Cannabis Use Increases ER Visits and Hospitalizations for Gastroparesis Patients | Research

The takeaway

Among 41,374 gastroparesis patients, cannabis users had 73% more ER visits and 44% more hospitalizations than non-users, despite theoretical benefits of cannabinoids for nausea and gastric motility.

Gastroenterologists, emergency physicians, gastroparesis patients considering cannabis, and clinicians counseling patients on cannabis and GI conditions.

What the researchers found

Cannabis-using gastroparesis patients had significantly increased ER visits (aOR=1.73, 95% CI=1.66-1.80) and hospitalizations (aOR=1.44, 95% CI=1.39-1.50) compared to propensity-matched non-users, despite slightly reduced endoscopy rates (aOR=0.93, 95% CI=0.88-0.98).

Why it matters

Despite cannabis being touted for nausea and appetite — key gastroparesis symptoms — this large real-world study shows cannabis users actually have worse healthcare outcomes, possibly due to cannabinoid hyperemesis syndrome or delayed gastric emptying from cannabis.

The numbers in context

N=41,374 matched (20,687 per group); ER visits aOR=1.73; hospitalizations aOR=1.44; endoscopy aOR=0.93; cannabis users: younger, more diabetes, more mood/anxiety disorders, higher HbA1c, more opioid use

How the study worked

Retrospective propensity-matched cohort study of 41,374 gastroparesis patients (20,687 cannabis users matched 1:1 to non-users) from the TriNetX database (119 million individuals), examining ER visits, hospitalizations, and endoscopy rates.

What this study cannot tell us

Observational design with confounding risk despite propensity matching; cannot determine if cannabis causes outcomes or sicker patients use cannabis; cannabis user definition may include CHS patients; database coding limitations; no cannabis dose/product information.

How to read the evidence

Large propensity-matched cohort from a major database provides strong real-world evidence, though observational design and potential confounding by indication limit causal conclusions.

When this study was published

Published 2026 in American Journal of Gastroenterology.

The bigger picture

This challenges the narrative that cannabis is beneficial for gastroparesis — at the population level, cannabis users have significantly worse outcomes, though the observational design cannot determine if cannabis causes worse outcomes or if sicker patients are more likely to use cannabis.

Questions still open

How much of the increased healthcare use is driven by CHS in gastroparesis patients? Would specific cannabinoid formulations (CBD-dominant) show different outcomes? Should gastroparesis patients be counseled against cannabis use?

Common questions

Is cannabis good for gastroparesis?

Despite theoretical benefits for nausea and motility, this study of over 41,000 patients found that cannabis users with gastroparesis actually had 73% more ER visits and 44% more hospitalizations — possibly due to cannabinoid hyperemesis syndrome or cannabis-related gastric slowing.

Can cannabis make stomach problems worse?

In gastroparesis patients, cannabis use was associated with significantly more ER visits and hospitalizations. Cannabis can paradoxically slow gastric emptying and cause cannabinoid hyperemesis syndrome, both of which would worsen gastroparesis.

Read the original research

The Impact of Cannabis Use in Gastroparesis: A Propensity-Matched Analysis of 41,374 Gastroparesis Patients.

The American journal of gastroenterology, 121(1), 248-257

View on PubMed ↗Publisher’s paper ↗

Citation

Kilani, Yassine; Gonzalez Mosquera, Daniel Alejandro; Puelo, Priscila Castro; Aldiabat, Mohammad; Ruffle, James K; Madi, Mahmoud Y; Farmer, Adam D. (2026). The Impact of Cannabis Use in Gastroparesis: A Propensity-Matched Analysis of 41,374 Gastroparesis Patients.. The American journal of gastroenterology, 121(1), 248-257. https://doi.org/10.14309/ajg.0000000000003479