Cannabis Use Increases the Odds of Irritable Bowel Syndrome Among Hospitalized Patients: A Propensity Matched Analysis

Abstract

Introduction: The Endogenous Cannabinnoid System (ECS) participates in many brain-gut and gutbrain pathologic pathways, all of which are dysfunctional in Irritable Bowel Syndrome (IBS). Herein, we investigate the association between the long-term cannabis use among individuals with cannabis use disorder (CUD) and a having a diagnosis of IBS. Methods: After selecting patients with age over 18 years from the 2014 Nationwide Inpatient Survey (NIS) and using the ICD-9 codes to identify individuals with CUD, IBS and the established risk factors for IBS, we estimated the crude and adjusted odds ratio (COR and AOR) of having a diagnosis of IBS with CUD. We then assessed for the interactions of CUD with other risk factors (SAS 9.4) and confirmed our findings in two ways: conducting a similar analysis of a prior (2012) NIS data; using a greedy algorithm to design a propensity-scored case-control (1:10) analysis. Results: Of 4,709,043 subjects, 0.03% had a primary admission for IBS and 1.32% had CUD. CUD was associated with increased odds of IBS (AOR: 2.03[1.53-2.71]). CUD was related to higher odds for IBS among males compared to females (3.48[1.98-6.12] vs. 1.48[0.88-2.50]), and Hispanics and Whites compared to Blacks (5.28[1.77-15.76], 1.80[1.02-3.18] vs. 1.80[0.65-5.03]). On propensity matching, CUD was associated with 80% increased odds for IBS (1.82[1.27-2.60]) Conclusion: Our findings suggest that CUD is associated with a diagnosis of IBS among the general population, and that males, Whites and Hispanics might be more sensitive to its impact on IBS. More epidemiological studies are required to elucidate this relationship.