Is Cannabis Good for Your Guts?

When it comes to digestive ailments, multiple medical studies and anecdotal reports highlight the beneficial effects of cannabis in treating nausea, abdominal pain and diarrhea.  Cancer patients undergoing chemotherapy and those battling HIV turn to cannabis for relief, which is more effective for the most part than most pharmaceuticals in tackling these digestive issues.  

CBD and THC alleviate stomach upset, vomiting, pain and diarrhea by quelling gut inflammation, and slowing stomach acid production and intestinal motility (the speed that food passes through the intestine).  These cannabinoids have also been shown to reverse abnormal intestinal permeability (known as a leaky gut) caused by inflammation.

Many intestinal disorders and other illnesses may arise through a faulty gut barrier that perpetuates inflammation and allows bacteria, toxins and foreign proteins to enter the bloodstream.  To this end, there is some promising research that cannabis may be helpful in the management of irritable bowel syndrome and the inflammatory bowel diseases (IBD), Crohn’s disease (CD) and ulcerative colitis.

IBD

A recent review on cannabis in the treatment of IBD (1) highlights the fact that IBD patients commonly self-medicate with cannabis to relieve abdominal pain, diarrhea, and loss of appetite. One study found that cannabis reduced the need for other medication in CD patients, while another small study of IBD patients found that smoking cannabis relieved their abdominal pain and significantly improved their quality of life.  

There has been only one placebo-controlled study conducted on the effects of THC in patients with CD which found that those that smoked cannabis reported lower steroid use, and improved sleep and appetite.  In a rat model of colitis, THC and CBD not only reduced inflammation, but also the occurrence of bouts of colitis (2).  The researchers found that while THC was more effective than CBD, the combination of CBD and THC was beneficial and worked synergistically.  They also suggested the CBD/THC combination for possible therapeutic applications to minimize the psychoactive actions of using THC alone.   

Some potentially unwanted side effects of cannabinoids on digestion

Stomach acid

Since THC can slow down the production of stomach acid, this is good news if you have acid reflux or heartburn. However, if you have digestive problems or other health conditions due to low stomach acid, then THC may actually aggravate your condition.  

Cannabis and vomiting

Chronic use of cannabis in adolescents and adults has been associated with a relatively rare condition known as cannabinoid hyperemesis syndrome (CHS) (3). While not much is known about CHS, after a period of heavy and prolonged cannabis use, some individuals experience intense cyclic vomiting and nausea and the urge to compulsively bathe in hot water, which seems to provide relief.

CHS is typically resistant to standard medical therapy.  However, researchers have found that applying a topical cream to the skin containing a chili pepper derivative, capsaicin, can be effective in the treatment of CHS in some cases. Application of 0.075% capsaicin to the abdomen and 0.025% capsaicin to the back, arms, and abdomen has been shown to be effective. Investigators studying CHS have also found a common factor between heat (from hot baths) and capsaicin in relieving CHS symptoms.  Both stimulate TRPV1 (transient receptor potential vanilloid-1 receptor), a pain receptor that is involved in the pain relief we feel from endocannabinoid stimulation and that also regulates body heat. TRPV1 is activated by exposure to high heat (109°F).  Findings from these studies will help in the development of treatments for CHS and hopefully decrease the use of potentially harmful medications such as opioids.

Concerned about potential side effects from prolonged cannabis consumption?  It seems like periodic breaks from cannabis may help.

Can cannabis help gastric diseases? Based on the ongoing studies and anecdotal reports, yes, but certainly more controlled studies are needed to determine how best cannabinoids can provide relief from these diseases.  

Much scientific research has focused on the development of synthetic cannabinoids in the treatment of IBD and other diseases.  However, these synthetic compounds are devoid of other beneficial phytochemicals found in the whole plant that likely act synergistically to promote gut health. It also leaves our health in the hands of big pharma.  There is no question that more studies are needed on the benefits of cannabinoids for gastrointestinal disorders, but the small amount that we know now points to promising results.

References

1 Expert Rev Gastroenterol Hepatol. 2017 Apr;11(4):329-337. doi: 10.1080/17474124.2017.1292851. Epub 2017 Feb 16.

2 Br J Pharmacol. 2010 Jun;160(3):712-23. doi: 10.1111/j.1476-5381.2010.00791.x

3 Allen JH, de Moore GM, Heddle R, Twartz JC. Cannabinoid hyperemesis: cyclical hyperemesis in association with chronic cannabis abuse. Gut. 2004;53(11):1566–1570pmid:15479672