{
  "abstract": "Introduction Approximately 8% of the UK population report recreational cannabis use—a Class B controlled drug—and this prevalence has increased over the past two decades. While cannabis is used for its antiemetic properties, chronic use has paradoxically been associated with impaired gastrointestinal (GI) motility and dysregulation of emesis pathways. We aimed to evaluate the prevalence of cyclical vomiting syndrome (CVS) and gastroparesis among cannabis users compared with non-users, and to contrast these findings with inflammatory bowel disease (IBD).Methods A retrospective cohort study was conducted using TriNetX – a large multicenter electronic health record database to determine the prevalence of CVS, gastroparesis, and IBD among cannabis versus non-users. IBD was selected as a comparator chronic GI condition with high healthcare utilisation, allowing assessment of whether associations were specific to disorders of motility and emesis rather than reflecting non-specific GI illness. Cohort 1 included participants with cannabis use, while Cohort 2 (non-users) was constructed using vitamin D users – a required variable for cohort creation in TriNetX. The following exclusion criteria were applied: GI malignancy, pregnancy, chronic opioid use, GLP-1 agonist use, organic GI condition (except for IBD), and neurological conditions known to impact GI motility. Propensity score matching (1:1) was performed to balance both cohorts on key demographic and clinical variables: age, gender, comorbidity index, body mass index (BMI), tobacco use, alcohol use, diabetes, and socioeconomic status.Results After propensity score matching, 456,016 individuals were included in the cannabis and non-cannabis user groups ( table 1). There was no statistically significant difference in the mean [SD] age between cannabis users versus non-users (34.6 [16.5] vs 32.5 [28.7] years), nor in the distribution of race and BMI between the two cohorts. A greater proportion of cannabis users reported anxiety (9.2% vs 7.0%, P<0.001), depression (2.0% vs 1.5%, P<0.001), bipolar disorder (1.1% vs 0.9%, P<0.001), and somatoform symptom disorder (0.24% vs 0.17%, P<0.001) compared with non-users. The prevalence of CVS (0.7% vs 0.1%, P<0.001; RR 6.5, CI [5.9, 7.2]) and gastroparesis (0.4% vs 0.1%, P<0.001; RR 2.4, CI [2.2, 2.6]) was at least four times greater in cannabis users versus non-users (table 1). In contrast, the prevalence of IBD among cannabis users was significantly lower than in non-users (0.6% vs 0.9%, P<0.001; RR 0.5 CI [0.5, 0.6].Conclusion This is the largest real-world study to examine the association between cannabis use and vomiting disorders. Cannabis use was associated with higher prevalence of gastroparesis and CVS, but a lower prevalence of IBD, compared with non-users. This contrast suggests condition-specific associations, with cannabis use more strongly linked to disorders of GI motility and emesis than to organic inflammatory disease.Abstract P397 Table 1Baseline characteristics and prevalence of gastroparesis, cyclical vomiting syndrome, and inflammatory bowel disease in the propensity matched cohorts. N/S, non-significant",
  "authors": [
    {
      "affiliations": [
        "University of Nottingham, Nottingham, United Kingdom"
      ],
      "name": "Mohsin Butt"
    },
    {
      "affiliations": [
        "University of California, Riverside, United States of America"
      ],
      "name": "Saranya Arumugam"
    },
    {
      "affiliations": [
        "Michigan State University, East Lansing, United States of America"
      ],
      "name": "Omayma Alshaarawy"
    },
    {
      "affiliations": [
        "University of Nottingham, Nottingham, United Kingdom"
      ],
      "name": "Maiss Reghefaoui"
    },
    {
      "affiliations": [
        "University of Nottingham, Nottingham, United Kingdom"
      ],
      "name": "Maura Corsetti"
    },
    {
      "affiliations": [
        "Ohio State University, Columbus, United States of America"
      ],
      "name": "Thangam Venkatesan"
    }
  ],
  "title": "P397 Cannabis use is associated with an increased prevalence of gastroparesis and cyclical vomiting syndrome",
  "uid": "295c6714-bdd3-5c5b-ae24-971ad58f7210"
}