title: Self-medication of achalasia with cannabis, complicated by a cannabis use disorder.
abstract: Achalasia is a rare esophagus motility disorder. Medical, endoscopic and surgical treatments are available, but all endorse high relapse rates. No data has been published to date reporting a therapeutic effect of cannabis use neither in achalasia nor on its influence on manometric measurements. We report the case of a patient diagnosed with achalasia. He could benefit from a large panel of therapeutic interventions, but none of them was effective over the time. He first used cannabis at age 20 and identified benefits regarding achalasia symptoms. He maintained regular moderate cannabis use for 9 years, with minimal digestive inconvenience. A manometry performed without cannabis premedication was realized at age 26 and still found a cardiospasm. Cannabis use could explain the gap between functional symptoms assessment and manometry measurement. Further investigations are warranted to explore a therapeutic effect of cannabis in achalasia and possible influence on outcome measurements.
authors.affiliation: Amandine Luquiens, Amine Benyamina, Henri-Jean Aubin, Hôpital Paul Brousse-Addictologie, 94804 Villejuif cedex, France.
authors.forename: Amandine
authors.initials: A
authors.lastname: Luquiens
authors.affiliation: Amandine Luquiens, Amine Benyamina, Henri-Jean Aubin, Hôpital Paul Brousse-Addictologie, 94804 Villejuif cedex, France.
authors.forename: Nelson
authors.initials: N
authors.lastname: Lourenco
authors.affiliation: Amandine Luquiens, Amine Benyamina, Henri-Jean Aubin, Hôpital Paul Brousse-Addictologie, 94804 Villejuif cedex, France.
authors.forename: Amine
authors.initials: A
authors.lastname: Benyamina
authors.affiliation: Amandine Luquiens, Amine Benyamina, Henri-Jean Aubin, Hôpital Paul Brousse-Addictologie, 94804 Villejuif cedex, France.
authors.forename: Henri-Jean
authors.initials: HJ
authors.lastname: Aubin
mesh_terms: D000328:Adult; D004931:Esophageal Achalasia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D004945:Esophagoscopy; D004947:Esophagus / Q000187:drug effects* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008365:Manometry; D002189:Marijuana Abuse / Q000175:diagnosis / Q000209:etiology*; D008385:Marijuana Smoking / Q000009:adverse effects*; D011237:Predictive Value of Tests; D012651:Self Medication / Q000009:adverse effects*
keywords: Achalasia; Addiction; Cannabis; Manometry; Treatment