Research on cannabis and GI disorders

Research demonstrates that cannabis and cannabinoids are effective in treating the symptoms of these GI disorders in part because it interacts with the endogenous cannabinoid receptors in the digestive tract, which can result in calming spasms, assuaging pain, and improving motility. Cannabis has also been shown to have anti-inflammatory propertie and recent research has demonstrated that cannabinoids are immune system modulators, either enhancing or suppressing immune response.

Cannabis has a long documented history of use in treating GI distress, going back more than a century in western medicine, and far longer in the east. While clinical studies on the use of cannabis for the treatment of gastrointestinal disorders have been largely limited to investigations on nausea suppression and appetite stimulation - two conditions for which cannabis has been consistently shown to be highly effective. The evidence in support of cannabis therapy for other gastrointestinal diseases and disorders is also strong. There is now extensive anecdotal evidence from patients with IBS, Crohn's disease and other painful GI disorders that cannabis eases cramping and helps modulate diarrhea, constipation and acid reflux. Recent laboratory research on the endogenous cannabinoid system in humans has identified that there are many cannabinoid receptors located in both the large and small intestine.

Cannabis and new cannabinoid drugs are attractive for GI treatment because they can address a number of symptoms at once with minimal side-effects. Cannabinoids alter how the gut feels, affect the signals the brain sends back and forth to the gut, and modulate the actions of the GI tract itself. For instance, cannabidiol (CBD), the second most abundant cannabinoid on the plant, has been shown to reduce hypermotility, inflammation, and tissue damage in experimental models of GI diseases.

Beginning in the 1970s, a series of human clinical trials established cannabis' ability to stimulate food intake and weight gain in healthy volunteers. In a randomized trial, THC significantly improved appetite and nausea in comparison with placebo. There were also trends towards improved mood and weight gain. Unwanted effects were generally mild or moderate in intensity.

Cannabis helps combat the painful and often debilitating cramping that accompanies many GI disorders because cannabinoids relax contractions of the smooth muscle of the intestines. In fact, the smooth muscle-relaxant properties of cannabinoids are so well established that preparations of guinea-pig intestine are routinely used as an in vitro screening tool to test the potency and function of synthetic cannabinoids.

Research on a variety of rodents has shown that endogenous cannabinoids play crucial neuromodulatory roles in controlling the operation of the gastrointestinal system, with synthetic and natural cannabinoids acting powerfully to control gastrointestinal motility and inflammation. Cannabinoid receptors comprise G-protein coupled receptors that are predominantly in enteric and central neurones (CB1R) and immune cells (CB2R). The digestive tract contains endogenous cannabinoids (anandamide and 2-arachidonylglycerol) and cannabinoid CB1 receptors can be found on myenteric and submucosal nerves. Activating cannabinoid receptors has been demonstrated to inhibit gastrointestinal fluid secretion and inflammation in animal models.

In the last decade, evidence obtained from the use of selective agonists and inverse agonists/antagonists indicates that manipulation of CB1R can have significant results. Research has also shown that in the case of intestinal inflammation, the body will increase the number of cannabinoid receptors in the area in an attempt to regulate the inflammation by processing more cannabinoids. The abundant cannabinoid receptors in the gut represent an excellent target to treat GI disorders, as the receptors are shown to be up-regulated in the intestinal tissue of patients suffering from IBD. The activation of these hyper-expressed cannabinoid receptors can have protective and therapeutic effects against disorders of the GI tract.

Cannabinoids have a demonstrated ability to block spinal, peripheral and gastrointestinal mechanisms that promote pain in IBS and related disorders. Animal research also indicates that cannabinoids work well in controlling gastroesophageal reflux disease, a condition in which gastric acids attack the esophagus and for which commonly prescribed medications, such as atropine, have serious, adverse side effects.

From this evidence, many researchers have concluded that pharmacological modulation of the endogenous cannabinoid system provides new treatment options for a number of gastrointestinal diseases, including nausea and vomiting, gastric ulcers, irritable bowel syndrome, Crohn's disease, secretory diarrhea, paralytic ileus and gastroesophageal reflux disease. The experience of patients with these GI disorders shows that for broad-spectrum relief, cannabis is highly effective and frequently helps when other treatment options prove ineffective.

