Introduction: Cannabis hyperemesis syndrome (CHS) is a newly understood and underdiagnosed condition characterized by episodic nausea and vomiting in the face of regular cannabis use. In Montana, medicinal cannabis was legalized in 2016, and recreational cannabis was legalized in 2020, with recreational sales beginning in 2022. Despite the growing use of legal cannabis, there is still underreporting of cannabis use and CHS in the greater Bozeman, Montana area. Therefore, the purpose of this retrospective analysis was to determine whether there was an increase in the percentage of Bozeman Health patients diagnosed with acute gastrointestinal (GI) symptoms after increased access to legal cannabis sales in Montana.
Methods: We searched our electronic medical records for diagnoses of functional dyspepsia (ICD-10-CM-K30), nausea and vomiting (ICD-10-CM-R11), and abdominal pain excluding pelvic pain (ICD-10-CM-R10 excluding ICD-10-CM-R10.2) between January 2016 and March 2024.
Results: : We found that the average percent of our total patient population with an acute GI related diagnosis per month increased from before recreational sales began (0.98 ± 0.45%) to after recreational sales began (2.31 ± 0.22%; p< 0.001). There were significant interactions between age and time (p< 0.0001) and sex and time (p< 0.0001), with females and those 21-39 and 60+ years old contributing to the majority of GI cases. Additionally, there was a steady linear increase in the percent per month of patients with a GI diagnosis (slope = 0.2970; R2 = 0.9797; p< 0.0001).
Discussion: While our data do not explicitly show increases in CHS, they do show an increase in acute GI diagnoses that mirror the increased legal access to cannabis in the greater Bozeman area and by extension greater presentation of cannabis side effects. Future work should continue to monitor these trends to determine if there is a definitive link between cannabis use and the increase in acute GI diagnoses.
Figure: A) Acute GI diagnoses pre recreational sales (closed circles) and post recreational sales (closed squares). Brackets show p-value of t-test. B) Acute GI diagnoses pre recreational sales (gray bars) and post recreational sales (white bars) in females (left) and males (right). Brackets show p-value of post-hoc comparisons. C) Acute GI diagnoses pre recreational sales (gray bars) and post recreational sales (white bars) in ages 0-20, 21-39, 40-59, and 60+. Brackets show p-value of post-hoc comparisons. D) Acute GI diagnoses over time from January 2016 to March 2024.
Disclosures:
Kaitlyn DiMarco indicated no relevant financial relationships.
Andrew Gentry indicated no relevant financial relationships.
Kaitlyn DiMarco, PhD1, Andrew Gentry, MD2. P1623 - Increase in Acute Gastrointestinal Diagnoses Post-Recreational Cannabis Sales in Montana, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
