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Digestive Disorders

Updated on April 1, 2020. Medical content reviewed by Dr. Joseph Rosado, MD, M.B.A, Chief Medical Officer

Digestive disorders can be annoying at best and debilitating at worst. Many people are all too familiar with just how uncomfortable — both physically and emotionally — dealing with digestive problems can be. To make matters worse, treatment options may be ineffective, and even when they do provide relief, can involve unwanted side effects. The good news for those dealing with digestive disorders is that marijuana can be a uniquely beneficial solution. This wonder plant promotes gut health through natural and effective means.

The Digestive Process

To get the necessary nutrients out of the food you eat, your body must break food down into smaller parts and ultimately into a form it can actually work with. The digestive process begins as soon as you start chewing and continues throughout your entire gastrointestinal (GI) tract until you discard the leftover waste through your stool.

Your GI tract isn’t the only part of the body involved in digestion. Your pancreas, liver and gallbladder play important roles too. Your muscular system, nervous system and hormones also contribute to the process.

What Are Digestive Disorders?

Since digestion is a complicated process involving numerous parts of the body, there are many ways by which it can be disrupted. Though some disruptions may be due to short-lived problems such as a viral infection, others can be associated with more long-term issues. These issues are considered chronic digestive disorders.

Common chronic digestive disorders include Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (IBD) — which includes both Ulcerative Colitis and Crohn’s Disease — and gastroesophageal reflux disease (GERD).

Symptoms of Digestive Disorders

Since disorders can affect different parts of the digestive system, symptoms can vary. Some common symptoms of digestive disorders include:

  • Chronic constipation
  • Vomiting
  • Diarrhea
  • Heartburn
  • Gas
  • Bloating
  • Abdominal cramps
  • Rectal bleeding
  • Bloody stool
  • Depressed appetite
  • Weight loss
  • Fatigue
  • Growth retardation

Digestive Disorder Statistics

Digestive problems are extremely prevalent. According to the National Institute of Health, digestive diseases affect 60 to 70 million people in the United States. Some more statistics that highlight the severity of the issue are:

  • 3 million visits to physicians in the U.S. are made by patients whose primary diagnosis is a digestive disease.
  • Up to 12 percent of visits to primary doctors in the U.S. are for IBS.
  • IBS affects approximately 1.6 million Americans, and that number is growing at a rate of up to 70,000 new diagnoses per year.
  • 74 percent of Americans in a 2013 survey said they suffered from digestive problems like diarrhea, gas, bloating and abdominal pain.

Conventional Treatment Options

Most Americans suffering from digestive disorders seek relief through a few different means. Though medical emergencies like gastrointestinal bleeding or appendicitis require surgery, most digestive disorders are treated through conventional medicine, natural supplements, and lifestyle changes.

1. Medication

Conventional medicine used to treat digestive conditions is typically aimed at either preemptively or reactively treating symptoms in order to minimize the effects of the disorder on a patient’s daily life. While some medications can be effective in treating symptoms, they typically cause some unfortunate side effects as well.

For example, proton pump inhibitors used to treat stomach acid issues such as GERD can cause other digestive issues, including nausea, vomiting, diarrhea, stomach pain, constipation, and gas. Patients with Crohn’s Disease are often prescribed steroids, which can cause many short-term side effects such as mood swings, insomnia, and weight gain, as well as more serious long-term effects like high blood pressure or glaucoma.

In addition to prescription medications, individual symptoms can be targeted through over-the-counter options such as antacids, antispasmodic or anti-diarrheal meds. These medications are typically not intended to have lasting healing effects but simply to provide temporary relief from symptoms.

2. Supplements

Patients who are wary of the side effects of conventional pharmaceuticals may turn to natural supplements as a healthier alternative. Supplements can help the body compensate for mild digestive problems and may even have longterm healing effects in some cases. For example, when the digestive tract becomes imbalanced, probiotics can help replenish good intestinal flora. A digestive enzyme supplement can assist the stomach in producing more acid in order to more effectively break down food. Natural substances like papaya and ginger root have also been shown to aid in digestion.

3. Lifestyle Changes

Certain lifestyle changes can also be a means of managing digestive disorders. These changes are typically focused on regulating the diet to avoid problematic foods and drinks. These foods and drinks can differ from person to person, but common ones to avoid include:

  • Chocolate
  • Dairy
  • Fried or greasy foods
  • Spicy foods
  • Alcohol
  • Caffeinated beverages like coffee

IBS can become so severe that some patients may find the list of foods they can consume shrinking while the list of foods to avoid continues to grow. Foods that are typically considered mild can still cause problems for an unhealthy GI tract.

Medical Marijuana for Digestive Disorders

Considering the limited benefits and sometimes dangerous side effects of conventional treatment options, it is no wonder those with digestive problems may become interested in alternative treatment options. Though clinical research on medical marijuana’s benefits is limited, the research that does exist demonstrates what many people already know from firsthand experience — that cannabis is powerfully effective at fighting pain, inflammation, and nausea.

