Medical and recreational cannabis use has increased dramatically over the last decade,
resulting from mainstream cultural acceptance and legalization in several countries
worldwide. Cannabis and its derivatives affect many gastrointestinal processes via
the endocannabinoid system (ECS). The ECS influences gastrointestinal homeostasis
through anti-inflammatory, anti-nociceptive, and anti-secretory effects. Some gastrointestinal
disorders might therefore be treated with cannabinoids. Despite numerous studies in
cell lines and animals, few human studies have evaluated the therapeutic effects of
cannabinoids. Cannabis’ schedule 1 drug status has limited its availability in research;
cannabis has been legalized only recently, in some states, for medicinal and/or recreational
use. Cannabinoids can alleviate chemotherapy-induced nausea and emesis and chronic
pain. Studies have demonstrated the important roles of the ECS in metabolism, obesity,
and nonalcoholic fatty liver disease and the anti-inflammatory effects of cannabis
have been investigated in patients with inflammatory bowel diseases. Despite its potential
benefits, undesired or even detrimental effects of cannabis can limit its use. Side
effects such as cannabinoid hyperemesis syndrome affect some users. We review the
ECS and the effects of cannabis and its derivatives on gastrointestinal and hepatic
function in health and disease.
Keywords
Abbreviations used in this paper:
AP (acute pancreatitis), CBD (cannabidiol), CDAI (Crohn’s Disease Activity Index), CHS (cannabinoid hyperemesis syndrome), CI (confidence interval), CNR1 (cannabinoid receptor 1), CNS (central nervous system), CP (chronic pancreatitis), CVS (cyclical vomiting syndrome), ECS (endocannabinoid system), FAAH (fatty acid amide hydrolyase), GE (gastric emptying), GERD (gastroesophageal reflux disease), IBD (inflammatory bowel disease), IBS (irritable bowel syndrome), IBS-D (irritable bowel syndrome with diarrhea), IL (interleukin), LES (lower esophageal sphincter), LPS (lipopolysaccharide), NAFLD (nonalcoholic fatty liver disease), STC (slow transit constipation), THC (Δ9-tetrahydrocannabinol), WAT (white adipose tissue)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: April 22, 2020
Accepted:
March 29,
2020
Received:
August 8,
2019
Footnotes
Conflicts of interest The authors disclose no conflicts.
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