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Cannabis and Gastrointestinal Disorders

The impact of cannabis on gastrointestinal (GI) disorders is more than just a gut feeling. The medical community has long observed the plant’s therapeutic potential to alleviate symptoms of some of the most painful GI disorders, including Crohn’s disease and ulcerative colitis. How does cannabis have such a significant influence on GI disorder symptoms?

The cannabis-GI connection

Understanding the cannabis-GI connection involves your endogenous cannabinoid system (ECS). This system, believed to be responsible for maintaining a state of equilibrium throughout your body, is made of receptors clustered in your digestive system, along with your skin, brain, and central nervous system, among other places. Endocannabinoids produced by your body interact with these receptors. Select phytocannabinoids like Tetrahydrocannabinol (THC) found in cannabis are believed to behave like endocannabinoids. Additionally, research shows that your digestive system plays a role in cannabinoid signaling(1), or the way your ECS influences your body. 

The interconnected nature of the ECS means interactions with gut-based cannabinoid receptors influence a variety of processes in the GI tract. They have been observed influencing appetite, food intake, inflammation, pain, nausea, and more. Additional research is needed to determine how phytocannabinoids could be used to treat specific disorders, but early studies are promising.

Researchers have observed its positive impact in these areas:

  • GI motility: Motility is the movement of food through your digestive system(2). Cannabinoids are believed to modulate GI motility(3) by altering its speed. Motility issues can be caused by malfunctions of muscles, nerves, or hormones responsible for moving food along. Research suggests that endocannabinoid and phytocannabinoid interactions with the CB2 receptor, coupled with an inhibition of certain hormones, could stabilize GI motility.

  • Gut inflammation: Inflammatory GI disorders include diseases like ulcerative colitis (UC) and Crohn’s disease. Cannabinoids have been observed to mediate inflammation in the gut(4) through interactions with the CB1 receptor. Endocannabinoids in combination with phytocannabinoids were found to have an even greater effect, suggesting their therapeutic potential across many GI disorders.

  • Nausea and vomiting: Cannabinoids have long been observed to suppress nausea and vomiting through activation of the CB1 receptor(5) and subsequent modulation of serotonin, a neurotransmitter that plays a significant role in gut-related processes. 

Cannabinoids may also help with a phenomenon known as anticipatory nausea(6). This type of nausea is tied to an emotional experience or trauma, unlike nausea and vomiting caused by a physical reaction. For example, some cancer patients report feeling ill as they arrive for treatment. This is a result of their emotional association with the experience. Cannabis anti-anxiety properties could settle an uneasy stomach (and mind).

Common GI disorders with symptoms that can be helped with cannabis

Although researchers are still examining how phytocannabinoids interact with the ECS, clinical trials suggest that cannabinoids could be used to ease the symptoms of some of the most common GI disorders affecting millions every day.

  • Crohn’s disease and other inflammatory bowel disorders: Multiple human trials suggest that phytocannabinoids could calm the symptoms of inflammation-related disorders like Crohn’s disease(7). One open-label, single-arm study conducted in 2013 showed that patients who inhaled THC reported reduced pain, improved quality of life, and increased body mass index (BMI).

  • Irritable bowel syndrome (IBS): Though like IBD, IBS is a distinct condition which slows or speeds up GI motility. While there are few studies linking IBS and cannabis, one pharmacological trial performed by researchers at the Mayo Clinic examined the effects of dronabinol(8) – a synthetic cannabinoid approved by the FDA and used to prevent nausea and vomiting during chemotherapy – on motility. While it slowed down the speed at which food moved through the digestive process, it did not affect the sensation patients reported.

  • Ulcerative Colitis (UC): A double-blind, placebo-controlled study published in 2018 – the largest of its kind with 60 subjects – examined the effects of a 96% CBD and 4% THC formulation on patients with UC(9). Subjects reported how they felt, and researchers administered endoscopies to view any changes to GI tract inflammation. The study found an improvement in quality of life, as well as a reduction in the Mayo score, a measurement of UC activity. The study noted that several subjects did not like the intoxicating qualities of THC, leading researchers to suggest THC-A, THC’s non-intoxicating precursor, as a potentially promising alternative.

  • Nausea and vomiting: Cannabinoids regulate nausea and vomiting by inhibiting activity in the CB1 receptor(10), making orally-administered cannabis products an effective option for those with recurring symptoms. Medical cannabis is often administered to cancer patients undergoing chemotherapy treatment who experience nausea and vomiting as side effects of chemotherapy or radiation. A 1995 study demonstrated that cannabis oil drops given to children receiving chemotherapy found that, after 480 total treatments, nausea and vomiting were controlled with no side effects beyond mild irritability in two of the children.

For those diagnosed with a gastrointestinal disorder, medical cannabis may bring relief and help return life to a state of normalcy. If you think medical cannabis may help symptoms of your GI condition, we welcome you to come to Ethos. Our staff can help guide your product choice as you begin your journey, recommending ways to track how you’re feeling and make adjustments along the way. No matter if you’re new to cannabis or experienced with the plant, we’re here to support you with clear, helpful, and science-backed information.

Sources

  1. https://pubmed.ncbi.nlm.nih.gov/27561826/
  2. https://health.ucsd.edu/specialties/gastro/areas-expertise/motility-physiology/pages/default.aspx#:~:text=Gastrointestinal%20(GI)%20motility%20refers%20to,body%20starts%20this%20complicated%20process.
  3. https://pubmed.ncbi.nlm.nih.gov/30635796/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3423254/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3165951/#:~:text=Considerable%20evidence%20demonstrates%20that%20manipulation,response%20to%20a%20toxic%20challenge.
  6. https://pubmed.ncbi.nlm.nih.gov/26561338/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441301/#s14title
  8. https://clinicaltrials.gov/ct2/show/NCT01253408
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441301/
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3165951/
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