Does Smoking Cannabis Increase the Risk of Barrett's Esophagus?

Millions of Americans smoke cannabis every day. With the recent legalization of cannabis in many states, the number of Americans who smoke cannabis is expected to climb even higher. This case report presents a chronic cannabis smoker who developed severe Barrett's esophagus at a young age. A 41-year-old African American male presented with an exacerbation of nausea and vomiting. The patient reported that he smoked cannabis two to three times daily for the past 20 years. Upper endoscopy and subsequent histology analysis displayed long-segment Barrett's esophagus indefinite for dysplasia. The patient was encouraged to cease cannabis use and have a follow-up endoscopy in 3-6 months. Barrett's esophagus is rare in African Americans; however, with the increase in the prevalence of cannabis smoking, endoscopic surveillance guidelines may need to be modified to include younger African Americans who chronically smoke cannabis.