate cannabinoids' efficacy and safety in this context.