Cannabis sativa has been used as medicine since ancient times, possibly even to soothe gastrointestinal disorders. But it’s only recently that scientific research as caught up, exploring the mechanisms behind the gastrointestinal benefits of phytocannabinoids.
Turns out, the endocannabinoid system — the body’s innate system of cannabinoid production, reception and processing — plays a role in gut health. Cannabinoids can influence microbiota, which in turn influence the overall state of the GI system. Among those whose ears should be perking up right now: people with inflammatory bowel disease, colon cancer and atherosclerosis (accumulated plaque and fatty material inside the arteries).
How Do We Know Cannabinoids Affect the Gut?
Research has demonstrated that the the gastrointestinal tract has endocannabinoid receptors, which indicates that this system is involved in gut health and, conversely, intestinal disease.
The endocannabinoid system interacts with gut microbiota — that’s science speak for the “tiny life forms” living in your digestive system — and has some influence over obesity, atherosclerosis, and visceral hypersensitivity (pain in the inner organs).
The endocannabinoid system also appears to help regulate intestinal inflammation, recruiting immune cells when they're needed and helping to turn off the body’s inflammatory response at the appropriate time. Research suggests that people with irritable bowel disease have an altered endocannabinoid system. More studies are needed exploring phytocannabinoids’ potential effects and the implications for people with IBD, but the outlook is promising.
“From a scientist’s perspective and all the caveats in mind, it seems to be a matter of time when cannabinoid compounds will be used in the treatment of GI disease,” wrote researchers Carina Hasenoehrl, Ulrike Taschler, Martin Storr, and Rudolf Schicho in a 2016 research review.
“It seems to be a matter of time when cannabinoid compounds will be used in the treatment of GI disease.”
— Carina Hasenoehrl, Ulrike Taschler, Martin Storr, and Rudolf Schicho in “The gastrointestinal tract – a central organ of cannabinoid signaling in health and disease”
Research vs. Real Life: How Does It Stand Up?
Cannabis is indeed gaining traction as a treatment method. And in many instances people are trying it with the support of their doctor.
Case in point, Joe Silverman, who lives with Crohn’s disease and recently shared his story with Time. After trying anti-inflammatory drugs, steroid suppositories and immunosuppressive drugs, he added CBD and THC capsules to his existing treatment regimen.
“Within an hour and a half of taking them, I felt better,” Silverman told Time. “The bloating and pain went down, and my appetite came back.”
Patients are drawn to cannabis as an alternative to immunosuppressive drugs, according to reporter Stacey Colino. Doctors tend to see it as a supplemental treatment rather than a replacement. (Note that even though cannabis is natural, there can be side effects including acid reflux or severe nausea and vomiting.)
A combination of THC and CBD seems to offer the most support, relieving abdominal pain and decreasing the frequency of bowel movements. However, it doesn’t appear that cannabis works by reducing inflammation, as some scientists have hypothesized.
“In human studies, if you look for blood markers of inflammation, you don’t see any change after using cannabis,” Dr. Jordan Tishler told Colino. Tishler teaches at Harvard Medical School and is president of the Association of Cannabinoid Specialists.
“There isn’t a lot of evidence that cannabis really modifies the underlying disease process,” he said. “But it treats the symptoms people have.”
In closing, there is almost certainly a link between cannabinoids and the gut, as evidenced by the presence of cannabinoid receptors in the gut. While more human studies are needed to fill in the blanks, many people with gastrointestinal diseases are already using cannabis — with the support of their doctors.
Anecdotal evidence shows that it probably doesn’t address the underlying cause of disease, but it can:
- help relieve symptoms;
- reduce the need for prescription medication; and
- improve quality of life and wellbeing.
