Cannabis and the GI tract

The endocannabinoid system (ECS) plays an important role in gastrointestinal (GI) homeostasis and remains a potential pathway for current and future therapeutics. Evidence of the antiinflammatory, antinociceptive, and antisecretory effects of cannabinoids is abundant, and consequently, many patients with GI conditions may benefit from cannabis or its derivatives as treatment options. Findings from several small studies support the use of cannabis or cannabinoids in patients with inflammatory bowel disease. However, there are discordant findings in the in vitro or in vivo animal studies and a limited number of controlled human studies evaluating these agents on obesity, fatty liver, gastroparesis, and irritable bowel syndrome. These discordant results indicate the complicated pathways and interactions of the ECS with other organ systems. Importantly, cannabinoids are far from the panacea that some claim, and additional investigation is needed to further understand their sometimes-detrimental effects. Most studies have only evaluated CB1 and CB2 receptors agonists. To avoid mainly central side effects, future studies are needed to understand ways to utilize the ECS, through targeting endocannabinoids and their associated enzymes.