Medical Marijuana And Gastrointestinal Disorders

  • Gastrointestinal (GI) disorders, including functional bowel diseases such as inflammatory bowel diseases (Crohn’s disease and colitis) and irritable bowel syndrome (IBS) afflict more than one in five Americans, particularly women. While some of the disorders could be prevented by diet and pharmaceutical medications, others are poorly moderated by conventional treatments.

     The symptoms of gastrointestinal disorders often include cramping, abdominal pain, inflammation of the lining of the large and/or small intestine, rectal bleeding, chronic diarrhea, and weight loss.

    Though several anecdotal reports and a handful of case reports exist in the scientific literature supporting the use of cannabinoids for treating symptoms of this disorder, virtually no clinical trial work has been performed in this area, aside from a 2007 clinical study assessing the impact of oral THC on colonic motility.

    Nevertheless, it has been demonstrated by numerous preclinical studies that activation of the CB1 and CB2 cannabinoid receptors exert biological functions on the gastrointestinal tract. In animals, effects of their activation include suppression of gastrointestinal motility, reduced acid reflux, inhibition of intestinal secretion, protection from inflammation, and promotion of epithelial wound healing in human tissue.

    As a result, it is believed by many experts that cannabinoids and/or modulation of the endogenous cannabinoid system represents a novel therapeutic approach for the treatment of numerous GI disorders — including inflammatory bowel diseases, functional bowel diseases, gastro-oesophagael reflux conditions, secretory diarrhea, gastric ulcers, and colon cancer.

    References:
    [1] Gahlinger, Paul M. 1984. Gastrointestinal illness and cannabis use in a rural Canadian community. Journal of Psychoactive Drugs 16: 263-265.
    [2] Swift et al. 2005. Survey of Australians using cannabis for medical purposes. Harm Reduction Journal 4: 2-18.
    [3] Baron et al. 1990. Ulcerative colitis and marijuana. Annals of Internal Medicine 112: 471.
    [4] Jeff Hergenrather. 2005. Cannabis alleviates symptoms of Crohn’s Disease. O’Shaughnessy’s 2: 3.
    [5] Esfandyari et al. 2007. Effects of a cannabinoid receptor agonist on colonic motor and sensory functions in humans: a randomized, placebo-controlled study. American Journal of Physiology, Gastrointestinal and Liver Physiology 293: 137-145.
    [6] Massa and Monory. 2006. Endocannabinoids and the gastrointestinal tract. Journal of Endocrinological Investigation 29 (Suppl): 47-57.
    [7] Roger Pertwee. 2001. Cannabinoids and the gastrointestinal tract. Gut 48: 859-867.
    [8] DiCarlo and Izzo. 2003. Cannabinoids for gastrointestinal diseases: potential therapeutic applications. Expert Opinion on Investigational Drugs 12: 39-49.
    [9] Lehmann et al. 2002. Cannabinoid receptor agonism inhibits transient lower esophageal sphincter relaxations and reflux in dogs. Gastroenterology 123: 1129-1134.
    [10] Massa et al. 2005. The endocannabinoid system in the physiology and pathophysiology of the gastrointestinal tract. Journal of Molecular Medicine 12: 944-954.
    [11] Wright et al. 2005. Differential expression of cannabinoid receptors in the human colon: cannabinoids promote epithelial wound healing. Gastroenterology 129: 437-453.
    [12] Massa and Monory. 2006. op. cit.
    [13] Izzo and Coutts. 2005. Cannabinoids and the digestive tract. Handbook of Experimental Pharmacology 168: 573-598.
    [14] Izzo et al. 2009. Non-psychotropic plant cannabinoids: new therapeutic opportunities from an ancient herb. Trends in Pharmacological Sciences 30: 515-527.

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