Treating Gastrointestinal Disease with CBD and Medical Cannabis. What the research says.

Updated: Aug 21, 2021



A popular misnomer is the hunger effect of cannabis on the body, mistakenly believed to originate from the gastrointestinal tract . The phenomenon that marijuana makes you hunger for rich foods, high in fat, is triggered in the brain, and supports the body's need for sustenance for survival.


The regulatory functions of the GI tract are connected to the Endocannabinoid system of the body and found to regulate most of the gut function. Both CB1 and CB2 receptors are found in the enteric nervous system made up of millions of neurons in the GI tract. What has been discovered is that from the consumption of food to insulin production and fat storage, endocannabinoids and their receptors are integral in body processes and energy production through the GI tract [2]. Because there are so many cannabinoid receptors throughout the GI tract it would stand to reason that cannabinoids provide a range of treatments for GI disorders.


The history of medical cannabis begins around 5000BC where it was used to stimulate appetite and counteract weight loss. By the 1900’s, cannabis was prescribed by doctors in the USA and Europe to treat stomach pain and gastrointestinal disorders. Contemporary Indian Ayurveda medicine has recommended medical cannabis for irritable bowel syndrome (IBS) and Crohn's disease for centuries. [1].


Crohn's patients received cannabis treatment in a study conducted in Israel, which resulted in remission of symptoms in more than half the participants [3]. According to the University of Sydney Lambert Initiative for cannabinoid therapeutics, one quarter of Australians with inflammatory bowel disease report the easing of symptoms using medicinal cannabis [4]. A survey of Australians suffering from crohn's disease confirmed that cannabinoids modulate gut pain and patients with severe bowel diseases report that cannabis reduces the intensity and frequency of nausea [5], and THC limits gut transition [7].


So how does it work?


Endocannabinoid production levels increase in the brain between meals until they trigger hunger, and drop when the consumption of food begins. CB1 reception in the GI gut, responds to endocannabinoid receptors signalling the regulation of multiple functions, such as stomach acid secretion, pyloric valve contraction and the transport of food in the digestive tract. CB1 and CB2 receptors modulate pain signaling in the gut [2;6].


It is believed that the production of CB2 receptors within the gut are stimulated by probiotic bacteria. We know that probiotics reduce a number of forms of intestinal inflammation, which identifies the role of CB2 receptors in the gut immune response [6]. A pharmacological paper identified that the endocannabinoid receptor GPR55 is linked to colon cancer and when activated becomes pro-inflammatory. CBD operates as an antagonist for this GPR55 receptor, suppressing gut inflammation and cell-mutation [7].


What does this mean?


Science tells us that THC inhibits gut transit, and it was originally used to treat diarrhea. We also know that CBD increases motility in the gut, in addition to reducing gut inflammation. The research suggests that the combination and ratio of CBD and THC needs to be tailored for the individual's specific medical diagnosis by a medical professional who specialises in medicinal cannabis. If you are suffering a gastrointestinal disorder, there is sufficient research to investigate CBD and medicinal cannabis as an effective treatment. If you think you or a loved one could benefit from medical cannabis for a gastrointestinal issue, contact a GP today.




 

References:


1. Peters H., Nahas G.G. (1999) A Brief History of Four Millennia (B.C. 2000—A.D. 1974) (B.C. 2000—A.D. 1974). In: Nahas G.G., Sutin K.M., Harvey D., Agurell S., Pace N., Cancro R. (eds) Marihuana and Medicine. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-710-9_1

2. Sharkey KA, Wiley JW. The Role of the Endocannabinoid System in the Brain-Gut Axis. Gastroenterology. 2016 Aug;151(2):252-66. doi: 10.1053/j.gastro.2016.04.015. Epub 2016 Apr 29. PMID: 27133395; PMCID: PMC4961581. The Role of the Endocannabinoid System in the Brain-Gut Axis

3. Naftali T, Dor M. Cannabis for the Treatment of Inflammatory Bowel Disease: A True Medicine or a False Promise? Rambam Maimonides Med J. 2020 Jan 30;11(1):e0008. doi: 10.5041/RMMJ.10390. PMID: 32017687; PMCID: PMC7000156.

4. University of Sydney Lambert Initiative

5. Benson, M., Abelev, S., Connor, S., Corte, C., Martin, L., & Gold, L. et al. (2020). Medicinal Cannabis for Inflammatory Bowel Disease: A Survey of Perspectives, Experiences, and Current Use in Australian Patients. Crohn's & Colitis 360, 2(2). doi: 10.1093/crocol/otaa015

6. Rousseaux, C., Thuru, X., Gelot, A. et al. Lactobacillus acidophilus modulates intestinal pain and induces opioid and cannabinoid receptors. Nat Med 13, 35–37 (2007). https://doi.org/10.1038/nm1521

7. Borrelli F, Fasolino I, Romano B, Capasso R, Maiello F, Coppola D, Orlando P, Battista G, Pagano E, Di Marzo V, Izzo AA. Beneficial effect of the non-psychotropic plant cannabinoid cannabigerol on experimental inflammatory bowel disease. Biochem Pharmacol. 2013 May 1;85(9):1306-16. doi: 10.1016/j.bcp.2013.01.017. Epub 2013 Feb http://doi:10.1016/j.bcp.2013.01.017


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