National survey data linked cannabis use to lower odds of some GI illnesses but the picture is complex | Research

The takeaway

Analysis of NHANES data from 2005-2018 found cannabis use associated with reduced odds of certain gastrointestinal illnesses in adults, while heavy use has separately been linked to intractable vomiting.

Gastroenterologists, cannabis researchers, and individuals using cannabis for digestive symptoms.

Cannabis associated with lower GI illness odds in national survey of 18,000+ adults

What the researchers found

Cannabis use was associated with lower odds of some gastrointestinal tract illnesses in a large nationally representative sample. This contrasts with increasing reports of cannabinoid hyperemesis syndrome among heavy users.

Why it matters

The relationship between cannabis and the gut is paradoxical: it has antiemetic properties used in chemotherapy but can also cause severe vomiting in heavy users. Large population-level data helps map this complex relationship.

The numbers in context

NHANES 2005-2018 data. Non-pregnant adults ages 20-59 without cancer or HIV (approximately 18,000+ participants). Cannabis use associated with reduced odds of certain GI illnesses.

How the study worked

Cross-sectional analysis of NHANES data (2005-2018). Included non-pregnant adults ages 20-59 without cancer or HIV (n~18,000+). Examined associations between cannabis use and GI illness.

What this study cannot tell us

Cross-sectional NHANES data cannot establish causation. Self-reported cannabis use and GI diagnoses. Healthy user bias possible (sicker people may avoid cannabis). Cannot distinguish cannabis use patterns (frequency, method, potency). Cannabinoid hyperemesis likely underdiagnosed in survey data.

How to read the evidence

Large nationally representative dataset with validated measures. Cross-sectional design and self-report limit causal inference.

When this study was published

Published 2023. NHANES data 2005-2018.

The bigger picture

The endocannabinoid system is active throughout the gastrointestinal tract, and cannabis affects gut motility, inflammation, and nausea pathways. The dual nature of cannabis (antiemetic at moderate use, potentially emetogenic at heavy use) complicates simple messaging.

Questions still open

At what level of use does the antiemetic benefit of cannabis shift to emetogenic risk? Would prospective studies with detailed use patterns clarify the dose-response relationship?

Common questions

Is cannabis good or bad for the stomach?

It depends on the pattern of use. This national survey found cannabis use associated with lower rates of some GI illnesses at the population level. However, heavy, chronic cannabis use has been linked to cannabinoid hyperemesis syndrome, involving severe, cyclical vomiting. The relationship appears dose-dependent and complex.

What is cannabinoid hyperemesis syndrome?

Cannabinoid hyperemesis syndrome (CHS) is a condition seen in heavy, long-term cannabis users characterized by repeated episodes of severe nausea and vomiting. Hot showers or baths typically provide temporary relief. CHS resolves with cannabis cessation. It is increasingly recognized in emergency departments.

Read the original research

Cannabis use and gastrointestinal tract illnesses: The National Health and Nutrition Examination Surveys, 2005-2018.

Drug and alcohol review, 42(4), 785-790

View on PubMed ↗Publisher’s paper ↗

Citation

Vanderziel, Alyssa; Alshaarawy, Omayma. (2023). Cannabis use and gastrointestinal tract illnesses: The National Health and Nutrition Examination Surveys, 2005-2018.. Drug and alcohol review, 42(4), 785-790. https://doi.org/10.1111/dar.13609