Irritable Bowel Syndrome

Irritable Bowel Syndrome and Cannabinoids

Although the use of cannabinoids as antiemetics (anti-nausea) is well-established, with Dronabinol available to stimulate appetite and counter effects of cancer chemotherapy, the effect of cannabinoids on disorders of the gut has not been extensively studied. However the current state of knowledge of the biochemistry of cannabinoids is increasing at an exponential rate and, with discoveries of cannabinoid receptors in unexpected areas of the body, new potential research/treatment avenues are appearing at an increasing rate.

Grinspoon reports anecdotal use of cannabis to control bowel movements in multiple sclerosis, and relief from the symptoms of Crohn”s disease. Mikuriya records irritable bowel syndrome, as well as other inflammatory gastrointestinal conditions (principally among AIDS patients), as one of a wide variety of conditions for which cannabis has been prescribed or recommended for therapeutic use in California. There are no clinical trials currently published, and consequently use for the treatment of irritable bowel syndrome would represent at best an experimental therapy.

However, there does appear to be some scientific support for any claimed therapeutic benefits from the research literature concerning the actions and metabolism of cannabinoids and cannabinoid receptors. The wall of the intestine is composed of a type of muscle known as “smooth muscle”, also found lining the walls of arteries and in other involuntary functions.

Rosell et al first demonstrated that cannabinoids inhibit contractions of the small intestine in the rat. Pertwee et al established the presence of cannabinoid (CB1) receptors within the guinea-pig intestine and Kazuhisa et al established the presence of enzymes break down anandamide (the endogenous cannabinoid CB1-agonist) within the small intestine. The 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 novel cannabinoids.

Shook & Burks found that THC reduced the frequency of intestinal contractions, and reduced the flow of food in the small intestine, without altering basal tone, and concluded that
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