Digestive Diseases and Sciences

, Volume 64, Issue 10, pp 2939–2944 | Cite as

Association Between Cannabis Use and Complications Related to Crohn’s Disease: A Retrospective Cohort Study

  • Chimezie MbachiEmail author
  • Bashar Attar
  • Yuchen Wang
  • Isaac Paintsil
  • Benjamin Mba
  • Setri Fugar
  • Rohit Agrawal
  • Roberto Carlos Simons-Linares
  • Palash Jaiswal
  • William Trick
  • Vikram Kotwal
Original Article



Crohn’s disease is an idiopathic inflammatory process that is occasionally associated with complications, which cause significant morbidity and mortality. The anti-inflammatory effect of cannabis in intestinal inflammation has been shown in several experimental models; it is unknown whether this correlates with fewer complications in Crohn’s disease patients.


To compare the prevalence of Crohn’s disease-related complications among cannabis users and non-users in patients admitted with a primary diagnosis of Crohn’s disease or a primary diagnosis of Crohn’s related complication and a secondary diagnosis of Crohn’s disease between 2012 and 2014.


We used data from the Healthcare Cost and Utilization Project–National Inpatient Sample. Cannabis users (615) were compared directly after propensity score match to non-users, in aspects of various complications and clinical end-points.


Among matched cohorts, Cannabis users were less likely to have the following: active fistulizing disease and intra-abdominal abscess (11.5% vs. 15.9%; aOR 0.68 [0.49 to 0.94], p = 0.025), blood product transfusion (5.0% vs. 8.0%; aOR 0.48 [0.30 to 0.79], p = 0.037), colectomy (3.7% vs. 7.5%; aOR 0.48 [0.29–0.80], p = 0.004), and parenteral nutrition requirement (3.4% vs. 6.7%, aOR 0.39 [0.23 to 0.68], p = 0.009).


Cannabis use may mitigate several of the well-described complications of Crohn’s disease among hospital inpatients. These effects could possibly be through the effect of cannabis in the endocannabinoid system.


Cannabis Crohn’s Complications Parenteral nutrition 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10620_2019_5556_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 15 kb)