Cannabis and Gut Health

Cannabis interacts with the gut through the endocannabinoid system (ECS), a network of cell receptors — called cannabinoid receptors — and chemical compounds — called endocannabinoids — found throughout the body. The ECS’s main responsibility is to balance and regulate various functions of the body, including:

  • Appetite
  • Pain
  • Mood
  • Memory
  • Immune function
  • GI motility
  • Stress response
  • Emotions

Levels of cannabinoid receptors and endocannabinoids can make the difference in a healthy and an unhealthy gut.

  • Cannabinoid receptors: There are two known cannabinoid receptors: CB1 and CB2. The CB1 receptor plays an important part in bridging the gap from the digestive system to the brain through the nervous system. CB2 receptors appear to be scarce in a healthy gut but become more plentiful when the digestive tract is inflamed, as in patients with conditions affecting their bowels, such as IBD.
  • Endocannabinoids: Endocannabinoids function as the body’s natural equivalent to Tetrahydrocannabinol (THC). Multiple sources, including a 2011 study, reveal that a healthy digestive tract contains high levels of endocannabinoids. And, inversely, some research indicates that a deficiency in endocannabinoids causes digestive issues and inflammation and may even be the cause of IBS.

Why Synthetic Forms Can’t Compete

Opponents of medical marijuana use have presented the Schedule III drug, Marinol, as a legal alternative to cannabis. Though this drug is meant to offer the same benefits as cannabis, it merely contains a synthetic form of THC. This THC is intended to stimulate the appetite and reduce nausea. The cannabis plant, on the other hand, not only contains THC but numerous other cannabinoids as well. The combination of all of these components is what makes marijuana effective at not only stimulating appetite and controlling nausea but managing pain. Another advantage of cannabis over Marinol is that it is inhalable. This is especially relevant for patients who may have trouble keeping a pill down due to nausea-induced vomiting.

Side Effects of Medical Marijuana

When taken in appropriate doses, which can be determined with the help of medical supervision and a patient’s own self-regulating, cannabis has very few potentially negative side effects. Still, it is important to consider these side effects and how they might impact your daily life. Medical marijuana use can cause:

Some of these side effects may be desirable for some patients. For instance, digestive problems like IBS, indigestion, and heartburn are often coupled with insomnia. For those who have digestive disorders and also have trouble sleeping, the side effect of drowsiness can actually be helpful.

The Best Marijuana Strains for Digestive Disorders

Specific strains of marijuana can be used to target symptoms associated with digestive disorders or side effects of medications taken for digestive problems. The best strains for some common symptoms are listed below.

1. Abdominal Cramping and Diarrhea

Many digestive disorders and even temporary digestive upsets can cause painful abdominal cramps and diarrhea. In addition to cramping, diarrhea typically involves urgent trips to the bathroom that result in loose stool. Experiencing cramps and a loss of control over your bowels can be unsettling both physically and mentally. The following strains are helpful in curbing the effects of abdominal cramping:

  • Honey Bananas (hybrid)
  • Black Diesel (sativa)
  • Grape Kush (hybrid)
  • Jean Guy (sativa-dominant hybrid)

2. Fatigue

Diarrhea can cause more than just physical discomfort or embarrassment. Especially if it lasts for an extended period of time, having diarrhea can also cause fatigue. Other digestive problems can also result in fatigue. As mentioned previously, insomnia is often paired with digestive disorders, so fatigue can result from lack of sleep as well. If you regularly suffer from fatigue, you may even have Chronic Fatigue Syndrome. The following strains of marijuana are especially good at providing energy and fighting fatigue:

  • Lemon Jack (sativa)
  • Super Silver Haze (sativa)
  • Jack Herer (sativa)
  • Green Crack (sativa)
  • Laughing Buddha (sativa-dominant hybrid)

3. Nausea and Vomiting

Nausea consists of an uneasy sensation in the stomach sometimes referred to as feeling queasy. Nausea often precedes vomiting. Treating nausea and vomiting can be difficult since ingested medicines likely won’t have a chance to be absorbed into the bloodstream before being expelled. This is where the ability to vaporize marijuana becomes especially handy. The following strains are especially helpful at fighting nausea:

  • King’s Kush (indica)
  • Orange Haze (hybrid)
  • Allen Wrench (sativa)
  • Northern Lights (indica)
  • Lavender (hybrid)
  • White Fire OG (hybrid)

4. Loss of Appetite

Digestive problems can sometimes cause a depressed appetite which can lead to unhealthy weight loss. Cannabis is known for its appetite-stimulating properties which can be especially helpful for those experiencing loss of appetite. The following strains are exceptionally effective at restoring appetite:

  • Ice (hybrid)
  • Sugar Kush (indica)
  • Purple Candy (hybrid)
  • Girl Scout Cookies (hybrid)
  • Candyland (hybrid)

5. Depression and Anxiety

Anxiety disorders can cause feelings of upset stomach, and likewise, digestive problems can cause anxiety. Depression is also sometimes a byproduct of digestive disorders, especially when they are severe and disruptive of everyday life. Fortunately, anxiety and depression can both be combatted naturally through cannabis use. The following strains are known to improve mood and fight against feelings of depression or anxiety:

  • Sour Tangie (sativa)
  • LA Kush (hybrid)
  • Caramelicious (hybrid)
  • Chocolate Chunk (indica)
  • Pineapple Express (hybrid)

6. Inflammation

Digestive disorders are often inflammatory in nature. Inflammation is the body’s immune response to heal itself and defend against perceived threats. While inflammation can serve a necessary and helpful role, it can also go awry. For those with IBD, for instance, immune cells needlessly attack the GI tract. Inflammation in the body can lead to long-term complications such as heart disease and cancer. The following strains of marijuana can help provide relief from inflammation:

  • Cookies Kush (indica)
  • Lemon G (sativa)
  • Mazar I Sharif (indica)
  • Cannatonic (hybrid)
  • Afghan Kush (indica)

How to Get Medical Marijuana for Digestive Disorders

Now that you understand just how beneficial medical marijuana can be for treating digestive disorders, you may need more information on how to legally become a medical marijuana user. Since marijuana’s legal status as a form of medicine is rather recent and is limited to certain states, regulations can be confusing.

In order to determine the best path forward, you should take advantage of the resources offered by MarijuanaDoctors.com. These resources will help you learn more and can assist in finding a marijuana doctor or a cannabis dispensary. We prescreen doctors to ensure that all are qualified to guide you in your selections and treatment. Once you are able to obtain a medical marijuana card, you’ll be able to shop for whichever strains are best for your digestive needs. The journey to better gut health can begin today.

For more information, find a medical marijuana doctor in your state today!

See how medical marijuana could help relieve your digestive disorder symptoms. Marijuana can be a natural and beneficial solution for your digestive issues.

Cannabis and GI Disorders

Pylorospasm reflux

Pylorospasm
Failure of normal relaxation of the pylorus which causes symptoms of pain and vomiting due to gastric outlet obstruction. It may be seen with anthritis, both infective and chemical, this latter often due to bile reflux and ulceration and during the development of hypertrophic pyloric stenosis. It is also seen in apprehensive children, a particular problem in performing upper gastrointestinal contrast studies. During ultrasound, there is failure of relaxation of the pylorus by normal measurements. The canal fails to relax and open normally during fluoroscopy.

What exactly is meant by pylorospasm? During conventional radiological examinations, with the patient in the erect position, and in the absence of an organic lesion in the upper gastrointestinal tract, it is not unusual to observe a delay in gastric emptying of liquid barium suspension. This, in many instances, is still considered to be caused by pylorospasm, by which is implied spasm of the pyloric ring, which is equated with the sphincter. The question may well be asked whether the ring is spastic in these cases. If it were, it could be expected to remain spastic irrespective of the position of the patient.

There has been much uncertainty about the concept “pylorospasm”. For many years radiologists considered pylorospasm to be due to spasm of the pyloric ring, where the ring was equated with the pyloric sphincter. It was thought that spasm of the ring (or “sphincter”) closed the pyloric aperture, thereby delaying gastric emptying and causing retention. In other words, whenever the barium-filled stomach showed delayed emptying, or failed to empty within a certain prescribed time (in the absence of an organic lesion), older radiologists were inclined to label the condition “pylorospasm”. This commonly made diagnosis, was usually accepted by clinicians, and probably had an erroneous bearing on the perception of many intra-abdominal conditions. Pylorospasm reflux is a chronic condition.

Definition of REFLUX-a flowing back.

The Role of Cannabinoids in the GI System

Symptoms of GI disorders often include cramping, abdominal pain, inflammation of the lining of the large and/or small intestine, chronic diarrhea, rectal bleeding and weight loss. Although several anecdotal reports and a handful of case reports exist in the scientific literature supporting the use of cannabinoids to treat symptoms of GI disorders, virtually no clinical trial work has been performed in this area, aside from a 2007 clinical study assessing the impact of oral THC on colonic motility.

However, numerous preclinical studies demonstrate that activation of the CB1 and CB2 cannabinoid receptors exert biological functions on the gastrointestinal tract. Effects of t heir activation in animals include suppression of gastrointestinal motility, inhibition of intestinal secretion, reduced acid reflux, and protection from inflammation, as well as the promotion of epithelial wound healing in human tissue. As a result, many experts now believe that cannabinoids and/or modulation of the endogenous cannabinoid system represents a novel therapeutic approach for the treatment of numerous GI disorders .

