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The Impact of Chronic Cannabis Use on Esophageal Motility in Patients Referred for Esophageal Manometry.
Ugwuegbu, Obinna; Shibli, Fahmi; Kim, Yeseong; Rangan, Vikram; Kurin, Michael; Ayoub, Fares; Ganocy, Stephen; Kavitt, Robert; Fass, Ronnie.
Afiliação
  • Ugwuegbu O; Case Western Reserve University, School of Medicine, Cleveland, OH.
  • Shibli F; Esophageal and Swallowing Center, Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH.
  • Kim Y; Esophageal and Swallowing Center, Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH.
  • Rangan V; Esophageal and Swallowing Center, Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH.
  • Kurin M; Beth Israel Deaconess Medical Center. Digestive Disease Center, Harvard University, Boston, MA.
  • Ayoub F; Esophageal and Swallowing Center, Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH.
  • Ganocy S; University Hospitals Cleveland Medical Center Department of Gastroenterology and Hepatology, Case Western Reserve University, Cleveland, OH.
  • Kavitt R; Section of Gastroenterology, Hepatology, and Nutrition, University of Chicago Medicine, Chicago, IL.
  • Fass R; Center for Health Care Research and Policy, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH.
J Clin Gastroenterol ; 58(4): 342-348, 2024 Apr 01.
Article em En | MEDLINE | ID: mdl-37436840
ABSTRACT

BACKGROUND:

Tetrahydrocannabinol, the main psychoactive compound in cannabis, binds with high affinity to the cannabinoid 1 receptor. Small randomized controlled studies using conventional manometry have shown that the cannabinoid 1 receptor can modulate esophageal function, namely transient lower esophageal sphincter relaxation frequency and lower esophageal sphincter tone. The effect of cannabinoids on esophageal motility in patients referred for esophageal manometry has not been fully elucidated using high-resolution esophageal manometry (HREM). We aimed to characterize the clinical effect of chronic cannabis use on esophageal motility utilizing HREM.

METHODS:

Patients who underwent HREM from 2009 to 2019 were identified at 4 academic medical centers. The study group consisted of patients with a noted history of chronic cannabis use, a diagnosis of cannabis-related disorder, or a positive urine toxicology screen. Age and gender-matched patients with no history of cannabis use were selected to form the control group. Data on HREM metrics based on the Chicago classification V3, and the prevalence of esophageal motility disorders were compared. Confounding effects of BMI and medications on esophageal motility were adjusted for.

RESULTS:

Chronic cannabis use was found to be an independent negative predictor of weak swallows (ß=-8.02, P =0.0109), but not a predictor of failed swallows ( P =0.6890). The prevalence of ineffective esophageal motility was significantly lower in chronic cannabis users compared with nonusers (OR=0.44, 95% CI 0.19-0.93, P =0.0384). There was no significant difference in the prevalence of other esophageal motility disorders between the 2 cohorts. In patients with dysphagia as their primary indication for HREM, chronic cannabis use was found to be independently associated with increased median integrated relaxation pressure (ß=6.638, P =0.0153) and increased mean lower esophageal sphincter resting pressure (ß=10.38, P =0.0084).

CONCLUSIONS:

Chronic cannabis use is associated with decreased weak swallows and reduced prevalence of ineffective esophageal motility in patients referred for esophageal manometry. In patients referred for dysphagia, chronic cannabis use is associated with increased integrated relaxation pressure and lower esophageal sphincter resting pressure, though not to levels above the normal range.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cannabis / Transtornos da Motilidade Esofágica / Transtornos de Deglutição Tipo de estudo: Clinical_trials / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cannabis / Transtornos da Motilidade Esofágica / Transtornos de Deglutição Tipo de estudo: Clinical_trials / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article