  1. 1.
    Kappelman MD, Rifas-Shiman SL, Kleinman K, et al. The prevalence and geographic distribution of Crohn’s disease and ulcerative colitis in the United States. Clin Gastroenterol Hepatol. 2007;5:1424–1429.CrossRefGoogle Scholar
  2. 2.
    Cho JH, Weaver CT. The genetics of inflammatory bowel disease. Gastroenterology. 2007;133:1327–1339.CrossRefGoogle Scholar
  3. 3.
    Barrett JC, Hansoul S, Nicolae DL, et al. Genome-wide association defines more than 30 distinct susceptibility loci for Crohn’s disease. Nat Genet. 2008;40:955.CrossRefGoogle Scholar
  4. 4.
    Merikangas KR, McClair VL. Epidemiology of substance use disorders. Hum Genet. 2012;131:779–789.CrossRefGoogle Scholar
  5. 5.
    Weiss A, Friedenberg F. Patterns of cannabis use in patients with inflammatory bowel disease: a population based analysis. Drug Alcohol Depend. 2015;156:84–89.CrossRefGoogle Scholar
  6. 6.
    Kilmer B. Recreational cannabis—minimizing the health risks from legalization. N Engl J Med. 2017;376:705–707.CrossRefGoogle Scholar
  7. 7.
    Storr MA, Keenan CM, Zhang H, Patel KD, Makriyannis A, Sharkey KA. Activation of the cannabinoid 2 receptor (CB2) protects against experimental colitis. Inflamm Bowel Dis. 2009;15:1678–1685.CrossRefGoogle Scholar
  8. 8.
    Kimball ES, Schneider CR, Wallace NH, Hornby PJ. Agonists of cannabinoid receptor 1 and 2 inhibit experimental colitis induced by oil of mustard and by dextran sulfate sodium. Am J Physiol Gastrointest Liver Physiol. 2006;291:G364–G371.CrossRefGoogle Scholar
  9. 9.
    Singh UP, Singh NP, Singh B, Price RL, Nagarkatti M, Nagarkatti PS. Cannabinoid receptor-2 (CB2) agonist ameliorates colitis in IL-10(-/-) mice by attenuating the activation of T cells and promoting their apoptosis. Toxicol Appl Pharmacol. 2012;258:256–267.CrossRefGoogle Scholar
  10. 10.
    Montecucco F, Lenglet S, Braunersreuther V, et al. CB2 cannabinoid receptor activation is cardioprotective in a mouse model of ischemia/reperfusion. J Mol Cell Cardiol. 2009;46:612–620.CrossRefGoogle Scholar
  11. 11.
    Mohnle P, Schutz SV, Schmidt M, et al. MicroRNA-665 is involved in the regulation of the expression of the cardioprotective cannabinoid receptor CB2 in patients with severe heart failure. Biochem Biophys Res Commun. 2014;451:516–521.CrossRefGoogle Scholar
  12. 12.
    Duerr GD, Heinemann JC, Dunkel S, et al. Myocardial hypertrophy is associated with inflammation and activation of endocannabinoid system in patients with aortic valve stenosis. Life Sci. 2013;92:976–983.CrossRefGoogle Scholar
  13. 13.
    Tam J, Liu J, Mukhopadhyay B, Cinar R, Godlewski G, Kunos G. Endocannabinoids in liver disease. Hepatology. 2011;53:346–355.CrossRefGoogle Scholar
  14. 14.
    Jenkin KA, Verty AN, McAinch AJ, Hryciw DH. Endocannabinoids and the renal proximal tubule: an emerging role in diabetic nephropathy. Int J Biochem Cell Biol. 2012;44:2028–2031.CrossRefGoogle Scholar
  15. 15.
    Adegbala O, Martin KD, Otuada D, Akinyemiju T. Diabetes mellitus with chronic complications in relation to carotid endarterectomy and carotid artery stenting outcomes. J Stroke Cerebrovasc Dis. 2017;26:217–224.CrossRefGoogle Scholar
  16. 16.
    Micic D, Gaetano JN, Rubin JN, et al. Factors associated with readmission to the hospital within 30 days in patients with inflammatory bowel disease. PLoS ONE. 2017;12:e0182900.CrossRefGoogle Scholar
  17. 17.
    Rumalla K, Reddy AY, Mittal MK. Association of recreational marijuana use with aneurysmal subarachnoid hemorrhage. J Stroke Cerebrovasc Dis. 2016;25:452–460.CrossRefGoogle Scholar
  18. 18.
    Adejumo AC, Alliu S, Ajayi TO, et al. Cannabis use is associated with reduced prevalence of non-alcoholic fatty liver disease: a cross-sectional study. PLoS ONE. 2017;12:e0176416.CrossRefGoogle Scholar
  19. 19.
    Quan H, Sundararajan V, Halfon P, et al. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care. 2005;43:1130–1139.CrossRefGoogle Scholar
  20. 20.
    Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivar Behav Res. 2011;46:399–424.CrossRefGoogle Scholar
  21. 21.
    Storr M, Devlin S, Kaplan GG, Panaccione R, Andrews CN. Cannabis use provides symptom relief in patients with inflammatory bowel disease but is associated with worse disease prognosis in patients with Crohn’s disease. Inflamm Bowel Dis. 2014;20:472–480.CrossRefGoogle Scholar
  22. 22.
    Ravikoff Allegretti J, Courtwright A, Lucci M, Korzenik JR, Levine J. Marijuana use patterns among patients with inflammatory bowel disease. Inflamm Bowel Dis. 2013;19:2809–2814.CrossRefGoogle Scholar
  23. 23.
    Lal S, Prasad N, Ryan M, et al. Cannabis use amongst patients with inflammatory bowel disease. Eur J Gastroenterol Hepatol. 2011;23:891–896.CrossRefGoogle Scholar
  24. 24.
    Naftali T, Lev LB, Yablecovitch D, Half E, Konikoff FM. Treatment of Crohn’s disease with cannabis: an observational study. Isr Med Assoc J. 2011;13:455–458.Google Scholar
  25. 25.
    Naftali T, Bar-Lev Schleider L, Dotan I, Lansky EP, Sklerovsky Benjaminov F, Konikoff FM. Cannabis induces a clinical response in patients with Crohn’s disease: a prospective placebo-controlled study. Clin Gastroenterol Hepatol. 2013;11:1276–1280e1271.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Chimezie Mbachi
    • 1
    • 5
    Email author
  • Bashar Attar
    • 1
  • Yuchen Wang
    • 1
  • Isaac Paintsil
    • 1
  • Benjamin Mba
    • 1
  • Setri Fugar
    • 2
  • Rohit Agrawal
    • 1
  • Roberto Carlos Simons-Linares
    • 3
  • Palash Jaiswal
    • 4
  • William Trick
    • 1
  • Vikram Kotwal
    • 1
  1. 1.John H Stroger Hospital of Cook CountyChicagoUSA
  2. 2.Rush University Medical CentreChicagoUSA
  3. 3.Gastroenterology and Hepatology Department, Digestive Disease InstituteCleveland ClinicClevelandUSA
  4. 4.SUNY Downstate Medical CentreNew YorkUSA
  5. 5.ChicagoUSA

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