CANNABIS AND GI DISORDERS

The effectiveness of cannabis for treating symptoms related to gastrointestinal disorders is widely recognized. Its value as an anti-emetic and analgesic has been proven in numerous studies and has been acknowledged by several comprehensive, government-sponsored reviews, including those conducted by the Institute of Medicine (IOM), the U.K. House of Lords Science and Technology Committee, the Australian National Task Force on Cannabis, and others. The IOM concluded, “For patients who suffer simultaneously from severe pain, nausea, and appetite loss, cannabinoid drugs might offer broad-spectrum relief not found in any other single medication.”

The most common gastrointestinal disorders-Irritable Bowel Syndrome and Inflammatory Bowel Disease-affect millions of people. The disorders are different, but each causes a great deal of discomfort and distress and both can be disabling. Painful cramping, chronic diarrhea or constipation, nausea, and inflammation of the intestines are all symptoms of these GI disorders that can be alleviated by cannabis.

Irritable Bowel Syndrome (IBS) is a common disorder of the intestines that leads to stomach pain, gassiness, bloating, constipation, diarrhea or both. Chronic, painful abdominal cramping is common. The cause of IBS is not known, and there is no cure. Researchers have found that the colon muscle of a person with IBS begins to spasm after only mild stimulation. IBS is at least partly a disorder affecting colon motility and sensation.

Inflammatory Bowel Disease (IBD) refers to both Ulcerative Colitis and Crohn’s Disease. Ulcerative colitis causes inflammation of the lining of the large intestine, while Crohn’s disease causes inflammation of the lining and wall of the large and/or small intestine. The causes of IBD are not known, but there are indications that the disease has a genetic component. The immune system changes that accompany IBD suggest that it may be an immune disorder.

The most common symptoms of Crohn’s Disease are pain in the abdomen, diarrhea, and weight loss. There may also be rectal bleeding and fever. The most common complications of Crohn’s Disease are blockage of the intestine and ulceration that breaks through into surrounding tissues. Surgery is sometimes required.

The symptoms of Ulcerative Colitis include diarrhea, abdominal cramps, and rectal bleeding. Some people may be very tired and have weight loss, loss of appetite, abdominal pain, and loss of body fluids and nutrients. Joint pain, liver problems, and redness and swelling of the eyes can also occur. Hospitalization and surgery are sometimes needed.

Research on cannabis and GI disorders

Research suggests that cannabis is effective in treating the symptoms of these GI disorders in part because it interacts with the endogenous cannabinoid receptors in the digestive tract, which can result in calming spasms, assuaging pain, and improving motility. Cannabis has also been shown to have anti-inflammatory properties and recent research has demonstrated that cannabinoids are immune system modulators, either enhancing or suppressing immune response.
Cannabis has a long documented history of use in treating GI distress, going back more than a century in western medicine, and far longer in the east. While clinical studies on the use of cannabis for the treatment of gastrointestinal disorders have been largely limited to investigations on nausea suppression and appetite stimulation—two conditions for which cannabis has been consistently shown to be highly effective—the evidence in support of cannabis therapy for other gastrointestinal diseases and disorders is also strong. There is now extensive anecdotal evidence from patients with IBS, Crohn’s disease and other painful GI disorders that cannabis eases cramping and helps modulate diarrhea, constipation and acid reflux. Recent laboratory research on the endogenous cannabinoid system in humans has identified that there are many cannabinoid receptors located in both the large and small intestines.

Cannabis and new cannabinoid drugs are attractive for GI treatment because they can address a number of symptoms at once with minimal side effects. Cannabinoids alter how the gut feels, affect the signals the brain sends back and forth to the gut and modulate the actions of the GI tract itself.
Beginning in the 1970s, a series of human clinical trials established cannabis’ ability to stimulate food intake and weight gain in healthy volunteers. In a randomized trial, THC significantly improved appetite and nausea in comparison with placebo. There were also trends towards improved mood and weight gain. Unwanted effects were generally mild or moderate in intensity. Cannabis helps combat the painful and often debilitating cramping that accompanies many GI disorders because cannabinoids relax contractions of the smooth muscle of the intestines. In fact, smooth-muscle relaxant properties of cannabinoids are so well established that preparations of guinea-pig intestine are routinely used as an in vitro screening tool to test the potency and function of synthetic cannabinoids.

Research on a variety of rodents has shown that endogenous cannabinoids play crucial neuromodulatory roles in controlling the operation of the gastrointestinal system, with synthetic and natural cannabinoids acting powerfully to control gastrointestinal motility and inflammation. Cannabinoid receptors comprise G-protein coupled receptors that are predominantly in enteric and central neurones (CB1R) and immune cells (CB2R). The digestive tract contains endogenous cannabinoids (anandamide and 2-arachidonylglycerol) and cannabinoid CB1 receptors can be found on myenteric and submucosal nerves. Activating cannabinoid receptors has been demonstrated to inhibit gastrointestinal fluid secretion and inflammation in animal models.

