The cannabinoids from the Cannabis Sativa plant have developed an increasing interest in relation to their medicinal potential. These compounds have been shown to interact with cannabinoid receptors found throughout our bodies – known as the Endocannabinoid System. This system is thought to modulate a number of important processes including pain perception and inflammation, temperature modulation, and mood control.

Tetrahydrocannabinol (THC) is the most well-recognised, and one of the most researched, of these compounds. Cannabidiol (CBD) is similarly well-researched and does not cause the euphoria associated with THC. Other non-psychogenic cannabinoids are now undergoing increasing investigation to understand any potential medicinal benefit they may have.

In addition to conditions such as chronic pain, epilepsy, and multiple sclerosis, these cannabinoids have also been assessed for their usefulness as medicines in gastrointestinal disorders. A recent review, published in the International Journal of Molecular Science, assessed the results of a number of studies in this area.

Cannabinoids and the Gastrointestinal Tract

The gastrointestinal tract contains cannabinoid receptors, making cannabinoids a promising option for use in treating gastrointestinal disease. Hemp products have been used for centuries for their proposed nutritional and potential health benefits. The evaluation of their effects within a scientific environment is just catching up with their prior use.

Endocannabinoids play a role in gut health through two main mechanisms: gut motility and inflammation. It is through these mechanisms it is proposed that plant-derived cannabinoids may be beneficial in diseases of the gastrointestinal tract.

What Does the Evidence Say?

Irritable Bowel Syndrome (IBS) and Gastrointestinal Motility

When assessing the effects of cannabinoids in gut motility early reports showed that CBD and other non-psychoactive cannabinoids had no significant effect in healthy animals. However, in mice with croton oil-induced intestinal irritation – which occurs in increased intestinal motility, CBD other cannabinoids completely normalised intestinal transit.

Similar reactions were also observed in lipopolysaccharide (LPS)-induced intestinal irritation and hypomotility. These observations support the theory that non-psychogenic cannabinoids could be effective as a treatment option for those affected with abnormal bowel motions as a result of gut dysmotility. However, in-human studies are awaited to support these findings.

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD), such as Crohn’s Disease and Ulcerative Colitis, are multifactorial, immune-mediated group of diseases affecting the gut and other organs. It can cause symptoms such as periods of inflammatory flares, abdominal pain, bleeding from the bottom, diarrhoea, and weight loss.

As individuals often report cannabis use for the relief of symptoms such as abdominal pain, nausea, diarrhoea, and anorexia, cannabinoids potentially represent an interesting area of study for IBD treatment. However, current evidence supporting the efficacy of cannabis in IBD is limited.

Yet, CBD may be considered as a safe adjunctive therapy to other medications in improving abdominal pain and quality of life. The use of cannabinoids in IBD may be justified by their modulatory roles on the gut and their effects on motility and sensation.

Cannabinoids and Inflammation

Additionally, cannabinoids have been shown to have promising anti-inflammatory potential. Although most of the current research assesses the anti-inflammatory properties of CBD and THC, other compounds such as have also shown promising outcomes.

CBD has potent anti-inflammatory potential in intestinal inflammation in mice and rats. Similar results have also been observed in in-vitro studies. In addition, cannabigerol (CBG) and cannabichromene (CBC) have also demonstrated anti-inflammatory activity in animal models of colitis.

These findings support the theory that cannabinoids may have potential for the treatment of underlying inflammation in gastrointestinal conditions. Although the current evidence is promising, randomised controlled trials have yet to demonstrate an improvement in bowel inflammation on endoscopy and therefore their use is only indicated in symptom control refractory to first-line medications.