Eleven marijuana users developed a rare bowel condition requiring surgery | Research

The takeaway

A case series of 11 patients found an association between heavy marijuana use and small bowel intussusception, a rare condition where the intestine telescopes into itself.

Gastroenterologists, surgeons, emergency physicians, and heavy cannabis users.

11 patients, all heavy marijuana users, all needed surgery

What the researchers found

Eleven patients, all heavy marijuana users, presented with small bowel intussusception at a single institution. All required surgical intervention. No alternative cause (such as tumor or anatomical defect) was identified in most cases, suggesting a possible functional mechanism related to cannabis effects on gut motility.

Why it matters

Small bowel intussusception in adults is rare and usually caused by structural abnormalities. This series raises the possibility that heavy cannabis use might affect gut motility in ways that predispose to this condition.

The numbers in context

11 patients; all heavy marijuana users; all required surgical treatment; no structural lead point identified in most cases.

How the study worked

Retrospective case series of 11 patients at a single institution who presented with small bowel intussusception and had documented heavy marijuana use.

What this study cannot tell us

Case series without controls; no way to establish causation. Single institution may reflect referral bias. Small sample size. No dose-response data or quantification of cannabis use.

How to read the evidence

Preliminary: case series with no control group and small sample size.

When this study was published

Published 2017.

The bigger picture

Cannabis is known to affect gastrointestinal motility through CB1 receptors in the gut. This case series adds to a growing body of literature linking heavy cannabis use to GI complications, including cannabinoid hyperemesis syndrome.

Questions still open

Is there a dose-dependent relationship between cannabis use and intussusception risk? What is the mechanism, and does it involve cannabinoid receptor-mediated changes in gut motility?

Common questions

What is intussusception?

A condition where one part of the intestine telescopes into an adjacent section, causing obstruction. In adults, it is rare and usually caused by a structural abnormality like a tumor.

How common is this complication?

Very rare overall. This case series identified 11 cases at one institution, but no population-level incidence data exists linking cannabis use to intussusception.

Read the original research

Small bowel intussusception in marijuana users.

Journal of surgical case reports, 2020(9), rjaa335

View on PubMed ↗Publisher’s paper ↗

Citation

Kakish, Daniel; Alaoudi, Marwan; Welch, Brian; Fan, David; Meghpara, Melissa; Mandava, Nageswara; Kumthekar, Narendra. (2020). Small bowel intussusception in marijuana users.. Journal of surgical case reports, 2020(9), rjaa335. https://doi.org/10.1093/jscr/rjaa335