Cannabis - Side Effects

By comparison to The medications currently employed to fight chronic GI disorders, the side effects associated with cannabis are typically mild and are classified as “low risk.” Euphoric mood changes are among the most frequent side effects. Cannabinoids can exacerbate schizophrenic psychosis in predisposed persons. Cannabinoids impede cognitive and psychomotor performance, resulting in temporary impairment. Chronic use can lead to the development of tolerance. Tachycardia and hypotension are frequently documented as adverse events in the cardiovascular system. A few cases of myocardial ischemia have been reported in young and previously healthy patients. Inhaling the smoke of cannabis cigarettes induces side effects on the respiratory system. Cannabinoids are contraindicated for patients with a history of cardiac ischemias. In summary, a low risk profile is evident from the literature available. Serious complications are very rare and are not usually reported during the use of cannabinoids for medical indications.

Licensed users and growers of medical marijuana know that the plant can be used to treat a variety of diseases and symptoms related to the gastrointestinal system. This isn't a bunch of stupid stoners trying to find a medical excuse to get high, folks, this is the real deal- the herb heals! The use of medical marijuana to treat digestive system problems is time-tested, and is usually a safer intervention than the use of pharmaceutical drugs or surgery.

Chron’s Disease, Irritable Bowel Syndrome (IBS), ulcers, constipation, diarrhea, nausea, anorexia, bulimia, acid reflux, and appetite loss are some of the diseases and conditions that medical marijuana patients have treated using medical marijuana.

Studies indicate that cannabinoids in marijuana bind with cannabinoid receptors in the digestive tract, especially the small and large intestine, causing muscle relaxation, reduction of inflammation, analgesia, increased nerve-muscle coordination, anti-emesis, and relief of spasms such as those that cause nausea.

Cannabis is also an adaptogenic immune system modulator that can increase or decrease immune systems function in ways that almost always contribute to healthier outcomes.

Cannabis is unique among medicines because it has a comprehensive range of actions that can alleviate several symptoms by altering how the body and brain communicate, and how the self perceives its internal organs and systems.

The self-feedback loop that produces nausea in some circumstances, which includes a feeling of dizziness that circles back on itself to produce fear, tension and more dizziness, is often defeated by cannabis.

Indeed, research shows that cannabis can relieve symptoms in unique ways that no other medicine can duplicate.

Medical benefits of marijuana for people with gastrointestinal disorders were backed up by the United States Institute of Medicine medical marijuana study. According to the Institute, "For patients who suffer simultaneously from severe pain, nausea, and appetite loss, cannabinoid drugs might offer broad-spectrum relief not found in any other single medication."

Medical cannabis has been a blessing for people with Irritable Bowel Syndrome and Inflammatory Bowel Disease. These diseases cause diarrhea or constipation, nausea, and intestinal inflammation, pain and the inability of the digestive system to absorb nutrients.

Irritable Bowel Syndrome (IBS) can cause pain, bloating, flatulence, cramps, spasms, motility loss, constipation, and diarrhea.

Inflammatory Bowel Disease (IBD) is a term that describes Ulcerative Colitis and Crohn's Disease. Ulcerative colitis inflames the lining of the large intestine. Crohn's disease causes inflammation of the lining and wall of the large and/or small intestine. The typical symptoms of Crohn's are diarrhea, weight loss, abdominal pain, rectal bleeding and fever. Crohn’s can cause intestinal blockages and ulcerations that might require surgery. Ulcerative Colitis can cause abdominal cramps, sharp pain, low energy, weight loss, arthritic symptoms, eye problems, and liver disease.

These disorders can be crippling. In extreme cases, they may result in long-term hospitalization or surgery. The unique ability of medical cannabis to alleviate most of these symptoms is becoming more widely known in the medical community.

Recreational and medical marijuana users have long known that cannabis has an effect of appetite. The increase in appetite that often accompanies cannabis use has been called "the munchies."

Scientists studying this phenomenon note that it probably involves blood sugar levels and other physiological markers affected by cannabis.

