S3190 Cannabis and Gastroparesis: Higher Symptom Burden and Greater Healthcare Use

Introduction: Cannabis use is increasingly prevalent among patients with gastrointestinal disorders, including gastroparesis. While it is often used to alleviate symptoms, its real-world impact on clinical outcomes and healthcare utilization in gastroparesis remains unclear. Methods: We performed a retrospective cohort study using the TriNetX Global Collaborative Network, which aggregates de-identified electronic health records from 145 healthcare organizations. Adults aged ≥18 years with a diagnosis of gastroparesis were divided into 2 propensity score-matched cohorts: those with documented cannabis use (n = 19,313) and those without (n = 19,313). Cannabis exposure was defined using ICD-10 codes for cannabis use, abuse, or dependence. Patients with any malignancy or receipt of chemotherapy were excluded. Outcomes were evaluated over a 5-year follow-up period. The primary outcome was the occurrence of emergency department visits, observation encounters, or inpatient admissions (proxy for healthcare utilization). The secondary outcome was a composite of nausea/vomiting, abdominal pain, and malnutrition. Kaplan-Meier and risk analyses excluded patients who had the outcome prior to the index event. Results: For the primary outcome, 27.4% of cannabis users had at least one acute care visit compared to 23.2% of non-users (risk ratio [RR] 1.182; 95% CI 1.114-1.254; P < 0.001). Time-to-event analysis demonstrated significantly earlier utilization in the cannabis group (hazard ratio [HR] 1.419; 95% CI 1.325-1.521; P < 0.001). For the secondary outcome, 42.2% of patients in the cannabis cohort experienced symptoms versus 38.6% in the non-cannabis group (RR 1.093; 95% CI 1.029-1.161; P = 0.005). Median symptom-free survival was shorter among cannabis users (825 vs 1339 days; HR 1.341; 95% CI 1.238-1.451; P < 0.001). Conclusion: Cannabis use among patients with gastroparesis is associated with higher symptom burden and increased acute care utilization. These findings raise concern regarding the potential exacerbation of symptoms despite presumed symptom-relief use of cannabis.