Can cannabis and CBD manage gut health?

According to a cross-sectional study presented at Digestive Disease Week, approximately one-third of patients with inflammatory bowel disease report actively using cannabis, and 45% report using cannabis for the management of their IBD (Irritable Bowel Disorder) related symptoms. Many others anecdotally report that medical cannabis and CBD can manage gut health, including stomach pain, bloating, nausea, and appetite. Unfortunately, due to US federal laws that block medical cannabis research, large studies for the efficacy of cannabis and IBD are lacking. But early studies have shown that cannabis can indeed help people with digestive diseases and few patients with these symptoms have the time or patience to wait for large clinical trials.

Have you ever wondered why you have butterflies in your stomach when you are stressed or why you have to run to the bathroom before speaking in front of an audience? There is a gut-brain connection that links the nervous system to the digestive system and these are clear examples of how your gut responds to stress.

There are two competing components to your nervous system: the sympathetic and parasympathetic system. The sympathetic system is the fight or flight response. It kicks into gear when you have to take the stage, meet a deadline, or when you’re exercising. It makes your pupils dilate, your heart pumps harder, your blood pressure rises, and causes you to sweat. The parasympathetic system helps you digest food, sleep, dream, relax. These days, many of us are living in a perpetual state of sympathetic overdrive. We are overworked, overtired, anxious about the future. This constant stress results in digestive issues such as bloating, irregular bowel movements, reflux, and rapid weight gain/loss. Stress may cause a decrease in blood flow and oxygen to the stomach, which could lead to cramping, inflammation, or an imbalance of gut bacteria.

The endocannabinoid system modulates and interfaces with all of the other systems throughout your body. It regulates physical functions, such as movement, pain sensation, immune responses, and cognitive or mental capacities, like perception, mood, and memory. The ECS naturally produces cannabinoid-like molecules that stimulate the body’s endocannabinoid receptors. These receptors are in the brain, muscles, and fat (adipose tissue). There is a galaxy of cannabinoid receptors in the digestive system.

There is a galaxy of cannabinoid receptors in the digestive system.

Michael’s story

Michael is a 15-year-old high school student who came to my office with his parents. When he was just four-years-old, Michael had a “nervous tummy.” For years doctors thought he was lactose and gluten intolerant. He was fatigued and his body ached constantly. He was embarrassed because of his constant diarrhea and constipation forced him to plan his life around the restroom. After batteries of endoscopies and colonoscopies, he was finally diagnosed with Colitis. In the next few years, Michael tried every medication; anti-inflammatory, steroids, anti-diarrhea, pain meds, and antibiotics.

Nothing stopped his deep, penetrating stomach cramps and bleeding colon. After all conventional therapies failed, his gastroenterologist recommended a bowel resection — removal of his colon. Michael was so frustrated; he began searching online for help. He came across thousands of websites where patients talked about how they cured Colitis or managed their symptoms by smoking pot. Some of these patients had detailed instructions on growing cannabis, lists of recommended strains and dispensaries, or recipes for pot- brownies. The sources of information and misinformation were endless.

Three months ago Michael admitted to his parents that smoking cannabis helped him tremendously with the pain and cramping. Before cannabis, he would wake up five times a night, sitting on the toilet with searing cramps, trying not to wake his parents in the room next door. After only a month of cannabis use, he started sleeping through the night and he noticed that the blood and mucus in his stools lessened significantly. His parents realized that Michael was going to use cannabis with or without their consent, which is when they appeared in my office in search of medical guidance.

 

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