Cannabis Use Disorders Lead to Hospitalizations for Peptic Ulcer Disease: Insights From a Nationwide Inpatient Sample Analysis

Abstract

In this study, we aimed to explore the independent association between cannabis use disorders (CUD) and peptic ulcer disease (PUD)-related hospitalization, and then to delineate the demographic differences among PUD inpatients with versus without CUD. MethodologyWe conducted a cross-sectional study using the Nationwide Inpatient Sample of 50,444,133 patients. We then subgrouped them into PUD and non-PUD cohorts. We compared non-PUD and PUD cohorts using bivariate analysis to delineate the differences in demographics and comorbid risk factors (chronic lung disease, chronic kidney disease, liver disease, diabetes, chronic nonsteroidal anti-inflammatory drug use, tobacco abuse, and alcohol abuse). We used logistic regression analysis to measure the odds ratio (OR) of the association between CUD and PUD-related hospitalization. ResultsThe prevalence of PUD was 0.14% (N = 70,898) among the total inpatient population. It was more prevalent in whites (65%) and males were at higher odds (OR: 1.11; P < 0.001) of being hospitalized for PUD. After controlling for potential comorbid risk factors and demographic confounders, the odds of association between CUD and PUD-related hospitalization were statistically significant (OR: 1.18; P < 0.001). ConclusionsCUD was associated with a modest but significant increase of 18% in the likelihood of hospitalization for PUD. With the legalization of cannabis use and its increasing and problematic consumption, it is imperative to understand the impact of cannabis use on the physical health of patients and the related gastrointestinal problems.

Cannabis Use and Associated Gastrointestinal Disorders: A Literature Review

“…The mechanism by which cannabis causes acute pancreatitis is not clearly understood, but different studies postulate that it acts via CBR1 and CBR2, which are expressed in pancreatic tissues [ 23 ]. The interaction with these receptors results in the release of pancreatic enzymes such as lipase, amylase, and ribonuclease.…”

“…Some studies have linked cannabis use with an increased risk of post-endoscopic retrograde cholangiopancreatography (ERCP)-induced pancreatitis [ 22 , 24 , 25 ]. Studies show that people under age 35 who use cannabis recreationally or for certain medical reasons are at increased risk for pancreatitis [ 22 , 23 , 26 , 27 ]. Although most studies show an increased overall incidence of AP with cannabis use, some other studies have documented improved outcomes in AP patients using cannabis when compared to non-users.…”

“…Studies have shown that chronic cannabis use increases the likelihood of complications and hospitalization for peptic ulcer disease. A cross-sectional study done by Joundi H., Pereira KN, Haneef G. et al on an inpatient data sample found that, compared to patients with peptic ulcer disease who do not use marijuana, patients using marijuana are 18 times more likely to get hospitalized for PUD [ 23 , 24 ].…”