Introduction: An erosive disease of the stomach, alcoholic gastritis is a common sequela of excessive alcohol use, causing significant morbidity, and frequently requiring hospitalization. Unlike alcohol, cannabis use decreases gastric acidity and might suppress the harmful effect of alcohol on the gastric mucosa. Although murine models have demonstrated that cannabis hampers gastritis, confirmatory human studies are lacking. Therefore, we investigate the impact of cannabis use on alcoholic gastritis among individuals with abusive alcohol use.
Methods: From 2014 of the Nationwide Inpatient Sample (NIS), we extracted hospital records of adults (age ≥ 18 years) who had a diagnosis of abusive alcohol use (n=316,916). We used a propensity-based matching algorithm to match 30,738 cohorts of abusive cannabis users to an equal number of non-users (1:1). Using conditional Poisson regression models with generalized estimating equations, we measured the relative risk (aRR) for having alcoholic gastritis with cannabis use, and then with increasing levels of cannabis use (dependent vs. non-dependent cannabis users) [SAS 9.4].
Results: We reveal that among our population of abusive alcohol users, cannabis co-use was associated with decreased incidence of alcoholic gastritis when compared to non-users of cannabis (1,289[1,169-1,421] vs. 1,723[1,583-1,875] per 100,000 hospitalizations for abusive alcohol use). This resulted in a 25% decreased probability of alcoholic gastritis (aRR:0.75[0.66-0.85]; p-value:<0.0001). Furthermore, dependent cannabis usage resulted in a lower incidence of alcoholic gastritis when compared to both non-dependent-cannabis users (0.72[0.52-0.99]), and to non-cannabis-users (0.56[0.41-0.76]).
Conclusion: Our results demonstrate that when abusive alcohol users co-use cannabis, they were less likely to develop alcohol-associated gastritis. With the rising popularity of cannabis use and cannabisinfused alcoholic beverages, more studies might reveal the optimal composition of the cannabinoid contents of these beverages, to provide maximal protection from alcoholic gastritis. Before then, our novel studies warrant confirmation from other prospective studies.