Impact of Cannabis Use on Eosinophilic Esophagitis: Study Reveals Increased Inflammation Post-Treatment

Cannabis users with eosinophilic esophagitis (EoE) show milder symptoms at diagnosis but may face increased inflammation after treatment compared to nonusers. This study appeared in Diseases of the Esophagus.

Eosinophilic esophagitis is a chronic inflammatory condition of the esophagus. Its incidence has grown notably over the past 20 years. While cannabis has been studied for various gastrointestinal issues, its effects on EoE remain largely unknown. This prompted researchers to explore how cannabis influences the disease’s presentation and treatment response.

Using data from the University of North Carolina EoE Clinicopathologic Database, researchers analyzed patients aged 12 years and older who were newly diagnosed with EoE. They compared cannabis users and nonusers based on self-reported use. The study assessed outcomes such as symptoms, endoscopic findings, and histologic results.

Out of 983 patients, 80 (8%) reported using cannabis, mostly via inhalation (76%). Most users consumed it daily (53%) for over three years. Cannabis users were generally younger (32.4 vs. 38.8 years) and more likely to be men (79% vs. 63%). Also, a higher percentage identified as non-White (17% vs. 9%) and had mental health issues like PTSD or bipolar disorder (49% vs. 34%).

Initial symptoms of EoE were similar between both groups. However, cannabis users had fewer endoscopic issues such as exudates (33% vs. 44%) and strictures (26% vs. 38%).

After treatment, both groups had comparable symptom relief (75% vs. 78%). No significant differences were found in endoscopic scores. However, cannabis users experienced more post-treatment inflammation, including furrows (70% vs. 47%). Although histologic responses were lower for cannabis users, the difference was not statistically significant. These findings raise concerns about cannabis’s long-term impact on EoE treatment.

The study had limitations, including reliance on self-reported cannabis use, which could be underreported in regions where cannabis is illegal. The small number of cannabis users also restricted detailed analysis by type of cannabis, and the single-center design posed further limitations.

Researchers noted a potential negative link between cannabis use and EoE treatment outcomes. Despite the milder initial endoscopic features, cannabis users had more inflammatory signs after treatment. The researchers commented on the implications of having fewer strictures at diagnosis.

Some authors of the study disclosed ties to biotech, pharmaceutical, and device companies. For a full list of disclosures, please refer to the original publication.