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Cannabis and Gastrointestinal Disorders

Gastrointestinal (or GI) problems can include difficulty taking in food/nourishment (appetite or nausea and vomiting problems), inadequate absorption of nutrients, elimination problems (constipation, diarrhea, irritable bowel) and/or cancer developing anywhere along the GI tract from mouth to esophagus to stomach to the small and large intestines, ending at the anus. Anecdotal experiences are numerous among patients suffering from Crohn’s disease, Ulcerative Colitis, Irritable Bowel Syndrome in their use of medicinal cannabis. The anti-inflammatory and relaxant effects of cannabis may be responsible for some of their relief.

Nausea and vomiting can occur as a result of a variety of conditions such as acute viral illness (the flu), cancer, cancer chemotherapy or side effects from other medications, radiation treatment, post-operative recovery, pregnancy, motion sickness and poisoning. There is clear evidence-based research that supports the anti-emetic effects of cannabis for persons suffering from nausea and vomiting. The 1999 IOM report, Marijuana and Medicine: Assessing the Science Base, agreed that the evidence supported the anti-emetic effects of cannabis, but expressed concern related to smoking the plant material. While inhalation allows for fairly immediate relief, clinicians should be recommending vaporization rather than smoking to eliminate this concern.

Having “the munchies” is a common phrase among cannabis users and this side effect of gaining an increased appetite can be a strong indication for use with persons suffering from cachexia or wasting syndrome. In fact, Jamaican women have long known that a ganja (cannabis) tea would settle the stomach and often gave some to newborn babies. There is new evidence that the ECS is involved in appetite stimulation. It is now known that all female mammals have anandamide in their breast milk and early research shows that newborn mice will die if the anandamide in the mother’s milk is blocked at birth.

Research Articles on Cannabis and Gastrointestinal Disorders

Coutts, A. A., & Izzo, A. A. (2004). The gastrointestinal pharmacology of cannabinoids: an update. Curr Opin Pharmacol, 4(6), 572-579.

Di Carlo, G., & Izzo, A. A. (2003). Cannabinoids for gastrointestinal diseases: potential therapeutic applications. Expert Opin Investig Drugs, 12(1), 39-49.

Gabbay, E., Avraham, Y., Ilan, Y., Israeli, E., & Berry, E. M. (2005). Endocannabinoids and liver disease–review. Liver Int, 25(5), 921-926.

Massa, F., & Monory, K. (2006). Endocannabinoids and the gastrointestinal tract. J Endocrinol Invest, 29(3 Suppl), 47-57.

Pertwee, R. G. (2001b). Cannabinoids and the gastrointestinal tract. Gut, 48(6), 859-867.

Russo, E. B. (2004). Clinical endocannabinoid deficiency (CECD): Can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions? Neuroendocrinol Lett, 25(1-2), 31-39.

Sylvestre, D. L., Clements, B. J., & Malibu, Y. (2006). Cannabis use improves retention and virological outcomes in patients treated for hepatitis C. Eur J Gastroenterol Hepatol, 18(10), 1057-1063.

Wright, K., Rooney, N., Feeney, M., Tate, J., Robertson, D., Welham, M., et al. (2005). Differential expression of cannabinoid receptors in the human colon: cannabinoids promote epithelial wound healing. Gastroenterology, 129, 437-453.

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