The gastrointestinal tract has a fully functional endocannabinoid system that controls motility, sensation, nausea, barrier integrity, and cellular environment, offering therapeutic targets for IBS, IBD, and colorectal cancer.
Gastroenterologists, IBS/IBD patients, medical cannabis researchers.
Four GI applications identified: normalizing motility in IBS, reducing inflammation in IBD, regulating cell growth in colorectal cancer, and managing chemotherapy-induced GI side effects.
What the researchers found
The GI tract expresses endocannabinoids, their receptors, and metabolizing enzymes. This system participates in motor and sensory activity, nausea/emesis, epithelial barrier maintenance, and cellular homeostasis. Cannabinoid agents may normalize dysmotility and reduce pain in IBS, decrease inflammation in IBD, and play a role in regulating the cell niche in colorectal cancer.
Why it matters
Gastrointestinal disorders affect millions of people, and current treatments are often inadequate. The discovery that the GI tract has its own endocannabinoid system opens multiple new therapeutic avenues.
The numbers in context
Covers four major GI conditions: IBS, IBD, colorectal cancer, and chemotherapy-induced GI side effects (nausea/vomiting, constipation, diarrhea).
How the study worked
Review of recent findings on cannabinoid receptors, natural and synthetic ligands, and metabolizing enzymes in normal GI function and in IBS, IBD, colon cancer, and chemotherapy-induced GI side effects.
What this study cannot tell us
Review covers a broad area with varying levels of evidence across conditions. Much evidence is preclinical. Clinical trial data for cannabinoids in GI disorders is still limited.
How to read the evidence
Moderate - comprehensive review of substantial basic science with emerging clinical evidence, though clinical data remains limited.
When this study was published
Published in 2018. GI cannabinoid research has continued to expand.
The bigger picture
Cannabis has been used for GI complaints for thousands of years. Modern science is now revealing the molecular basis for these effects, potentially leading to targeted cannabinoid therapies that avoid psychoactive side effects.
Questions still open
- Which GI condition is most likely to benefit from cannabinoid therapy? Could peripherally restricted cannabinoids treat GI disorders without CNS effects? How do different cannabinoids (THC vs CBD vs synthetic) compare for GI conditions?
Common questions
Can cannabis help with IBS?
Does the gut have its own cannabinoid system?
Read the original research
Cannabinoid pharmacology and therapy in gut disorders.
Biochemical pharmacology, 157, 134-147
Citation
Uranga, J A; Vera, G; Abalo, R. (2018). Cannabinoid pharmacology and therapy in gut disorders.. Biochemical pharmacology, 157, 134-147. https://doi.org/10.1016/j.bcp.2018.07.048
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