In the last decade, evidence obtained from the use of selective agonists and inverse agonists/antagonists indicates that manipulation of CB1R can have significant results. Research has also shown that in the case of intestinal inflammation, the body will increase the number of cannabinoid receptors in the area in an attempt to regulate the inflammation by processing more cannabinoids.
Cannabinoids have a demonstrated ability to block spinal, peripheral and gastrointestinal mechanisms that promote pain in IBS and related disorders. Animal research also indicates that cannabinoids work well in controlling gastroesophageal reflux disease, a condition in which gastric acids attack the esophagus and for which commonly prescribed medications, such as atropine, have serious adverse side effects.

From this evidence, many researchers have concluded that pharmacological modulation of the endogenous cannabinoid system provides new treatment options for a number of gastrointestinal diseases, including nausea and vomiting, gastric ulcers, irritable bowel syndrome, Crohn’s disease, secretory diarrhea, paralytic ileus and gastroesophageal reflux disease. The experience of patients with these GI disorders shows that for broad-spectrum relief, cannabis is highly effective and frequently helps when other treatment options prove ineffective.

How Cannabis Compares to Other Treatments

The medications currently employed to fight chronic GI disorders include many that produce serious side effects. These side effects frequently threaten the health of the patient and require other medications to combat them. Drugs commonly prescribed to combat GI disorders include:

Megestrol acetate (Megace)

an anticachectic. Serious side effects of this medicine include high blood pressure, diabetes, inflammation of the blood vessels, congestive heart failure, seizures, and pneumonia. Less serious side effects of this medicine include diarrhea, flatulence, nausea, vomiting, constipation, heartburn, dry mouth, increased salivation, and thrush; impotence, decreased libido, urinary frequency, urinary incontinence, urinary tract infection, vaginal bleeding and discharge; disease of the heart, palpitation, chest pain, chest pressure, and edema; pharyngitis, lung disorders, and rapid breathing; insomnia, headache, weakness, numbness, seizures, depression, and abnormal thinking.

Prednisone (Delatasone)

like all steroids, can have serious adverse musculoskeletal, gastrointestinal, dermatologic, neurological, endocrine, and ophthalmic side effects. These include: congestive heart failure in susceptible patients, potassium loss, hypokalemic alkalosis, sodium retention, and hypertension. Muscle weakness, steriod myopathy, loss of muscle mass, osteoporosis, tendon rupture, vertebral compression fractures, aseptic necrosis of femoral and humeral heads, and pathologic fracture of long bones. Peptic ulcer with possible perforation and hemorrhage; pancreatitis; abdominal distention; ulcerative esophagitis. Impaired wound healing, thin fragile skin, petechiae and ecchymoses, facial erythema. Increased intracranial pressure (pseudo-tumor cerebri) usually after treatment, convulsions, vertigo, and headache. Menstrual irregularities; development of Cushingoid state; secondary adrenocortical and pituitary unresponsiveness; decreased carbohydrate tolerance; manifestations of latent diabetes mellitus. Posterior subcapsular cataracts, increased intraocular pressure, glaucoma, and exophthalmos.

Metronidazole (Flagyl)

has been shown to be carcinogenic in mice and rats. Two serious adverse reactions reported in patients treated with Metronidazole have been convulsive seizures and peripheral neuropathy, the latter characterized mainly by numbness or paresthesia of an extremity. The most common adverse reactions reported have been referable to the gastrointestinal tract, particularly nausea reported by about 12% of patients, sometimes accompanied by headache, anorexia, and occasionally vomiting; diarrhea; epigastric distress, and abdominal cramping. Constipation has been reported.

Sulfasalazine (Azulfidine)

The most common adverse reactions associated with sulfasalazine are anorexia, headache, nausea, vomiting, gastric distress, and apparently reversible oligospermia. These occur in about one-third of the patients. Less frequent adverse reactions are pruritus, urticaria, fever, Heinz body anemia, hemolytic anemia and cyanosis, which may occur at a frequency of one in every thirty patients or less.

Chlordiazepoxide/Clidinium (Librax)

Drowsiness, ataxia and confusion have been reported in some patients, particularly the elderly and debilitated. Adverse effects reported with use of Librax are those typical of anticholinergic agents, i.e., dryness of the mouth, blurring of vision, urinary hesitancy and constipation. Withdrawal symptoms, similar in character to those noted with barbiturates and alcohol (convulsions, tremor, abdominal and muscle cramps, vomiting and sweating), have occurred following abrupt discontinuance of chlordiazepoxide.

Hyoscyamine Sulfate (Levsin)

Adverse reactions may include dryness of the mouth; urinary hesitancy and retention; blurred vision; tachycardia; palpitations; mydriasis; cycloplegia; increased ocular tension; loss of taste; headache; nervousness; drowsiness; weakness; dizziness; insomnia; nausea; vomiting; impotence; suppression of lactation; constipation; bloated feeling; allergic reactions or drug idiosyncrasies; urticaria and other dermal manifestations; ataxia; speech disturbance; some degree of mental confusion and/or excitement (especially in elderly persons); and decreased sweating.

