Department of Medicine, North Shore Medical Center, Salem.
Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
Eur J Gastroenterol Hepatol. 2019 Jul;31(7):756-765. doi: 10.1097/MEG.0000000000001382.
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.
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.
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).
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.
内源性大麻素系统调节许多脑-肠和肠-脑生理途径，这些途径被认为在肠易激综合征（IBS）中功能失调。在此，我们研究了大麻使用障碍（CUD）与 IBS 之间的关系。
从 2014 年全国住院调查中选择年龄在 18 岁及以上的患者后，我们使用国际疾病分类，第 9 版代码来确定患有 CUD、IBS 和 IBS 既定风险因素的个体。然后，我们估计了 CUD 与 IBS 诊断的粗比值比和调整比值比，并评估了 CUD 与其他风险因素的相互作用（SAS 9.4）。我们通过两种方式确认了我们的发现：在之前的全国住院调查数据（2012 年）上进行类似分析；并使用贪婪算法设计倾向评分病例对照（1：10）研究，近似于伪随机临床试验。
在评估的 4709043 名患者中，0.03%有 IBS 的主要入院，1.32%有 CUD。CUD 与 IBS 的患病几率增加有关[调整后的比值比：2.03；95%置信区间（CI）：1.53-2.71]。与女性相比，CUD 与男性中 IBS 的几率更高相关（3.48；1.98-6.12 与 1.48；0.88-2.50），与黑人和西班牙裔与白人相比（5.28；1.77-15.76，1.80；1.02-3.18 与 1.80；0.65-5.03）。在倾向匹配后，CUD 与 IBS 的几率增加 80%相关（1.82；1.27-2.60）。
我们的发现表明，CUD 与普通人群中的 IBS 显著相关。男性、白人和西班牙裔可能更容易受到 CUD 相关 IBS 的影响。需要进一步的生物医学研究来阐明这种关系。
