Cannabis Use Linked to Worse Outcomes After Gastroparesis Surgery | Research

The takeaway

Cannabis-using gastroparesis patients had higher symptom burden, 8x more early reoperations, and 59% hospitalization rate over 5 years — but also attended fewer follow-up visits, creating a dangerous combination.

Gastroparesis patients who use cannabis, gastroenterologists, surgeons, and healthcare teams managing complex GI conditions.

What the researchers found

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%).

Why it matters

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.

The numbers in context

1,572 patients total. 108 (6.9%) with cannabis use. 90-day reintervention: 9.3% vs. 1.2% (p<.001). 90-day admission: 32.4% vs. 23.7%. 5-year admission: 59.3% vs. 41.0%. Follow-up attendance: 54.6% vs. 76.2%. Late reintervention rates similar between groups.

How the study worked

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.

What this study cannot tell us

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.

How to read the evidence

Database study with 5-year outcomes, but small cannabis user group and likely confounding by disease severity.

When this study was published

Published in 2026, addressing a practical clinical question as cannabis use increases among GI patients.

The bigger picture

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.

Questions still open

Should gastroparesis patients stop cannabis before surgery? Does cannabis worsen gastroparesis or are sicker patients more likely to use it? How can follow-up engagement be improved in this group?

Common questions

Should I stop using cannabis before gastroparesis surgery?

This study found cannabis-using patients had significantly more complications after gastroparesis surgery, including 8x more reoperations within 90 days. While it can't prove cannabis caused the worse outcomes, discussing your use with your surgical team is important.

Why might cannabis affect gastroparesis surgery outcomes?

Cannabis can slow gastric emptying, which could complicate post-surgical recovery. Cannabis-using patients in this study also had worse baseline symptoms and attended fewer follow-ups, both of which could contribute to worse outcomes.

Read the original research

Impact of preoperative cannabis use on outcomes following surgical intervention for gastroparesis.

Surgical endoscopy

View on PubMed ↗Publisher’s paper ↗

Citation

Eriksson, Sven E; Chaudhry, Naveed; Gardner, Margaret E; Zarrineh, Tara; Zheng, Ping; Ayazi, Shahin. (2026). Impact of preoperative cannabis use on outcomes following surgical intervention for gastroparesis.. Surgical endoscopy. https://doi.org/10.1007/s00464-025-12558-8