Many professional studies have shown that cannabis stimulates appetite and weight gain. Researchers say that medical cannabis users have to be careful to moderate their intake of carbohydrates and sugars when they are responding to the munchies. It is best to eat less carbos and sugars and eat more organic vegetables, fruits and protein, rather than to pig out on candy or ice cream.

Cannabis helps combat cramping that accompanies many GI disorders because cannabinoids relax contractions of the smooth muscle of the intestines. Research shows that the body’s own cannabinoids, known as anandamides, affect neurological systems that control the gastrointestinal system. External and internal cannabinoids strongly control gastrointestinal motility and inflammation. They also have the ability to decrease gastrointestinal fluid secretion and inflammation. This means that cannabis can be useful to stop ulcers and other syndromes.

The chronic pain and spasms that accompany many gastrointestinal disorders are a life hindrance to those who suffer from IBS and other diseases. Medical cannabis is a very effective pain reliever. It blocks spinal, peripheral and gastrointestinal mechanisms that promote pain in IBS and related disorders. It also can be used against gastroesophageal reflux disease (acid reflux). When acid reflux occurs, gastric acids attack the esophagus. The pharmaceutical medicines that doctors prescribe for this condition are in some ways as bad as the condition itself. They prescribe drugs like atropine, for example, which have severe side-effects.

Pharmaceutical drugs commonly prescribed to combat GI disorders include:

Megestrol acetate (Megace), an anticachectic. This substance can cause high blood pressure, diabetes, inflammation of the blood vessels, congestive heart failure, seizures, and pneumonia. Less serious side effects of this medicine include diarrhea, flatulence, nausea, vomiting, constipation, heartburn, dry mouth, increased salivation, and thrush; impotence, decreased libido, urinary frequency, urinary incontinence, urinary tract infection, vaginal bleeding and discharge; disease of the heart, palpitation, chest pain, chest pressure, and edema; pharyngitis, lung disorders, and rapid breathing; insomnia, headache, weakness, numbness, seizures, depression, and abnormal thinking.

Metronidazole (Flagyl) is carcinogenic. Patients treated with Metronidazole have reported convulsive seizures and peripheral neuropathy. Ironically, this medicine causes problems in the gastrointestinal tract; nausea is reported by about 12% of patients, and is sometimes accompanied by headache, anorexia, and occasionally vomiting; diarrhea; epigastric distress, and abdominal cramping. Constipation has also been reported.

Sulfasalazine (Azulfidine) -Common adverse reactions associated with sulfasalazine are anorexia, headache, nausea, vomiting, gastric distress, and apparently reversible oligospermia. These occur in about one-third of the patients. Less frequent adverse reactions are pruritus, urticaria, fever, Heinz body anemia, hemolytic anemia and cyanosis, which may occur at a frequency of one in every thirty patients or less.

Chlordiazepoxide/Clidinium (Librax) - Drowsiness, ataxia and confusion have been reported in some patients, particularly the elderly and debilitated. Adverse effects reported with use of Librax are those typical of anticholinergic agents, i.e., dryness of the mouth, blurring of vision, urinary hesitancy and constipation. Withdrawal symptoms, similar in character to those noted with barbiturates and alcohol (convulsions, tremor, abdominal and muscle cramps, vomiting and sweating), have occurred following abrupt discontinuance of chlordiazepoxide. Hyoscyamine Sulfate (Levsin) - Adverse reactions may include dryness of the mouth; urinary hesitancy and retention; blurred vision; tachycardia; palpitations; mydriasis; cycloplegia; increased ocular tension; loss of taste; headache; nervousness; drowsiness; weakness; dizziness; insomnia; nausea; vomiting; impotence; suppression of lactation; constipation; bloated feeling; allergic reactions or drug idiosyncrasies; urticaria and other dermal manifestations; ataxia; speech disturbance; some degree of mental confusion and/or excitement (especially in elderly persons); and decreased sweating.

Mesalamine CR (Pentasa) - Common side effects are diarrhea, headache, nausea, abdominal pain, dyspepsia, vomiting, and rash

Phosphorated carbohydrate (Emetrol) - Side effects include: fainting; swelling of face, arms, and legs; unusual bleeding; vomiting; weight loss; yellow eyes or skin. Less common-more common with large doses: Diarrhea; stomach or abdominal pain.

