Higher odds of irritable bowel syndrome among hospitalized patients using cannabis: a propensity-matched analysis

Adejumo AC1,2, Ajayi TO3, Adegbala OM4, Bukong TN2,5. Eur J Gastroenterol Hepatol. 2019 Feb 21. doi: 10.1097/MEG.0000000000001382. [Epub ahead of print]


Author information

Department of Medicine, North Shore Medical Center, Salem.

Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.

Department of Medicine, Johns Hopkins Medicine, Howard County General Hospital, Columbia, Maryland.

Department of Medicine, Englewood Hospital and Medical Center, Englewood, New Jersey, USA.

INRS-Institut Armand-Frappier, Institut National de la Recherche Scientifique, Laval, Québec, Canada.


BACKGROUND: The endogenous cannabinoid system modulates many brain-gut and gut-brain physiologic pathways, which are postulated to be dysfunctional in irritable bowel syndrome (IBS). Herein, we examine the relationship between cannabis use disorder (CUD) and having IBS.

PATIENTS AND METHODS: After selecting patients aged 18 years and above from the 2014 Nationwide Inpatient Survey, we used the International Classification of Diseases, 9th ed. codes to identify individuals with CUD, IBS, and the established risk factors for IBS. We then estimated the crude and adjusted odds ratios of having a diagnosis of IBS with CUD and assessed for the interactions of CUD with other risk factors (SAS 9.4). We confirmed our findings in two ways: conducting a similar analysis on a previous Nationwide Inpatient Survey data (2012); and using a greedy algorithm to design a propensity-scored case-control (1 : 10) study, approximating a pseudorandomized clinical trial.

RESULTS: Out of 4 709 043 patients evaluated, 0.03% had a primary admission for IBS and 1.32% had CUD. CUD was associated with increased odds of IBS [adjusted odds ratio: 2.03; 95% confidence interval (CI): 1.53-2.71]. CUD was related to higher odds for IBS among males compared with females (3.48; 1.98-6.12 vs. 1.48; 0.88-2.50), and Hispanics and Caucasians compared with Blacks (5.28; 1.77-15.76, 1.80; 1.02-3.18 vs. 1.80; 0.65-5.03). On propensity-matching, CUD was associated with 80% increased odds for IBS (1.82; 1.27-2.60).

CONCLUSION: Our findings suggest that CUD is significantly associated with IBS among the general population. Males, Caucasians, and Hispanics might be more impacted by CUD associated IBS. Additional biomedical studies are required to elucidate this relationship.

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