Kaur Avneet, Singh Ishandeep, Kohli Isha, Singh Bhupal Sahiljot, Patel Jay, Nikzad Nikki, Sohal Aalam, Yang Juliana
Department of Internal Medicine, Punjab Institute of Medicine Sciences, Jalandhar, India.
Department of Internal Medicine, Dayanand Medical College and Hospital, India.
Cannabis Cannabinoid Res. 2025 Apr;10(2):e333-e340. doi: 10.1089/can.2024.0011. Epub 2024 May 3.
Cannabis, one of the most widely used recreational drug in the United States, has had a significant surge in usage following its legalization in 1996. In recent years, there has been research into the physiological effects of cannabis on the gastrointestinal (GI) system. Our study aims to systematically examine the association between cannabis use and complications of gastroesophageal reflux disease (GERD). We queried the 2016-2020 National Inpatient Sample database to identify patient encounters with GERD. Patients with eosinophilic esophagitis or missing demographics were excluded. We compared patient demographics, comorbidities, and complications among cannabis users and nonusers. Multivariate logistic regression analysis was used to investigate the relationship between cannabis use and complications of GERD. A total of 27.2 million patient encounters were included in the analysis, out of which 507,190 were cannabis users. Majority of the cannabis users were aged between 45-64 years (46.6%), males (57.4%), White (63.84%), and belonged to the lowest income quartile (40.6%). Cannabis users demonstrated a higher prevalence of esophagitis compared to nonusers (6.11% vs. 3.23%, <0.001). However, they exhibited a lower rates of esophageal stricture (0.6% vs. 0.8%, <0.001) and esophageal cancer (0.2% vs. 0.24%, <0.001). After adjusting for confounding factors, cannabis users were noted to have higher odds of esophagitis (adjusted odds ratio [aOR]: 1.34, 95% confidence interval [CI]: 1.30-1.39, <0.001). A lower odds of esophageal stricture (aOR: 0.88, 95% CI: 0.81-0.96, =0.02) and esophageal cancer (aOR: 0.48,95% CI: 0.42-0.57, <0.001) were noted. Our cross-sectional study using the nationally available database indicates an association between cannabis use and higher odds of esophagitis, along with lower odds of esophageal stricture and cancer. While these findings suggest a potential relationship between cannabis use and esophageal complications, it is limited in establishing causality. Therefore, further long-term studies are warranted to understand the mechanism behind this association and to determine if cannabis use has an impact on esophagus.
大麻是美国使用最广泛的消遣性毒品之一，自1996年合法化以来，其使用量大幅激增。近年来，已有关于大麻对胃肠道（GI）系统生理影响的研究。我们的研究旨在系统地研究大麻使用与胃食管反流病（GERD）并发症之间的关联。我们查询了2016 - 2020年全国住院患者样本数据库，以确定患有GERD的患者病例。排除患有嗜酸性食管炎或人口统计学信息缺失的患者。我们比较了大麻使用者和非使用者的患者人口统计学、合并症和并发症情况。采用多变量逻辑回归分析来研究大麻使用与GERD并发症之间的关系。分析共纳入2720万例患者病例，其中507190例为大麻使用者。大多数大麻使用者年龄在45 - 64岁之间（46.6%），男性（57.4%），白人（63.84%），且属于最低收入四分位数（40.6%）。与非使用者相比，大麻使用者食管炎的患病率更高（6.11%对3.23%，<0.001）。然而，他们食管狭窄（0.6%对0.8%，<0.001）和食管癌（0.2%对0.24%，<0.001）的发生率较低。在调整混杂因素后，发现大麻使用者患食管炎的几率更高（调整后的优势比[aOR]：1.34，95%置信区间[CI]：1.30 - 1.39，<0.001）。食管狭窄（aOR：0.88，95% CI：0.81 - 0.96，=0.02）和食管癌（aOR：0.48，95% CI：0.42 - 0.57，<0.001）的几率较低。我们使用全国可用数据库进行的横断面研究表明，大麻使用与食管炎几率较高以及食管狭窄和癌症几率较低之间存在关联。虽然这些发现表明大麻使用与食管并发症之间可能存在关系，但在确定因果关系方面存在局限性。因此，有必要进行进一步的长期研究，以了解这种关联背后的机制，并确定大麻使用是否对食管有影响。
