Cannabis-Using IBD Patients Had Longer Procedures and More Inflammation on Endoscopy

IBD patients who used cannabis had significantly longer endoscopy durations (p<0.001) and were more likely to have endoscopic inflammation (p=0.044) than matched non-users. There was no significant difference in recovery time, propofol dose per procedure duration, or IBD treatment at the time of endoscopy.

Retrospective case-control study at a tertiary academic medical center (2018-2022). 62 IBD patients reporting cannabis use were matched by age, sex, and BMI with 62 non-using IBD patients. All underwent endoscopy for acute IBD complaints.

Many IBD patients use cannabis for symptom relief, but this study found cannabis users actually had more inflammation on endoscopy. This raises the question of whether cannabis masks symptoms while inflammation continues, or whether people with worse disease are more likely to turn to cannabis.

Cannabis is widely used by IBD patients despite limited evidence. This study suggests cannabis use may be a marker for more severe disease or may provide symptomatic relief without addressing underlying inflammation, both concerning possibilities.

Retrospective case-control design cannot determine causation. Cannabis use was self-reported. Selection bias: patients undergoing endoscopy for acute complaints represent a sicker subset. Cannot determine whether cannabis use preceded or followed disease worsening.