Cannabis users hospitalized with inflammatory bowel disease had shorter stays and lower bills | Research

The takeaway

In a propensity-matched national sample, cannabis-using IBD patients had shorter hospital stays and lower charges than non-users, with mixed results on specific complications.

People with inflammatory bowel disease interested in cannabis research, and anyone following anti-inflammatory cannabinoid studies.

Cannabis-using Crohn's patients: 0.3% vs 1.2% colorectal cancer, shorter hospital stays

What the researchers found

In Crohn's disease, cannabis users had lower rates of colorectal cancer (0.3% vs 1.2%), parenteral nutrition need, and anemia, but higher rates of fistulizing disease and lower GI hemorrhage. Both CD and UC cannabis users had shorter hospital stays (4.2 vs 5.0 days for CD; 4.3 vs 5.7 days for UC) and lower charges.

Why it matters

Cannabis has known anti-inflammatory properties, and IBD patients increasingly use it for symptom management. This large national analysis provides real-world data on how cannabis use correlates with hospitalization outcomes in this population.

The numbers in context

Crohn's: 6,002 propensity-matched patients. Colorectal cancer: 0.3% vs 1.2% (cannabis vs non). Hospital stay: 4.2 vs 5.0 days. Charges: $28,956 vs $35,180. UC: 1,481 matched patients. Hospital stay: 4.3 vs 5.7 days. Charges lower with cannabis use (p < .001).

How the study worked

Propensity-matched analysis of the Nationwide Inpatient Sample (2010-2014) comparing cannabis-using vs non-using hospitalizations for Crohn's disease (6,002 matched) and ulcerative colitis (1,481 matched) using ICD-9 codes.

What this study cannot tell us

Observational propensity-matched study cannot establish causation. ICD-9 codes for cannabis use likely underestimate prevalence. No data on cannabis type, dose, frequency, or route of administration. Recreational use codes may miss medical users.

How to read the evidence

Moderate: large national dataset with propensity matching, but retrospective and reliant on billing codes.

When this study was published

Published in 2019, using 2010-2014 data.

The bigger picture

The anti-inflammatory potential of cannabis aligns with the shorter hospitalizations and lower complication rates seen here, though the observational design means cannabis users may differ from non-users in ways beyond their cannabis use that affect outcomes.

Questions still open

Would controlled medical cannabis administration show clearer benefits for IBD patients? Is the lower colorectal cancer rate in cannabis users a direct anti-inflammatory effect or confounded by other factors? Which cannabinoids are most relevant for gut inflammation?

Common questions

Can cannabis help with inflammatory bowel disease?

This large hospital study found cannabis-using IBD patients had shorter stays and lower complication rates in some areas. However, it's observational data and can't prove cannabis caused better outcomes.

Why were some complications higher in cannabis users?

Cannabis-using Crohn's patients had higher rates of fistulizing disease and lower GI hemorrhage. This may reflect that sicker patients are more likely to use cannabis for symptom relief, rather than cannabis causing these complications.

Read the original research

In-hospital outcomes of inflammatory bowel disease in cannabis users: a nationwide propensity-matched analysis in the United States.

Annals of translational medicine, 7(12), 252

View on PubMed ↗Publisher’s paper ↗

Citation

Desai, Rupak; Patel, Upenkumar; Goyal, Hemant; Rimu, Afrina Hossain; Zalavadia, Dipen; Bansal, Pardeep; Shah, Nihar. (2019). In-hospital outcomes of inflammatory bowel disease in cannabis users: a nationwide propensity-matched analysis in the United States.. Annals of translational medicine, 7(12), 252. https://doi.org/10.21037/atm.2019.04.63