A review of cannabis and the GI tract found the endocannabinoid system is a promising therapeutic target for inflammatory bowel disease, irritable bowel syndrome, and motility disorders, though clinical efficacy remains unclear.
Read this if you want to understand how cannabis affects the digestive system and its potential for treating GI disorders.
Endocannabinoid system: a unified target for multiple GI conditions including IBD and IBS
What the researchers found
The endocannabinoid system performs protective activities throughout the gastrointestinal tract and modulates gut inflammation, motility, secretion, and pain perception. THC exerts biological functions on the GI tract through CB1 and CB2 receptors.
The review found promising evidence for cannabinoid therapy in several GI conditions: inflammatory bowel disease (especially Crohn's disease), irritable bowel syndrome, and secretion/motility-related disorders. Cannabis has also been used for GI symptoms including nausea and vomiting, anorexia, weight loss, and chronic abdominal pain.
However, the review also covered cannabinoid hyperemesis syndrome and noted that while the current literature supports use for digestive disorders, the clinical efficacy remains unclear pending more rigorous trials.
Why it matters
GI disorders affect a large proportion of the population, and current treatments are often inadequate. The endocannabinoid system's broad involvement in gut function, from inflammation to motility to pain, suggests it could be a unified target for multiple GI conditions.
The numbers in context
Conditions reviewed: IBD (especially Crohn's), IBS, motility disorders, nausea/vomiting, CHS, anorexia, chronic abdominal pain. Receptor targets: CB1 and CB2 in the GI tract.
How the study worked
Narrative review of the role of cannabis and the endocannabinoid system in the gut, liver, and pancreas, covering both therapeutic potential and adverse effects (CHS).
What this study cannot tell us
Narrative review without systematic methodology. The clinical evidence for most GI indications comes from small studies and case reports. The review acknowledges that clinical efficacy "remains unclear." Does not address drug interactions or contraindications.
How to read the evidence
Narrative review presenting a comprehensive overview. The underlying clinical evidence is limited and the review acknowledges unclear efficacy.
When this study was published
Published in 2017. Clinical trials of cannabinoids for IBD and IBS have expanded since.
The bigger picture
The gut has one of the richest endocannabinoid systems in the body, with both CB1 and CB2 receptors distributed throughout. This makes it a natural target for cannabinoid-based therapies, but the paradox of CHS (cannabis causing GI symptoms in chronic users) shows that the relationship between cannabinoids and the gut is complex and dose-dependent.
Questions still open
- Which GI conditions are most likely to respond to cannabinoid therapy? Are CBD-dominant preparations better tolerated in the gut than THC-dominant ones? How can the risk of CHS be balanced against the potential GI benefits of cannabis?
Common questions
Can cannabis help with Crohn's disease?
How can cannabis both help and harm the gut?
Read the original research
Role of cannabis in digestive disorders.
European journal of gastroenterology & hepatology, 29(2), 135-143
Citation
Goyal, Hemant; Singla, Umesh; Gupta, Urvashi; May, Elizabeth. (2017). Role of cannabis in digestive disorders.. European journal of gastroenterology & hepatology, 29(2), 135-143. https://doi.org/10.1097/MEG.0000000000000779
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