Mesalamine CR (Pentasa)

The most common side effects are diarrhea, headache, nausea, abdominal pain, dyspepsia, vomiting, and rash.

Phosphorated carbohydrate (Emetrol)

Side effects include: fainting; swelling of face, arms, and legs; unusual bleeding; vomiting; weight loss; yellow eyes or skin. Less common-more common with large doses: Diarrhea; stomach or abdominal pain.

Dicyclomine (Bentyl)

The most common side effects occurring with dicyclomine are due to its anticholinergic activity: dry mouth, blurred vision, confusion, agitation, increased heart rate, heart palpitations, constipation, difficulty urinating, and occasionally seizures can occur. Other potential side effects include changes in taste perception, difficulty swallowing, headache, nervousness, drowsiness, weakness, dizziness, impotence, flushing, difficulty falling asleep, nausea, vomiting, rash, and a bloated feeling.

Ciprofloxacin (Cipro)

The most frequent side effects include nausea, vomiting, diarrhea, abdominal pain, rash, headache, and restlessness. Rare allergic reactions have been described, such as hives and anaphylaxis.

Methotrexate (Rheumatrex, Trexall)

can cause severe toxicity that is usually related to the dose taken. The most frequent reactions include mouth sores, stomach upset, and low white blood counts. Methotrexate can cause severe toxicity of the liver and bone marrow, which require regular monitoring with blood testing. It can cause headache and drowsiness, which may resolve if the dose is lowered. Methotrexate can cause itching, skin rash, dizziness, and hair loss. A dry, non-productive cough can be a result of a rare lung toxicity.

Diphenoxylate and atropine (Lotomil)

The most common side effects include drowsiness, dizziness, and headache, nausea or vomiting, and dry mouth. Euphoria, depression, lethargy, restlessness, numbness of extremities, loss of appetite, and abdominal pain or discomfort have been reported less frequently. Although the dose of atropine in Lomotil is too low to cause side effects when taken in the recommended doses, side effects of atropine (including dryness of the skin and mucous membranes, increased heart rate, urinary retention, and increased body temperature) have been reported, particularly in children under two. span>

Cannabis

By comparison, the side effects associated with cannabis are typically mild and are classified as “low risk.” Euphoric mood changes are among the most frequent side effects. Cannabinoids can exacerbate schizophrenic psychosis in predisposed persons. Cannabinoids impede cognitive and psychomotor performance, resulting in temporary impairment. Chronic use can lead to the development of tolerance. Tachycardia and hypotension are frequently documented as adverse events in the cardiovascular system. A few cases of myocardial ischemia have been reported in young and previously healthy patients. Inhaling the smoke of cannabis cigarettes induces side effects on the respiratory system. Cannabinoids are contraindicated for patients with a history of cardiac ischemias.

In summary, a low risk profile is evident from the literature available. Serious complications are very rare and are not usually reported during the use of cannabinoids for medical indications.

Is Cannabis Safe?

“The smoking of cannabis, even long term, is not harmful to health. ” So began a 1995 editorial statement of Great Britain’s leading medical journal, The Lancet.
The long history of human use of cannabis also attests to its safety—nearly 5,000 years of documented use without a single death. In the same year as the Lancet editorial, Dr. Lester Grinspoon, a professor emeritus at Harvard Medical School who has published many influential books and articles on medical use of cannabis, had this to say in an article in the Journal of the American Medical Association (1995):
“One of marihuana’s greatest advantages as a medicine is its remarkable safety. It has little effect on major physiological functions. There is no known case of a lethal overdose; on the basis of animal models, the ratio of lethal to effective dose is estimated at 40,000 to 1. By comparison, the ratio is between 3 and 50 to 1 for secobarbital and between 4 and 10 to 1 for ethanol. Marihuana is also far less addictive and far less subject to abuse than many drugs now used as muscle relaxants, hypnotics, and analgesics. The chief legitimate concern is the effect of smoking on the lungs. Cannabis smoke carries even more tars and other particulate matter than tobacco smoke. But the amount smoked is much less, especially in medical use, and once marihuana is an openly recognized medicine, solutions may be found; ultimately a technology for the inhalation of cannabinoid vapors could be developed.” (vaporizer)!!

