- Fecal Incontinence
|Role of cannabis in inflammatory bowel diseases
Perisetti A1, Rimu AH2, Khan SA3, Bansal P4, Goyal H5. Ann Gastroenterol. 2020 Mar-Apr;33(2):134-144. doi: 10.20524/aog.2020.0452. Epub 2020 Feb 12.
1 Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences (Abhilash Perisetti).
2 Department of Nutritional Sciences, Texas Tech University, Lubbock, TX (Afrina Hossain Rimu).
3 University of Arkansas for Medical Sciences, AR (Salman Ali Khan).
4 Department of Gastroenterology, Regional Hospital and Moses Taylor Hospital, PA (Pardeep Bansal).
5 Department of Medicine, The Wright Center for Graduate Medical Education (Hemant Goyal), USA.
For many centuries, cannabis (marijuana) has been used for both recreational and medicinal purposes. Currently, there are about 192 million cannabis users worldwide, constituting approximately 3.9% of the global population. Cannabis comprises more than 70 aromatic hydrocarbon compounds known as cannabinoids. Endogenous circulating cannabinoids, or endocannabinoids, such as anandamide and 2-arachidonoyl-glycerol, their metabolizing enzymes (fatty acid amide hydrolase and monoacylglycerol lipase) and 2 G-protein coupled cannabinoid receptors, CB1 and CB2, together represent the endocannabinoid system and are present throughout the human body. In the gastrointestinal (GI) tract, the activated endocannabinoid system reduces gut motility, intestinal secretion and epithelial permeability, and induces inflammatory leukocyte recruitment and immune modulation through the cannabinoid receptors present in the enteric nervous and immune systems. Because of the effects of cannabinoids on the GI tract, attempts have been made to investigate their medicinal properties, particularly for GI disorders such as pancreatitis, hepatitis, and inflammatory bowel diseases (IBD). The effects of cannabis on IBD have been elucidated in several small observational and placebo-controlled studies, but with varied results. The small sample size and short follow-up duration in these studies make it difficult to show the clear benefits of cannabis in IBD. However, cannabis is now being considered as a potential drug for inflammatory GI conditions, particularly IBD, because of its spreading legalization in the United States and other countries and the growing trend in its use. More high-quality controlled studies are warranted to elucidate the mechanism and benefits of cannabis use as a possible option in IBD management.