Dicyclomine (Bentyl) - Can cause blurred vision, dry mouth, heart problems, seizures, impotence, and difficulty in urinating, among other effects.

Ciprofloxacin (Cipro) - The most frequent side effects include nausea, vomiting, diarrhea, abdominal pain, rash, headache, and restlessness. Rare allergic reactions have been described, such as hives and anaphylaxis (shock). Methotrexate (Rheumatrex, Trexall) – Is very toxic, depending on dose. The most frequent reactions include mouth sores, stomach upset, and low white blood counts. Methotrexate can cause severe toxicity of the liver and bone marrow, which require regular monitoring with blood testing. It can cause headache and drowsiness, which may resolve if the dose is lowered. Methotrexate can cause itching, skin rash, dizziness, and hair loss.

Diphenoxylate and atropine (Lotomil) - Bad effects include drowsiness, dizziness, and headache, nausea or vomiting, and dry mouth. Euphoria, depression, lethargy, restlessness, numbness of extremities, loss of appetite, and abdominal pain or discomfort has been reported less frequently. Although the dose of atropine in Lomotil is too low to cause side effects when taken in the recommended doses, side effects of atropine (including dryness of the skin and mucous membranes, increased heart rate, urinary retention, and increased body temperature) have been reported, particularly in children under 2.

Prednisone (Delatasone). This is a steroid drug that can have serious adverse musculoskeletal, gastrointestinal, dermatologic, neurological, endocrine, and ophthalmic side effects. These include: congestive heart failure in susceptible patients, potassium loss, hypokalemic alkalosis, sodium retention, and hypertension. Muscle weakness, steroid myopathy, loss of muscle mass, osteoporosis, tendon rupture, vertebral compression fractures, aseptic necrosis of femoral and humeral heads, and pathologic fracture of long bones. Peptic ulcer with possible perforation and hemorrhage; pancreatitis; abdominal distention; ulcerative esophagitis. Impaired wound healing, thin fragile skin, petechiae and ecchymoses, facial erythema. Increased intracranial pressure, usually after treatment, convulsions, vertigo, and headache. Menstrual irregularities; development of Cushingoid state; secondary adrenocortical and pituitary unresponsiveness; decreased carbohydrate tolerance; manifestations of latent diabetes mellitus. Posterior subcapsular cataracts, increased intraocular pressure, glaucoma, and exophthalmos.

Given this verified list of problems that can be created by prescription drugs used to treat gastrointestinal disorders, and the lack of such problems caused by medical marijuana which provides better relief, it’s amazing that medical marijuana is not already the most popularly prescribed medication for such disorders.

The overall opinion of enlightened people in the medical community is that medical cannabis can interact with the endogenous cannabinoid system to reduce problems associated with nausea, vomiting, gastric ulcers, irritable bowel syndrome, Crohn's disease, secretory diarrhea, paralytic ileus and gastroesophageal reflux disease.

It is true that cannabis has to be used intelligently. Some people are disconcerted by spiritual, psychological, physiological and emotional changes they experience after using cannabis. Cannabis in rare cases increases schizophrenic symptoms in people who already have a predisposition for schizophrenia. Cannabis can interfere with cognitive function and body coordination, although the impairment is relatively minor and is temporary. Tachycardia and hypotension often occur with cannabis use. Ingesting cannabis as a smoked substance can cause negative effects on the respiratory system. Some people develop a tolerance to cannabis and have to use more and more of it to achieve the same results. Others develop a psychological dependence on it.

As you can see, none of these side effects come close to being as severe as the ones cited for the prescription drugs that cannabis competes with.

Licensed medical marijuana grower-patients who grow medical marijuana using organic ingredients and properly engineered synthetic ingredients have told us that cannabis provides a wide range of relief, without severe side-effects, in ways that other drugs, treatment and surgery do not.

Medical cannabis patients also report that other interventions are useful during the cannabis regimen. These interventions include detoxifying and cleansing the internal body with herbs, vitamins and supplements, eating only pure, living foods, completely abstaining from junk foods, coffee, caffeine and alcohol, doing yoga and meditation, exercise, nature experiences, and various types of bodywork such as cranial-sacral therapy.