The technology Dr. Grinspoon imagined in 1995 now exists in the form of “vaporizers,” (which are widely available through stores and by mail-order) and recent research attests to their efficacy and safety. Additionally, pharmaceutical companies have developed sublingual sprays and tablet forms of the drug. Patients and doctors have found other ways to avoid the potential problems associated with smoking, though long-term studies of even the heaviest users in Jamaica, Turkey and the U.S. have not found increased incidence of lung disease or other respiratory problems. As Dr. Grinspoon goes on to say, “the greatest danger in medical use of marihuana is its illegality, which imposes much anxiety and expense on suffering people, forces them to bargain with illicit drug dealers, and exposes them to the threat of criminal prosecution.” This was the same conclusion reached by the House of Lords report, which recommended rescheduling and decriminalization, both of which were enacted in Great Britain in 2004.

Endogenous Cannabinoids (Endocannabinoids)

Endocannabinoids are produced ‘on demand’ from fatty acid precursors and are released into the extracellular space to bind to CBs (Figure 1). The first endocannabinoids investigated in the GI tract were anandamide and 2-arachidonoylglycerol (2-AG) during croton oil-induced intestinal inflammation in mice. Basal levels of 2-AG are higher than those of anandamide in mouse and human gut but despite this difference, anandamide may have more importance in CB signaling than 2-AG owing to its stronger affinity to CB1 and higher activity of its synthetic and degradative enzymes. Anandamide is also known to activate transient receptor potential vanilloid receptor (TRPV)1, the capsaicin receptor, which may be important in the induction of neurogenic inflammation and hypersensitivity in the GI tract.

Cannabis and Gastrointestinal Disorders

Studies indicate that cannabinoids in marijuana bind with cannabinoid receptors in the digestive tract, especially the small and large intestine, causing muscle relaxation, reduction of inflammation, analgesia, increased nerve-muscle coordination, anti-emesis, and relief of spasms

Medical benefits of marijuana for people with gastrointestinal disorders were backed up by the United States Institute of Medicine ( medical marijuana study). According to the Institute, “For patients who suffer simultaneously from severe pain, nausea, and appetite loss, cannabinoid drugs might offer broad-spectrum relief not found in any other single medication.”

Irritable Bowel Syndrome (IBS) can cause pain, bloating, flatulence, cramps, spasms, motility loss, constipation, and diarrhea. Medical cannabis has been a blessing for people with Irritable Bowel Syndrome and Inflammatory Bowel Disease. These diseases cause diarrhea or constipation, nausea, and intestinal inflammation, pain and the inability of the digestive system to absorb nutrients.

Inflammatory Bowel Disease (IBD) is a term that describes Ulcerative Colitis and Crohn’s Disease. Ulcerative colitis inflames the lining of the large intestine. Crohn’s disease causes inflammation of the lining and wall of the large and/or small intestine. The typical symptoms of Crohn’s are diarrhea, weight loss, abdominal pain, rectal bleeding and fever. Crohn’s can cause intestinal blockages and ulcerations that might require surgery. Ulcerative Colitis can cause abdominal cramps, sharp pain, low energy, weight loss, arthritic symptoms, eye problems, and liver disease. These disorders can be crippling. In extreme cases, they may result in long-term hospitalization or surgery. The unique ability of medical cannabis to alleviate most of these symptoms is becoming more widely known in the medical community.

Recreational and medical marijuana users have long known that cannabis has an effect on appetite. The increase in appetite that often accompanies cannabis use has been called “the munchies.”
Scientists studying this phenomenon note that it probably involves blood sugar levels and other physiological markers affected by cannabis. Many professional studies have shown that cannabis stimulates appetite and weight gain. Researchers say that medical cannabis users have to be careful to moderate their intake of carbohydrates and sugars when they are responding to the munchies. It is best to eat less carbos and sugars and eat more organic vegetables, fruits and protein, rather than to pig out on candy or ice cream.

Cannabis helps combat cramping that accompanies many GI disorders because cannabinoids relax contractions of the smooth muscle of the intestines. Research shows that the body’s own cannabinoids, known as anandamides, affect neurological systems that control the gastrointestinal system. External and internal cannabinoids strongly control gastrointestinal motility and inflammation. They also have the ability to decrease gastrointestinal fluid secretion and inflammation. This means that cannabis can be useful to stop ulcers and other syndromes.

The chronic pain and spasms that accompany many gastrointestinal disorders are a life hindrance to those who suffer from IBS and other diseases. Medical cannabis is a very effective pain reliever. It blocks spinal, peripheral and gastrointestinal mechanisms that promote pain in IBS and related disorders. The chronic pain and spasms that accompany many gastrointestinal disorders are a life hindrance to those who suffer from IBS and other diseases. Medical cannabis is a very effective pain reliever. It blocks spinal, peripheral and gastrointestinal mechanisms that promote pain in IBS and related disorders. It also can be used against gastroesophageal reflux disease (acid reflux). When acid reflux occurs, gastric acids attack the esophagus. The pharmaceutical medicines that doctors prescribe for this condition are in some ways as bad as the condition itself. They prescribe drugs like atropine, for example, which have severe side-effects.

