Cannabis Use Linked to Worse Outcomes After Gastroparesis Surgery

Cannabis users had higher baseline symptom burden (nausea 85.2% vs. 59.4%, pain 73.1% vs. 50.2%). Within 90 days of surgery: higher reintervention (9.3% vs. 1.2%), more admissions (32.4% vs. 23.7%), fewer clinic visits (37.0% vs. 54.5%). By 5 years: more hospitalizations (59.3% vs. 41.0%), lower outpatient follow-up (54.6% vs. 76.2%).

Retrospective cohort using TriNetX federated EMR database. 1,572 gastroparesis patients (pyloric drainage or gastric stimulator placement). 108 with documented cannabis use (ICD-10 F12) vs. 1,464 without. Outcomes assessed at 90 days and 5 years post-surgery.

Cannabis is often used by gastroparesis patients to manage nausea, but this study suggests it may be associated with worse surgical outcomes. The combination of more complications and fewer follow-up visits is particularly concerning for post-surgical recovery.

Cannabis-using gastroparesis patients appear to be a sicker, more symptomatic population that also engages less with follow-up care. This creates a vicious cycle where patients most needing monitoring are least likely to attend, potentially contributing to worse long-term outcomes.

Small cannabis user group (108 patients). ICD-10 coding likely underestimates cannabis use. Cannabis users had more baseline symptoms — confounding by severity. Cannot determine if cannabis use worsens outcomes or if worse underlying disease drives both cannabis use and outcomes.