Marijuana-Associated Delayed Gastric Emptying
Marijuana (cannabis) use can slow gastric emptying and may worsen gastroparesis symptoms. [1], [2] Marijuana is listed as a cause of gastroparesis in the American College of Gastroenterology (ACG) patient guideline materials. [2]
Mechanism of Cannabis-Related Gastric Dysmotility
Cannabinoids can impair normal gastric motility by slowing gastric emptying. [1] This delayed emptying can worsen symptoms in patients with underlying gastroparesis or severe delayed gastric emptying. [1]
Clinical Distinction From Cannabinoid Hyperemesis Syndrome
Cannabinoid hyperemesis syndrome (CHS) is characterized by nausea and vomiting associated with chronic, typically heavy, cannabis use. [3] CHS is considered a subtype of cyclical vomiting syndrome. [3] CHS is a distinct syndrome from gastroparesis even though both can present with nausea and vomiting. [3]
Initiation and Ongoing Use Considerations
Prolonged cannabis or CBD exposure is associated with adverse GI effects that can include worsening delayed gastric emptying and symptoms. [1] Chronic daily cannabis use is described as being associated with CHS, which can be deleterious for patients with gastroparesis who already have nausea and vomiting. [1]
Evaluation When Symptoms Occur
Gastroparesis is diagnosed with objective assessment of gastric emptying using gastric emptying testing. [2] History should include cannabis use because it can be etiologically relevant and can also worsen gastric emptying. [2], [1]
Treatment and Risk Mitigation Principles
For patients with gastroparesis symptoms, clinicians should account for cannabis-related slowing of gastric emptying when selecting management strategies. [1] Avoidance of cannabis is commonly relevant in patients being evaluated for or managed for delayed gastric emptying when symptoms are temporally related to use. [1], [2]
When to Seek Urgent Care
Severe or persistent vomiting with dehydration risk, inability to keep fluids down, or signs of electrolyte or kidney complications warrants urgent evaluation. [3]