The overall opinion of enlightened people in the medical community is that medical cannabis can interact with the endogenous cannabinoid system to reduce problems associated with nausea, vomiting, gastric ulcers, irritable bowel syndrome, Crohn’s disease, secretory diarrhea, paralytic ileus and gastroesophageal reflux disease.

Cannabinoids for gastrointestinal diseases: potential therapeutic applications

Giulia Di Carlo & Angelo A Izzo†

Δ9-Tetrahydrocannabinol (the active ingredient of marijuana), as well as endogenous and synthetic cannabinoids, exert many biological functions by activating two types of cannabinoid receptors, CB1 and CB2 receptors., CB1 receptors have been detected on enteric nerves, and pharmacological effects
of their activation include gastroprotection, reduction of gastric and intestinal motility and reduction of intestinal secretion. The digestive tract also contains endogenous cannabinoids (i.e., the endocannabinoids anandamide and 2-aracidonylglycerol) and mechanisms for endocannabinoid inactivation (i.e.,
endocannabinoids uptake and enzymatic degradation). Cannabinoid receptors, endocannabinoids and the proteins involved in endocannabinoids inactivation are collectively referred as the ‘endogenous cannabinoid system’. A pharmacological modulation of the endogenous cannabinoid system could

provide new therapeutics for the treatment of a number of gastrointestinal diseases, including nausea and vomiting, gastric ulcers, irritable bowel syndrome, Crohn’s disease, secretory diarrhoea, paralytic ileus and gastroesophageal reflux disease. Some cannabinoids are already in use clinically, for example, nabilone and Δ9-tetrahydrocannabinol are used as antiemetics.
These include sedation, cognitive dysfunction, ataxia and immunosuppressant effects, as well as psychotropic effects.
Finally, animal studies suggest that the cannabimimetic substance palmitoylethanolamide (a fatty acid ethanolamide coreleased with anandamide from nerves) possesses antiinflammatory and antimotility actions which are not mediated by cannabinoid receptor activation . These effects open up the possibility that this compound, which, unlike anandamide, has weak psychotropic effects, can be used as a possible therapeutic drug for the treatment of intestinal hypermotility during inflammatory bowel diseases.
Gastrointestinal (or GI) problems can include difficulty taking in food/nourishment (appetite or nausea and vomiting problems), inadequate absorption of nutrients, elimination problems (constipation, diarrhea, irritable bowel) and/or cancer developing anywhere along the GI tract from mouth to esophagus to stomach to the small and large intestines, ending at the anus. Anecdotal experiences are numerous among patients suffering from Crohn’s disease, Ulcerative Colitis, Irritable Bowel Syndrome in their use of medicinal cannabis. The anti-inflammatory and relaxant effects of cannabis may be responsible for some of their relief.

Nausea and vomiting can occur as a result of a variety of conditions such as acute viral illness (the flu), cancer, cancer chemotherapy or side effects from other medications, radiation treatment, post-operative recovery, pregnancy, motion sickness and poisoning. There is clear evidence-based research that supports the anti-emetic effects of cannabis for persons suffering from nausea and vomiting. The 1999 IOM report, Marijuana and Medicine: Assessing the Science Base, agreed that the evidence supported the anti-emetic effects of cannabis, but expressed concern related to smoking the plant material. While inhalation allows for immediate relief, clinicians should be recommending vaporization rather than smoking to eliminate this concern.

Mainz, Germany: Cannabinoids protect the gastrointestinal (GI) tract from inflammation and abnormally high gastric secretions, and could potentially treat numerous GI-related disorders such as Crohn’s disease and irritable bowl syndrome, according to review data published in the Journal of Endocrinological Investigation.

Investigators at Germany’s Johannes Gutenberg University report that activation of the body’s cannabinoid receptors protect the gastrointestinal tract from inflammation and modulate gastric secretions and intestinal motility. “For such protective activities, the endocannabinoid system may represent a new promising therapeutic target against different GI disorders, including inflammatory bowel diseases, functional bowel diseases, and secretion and motility disorders,” they conclude.

Though the use of cannabis to treat symptoms of GI disorders has been reported anecdotally for several decades, virtually no clinical trials on the subject have been conducted. Survey data reported last fall in O’Shaughnessy’s: The Journal of Cannabis in Clinical Practice, found that Crohn’s patients experienced subjective benefits from cannabis, including pain relief and increased appetite. German investigators at the University Hospital in Munich are now assessing the efficacy of cannabis extracts for the treatment of Crohn’s.

Researchers in the United Kingdom also reported last year that cannabinoids promote healing in the gastrointestinal membrane.

Authors Notes

All the research seems to agree that cannabis is an excellent treatment for gastrointestinal difficulties. Cannabis works as a cure for symptoms but also as a treatment ( and cure ) for the disorders themselves.

Pylorospasm Failure of normal relaxation of the pylorus which causes symptoms of pain and vomiting due to gastric outlet obstruction. It may be seen with… ]]>