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The Endocannabinoid System Behaves Differently with Gastrointestinal Disease

Medical content reviewed by Dr. Joseph Rosado, MD, M.B.A, Chief Medical Officer

In many states, people with gastrointestinal (GI) conditions like ulcerative colitisCrohn’s disease, and colorectal cancer qualify for medical marijuana access. These patients often find relief from symptoms like chronic abdominal pain with medical marijuana. 

Previous research has shown that three components of cannabis—CBD, cannabigerol (CBG), and beta-caryophyllene—can help reduce inflammation in the GI tract by interacting with the body’s endocannabinoid system (ECS). However, the exact ways the ECS works when it comes to gut inflammation in humans isn’t entirely clear. One theory is that the ECS “turns on,” or engages more actively in the presence of inflammation in order to bring the gut back to homeostasis. 

An Austrian study from 2019 compared people with GI diseases to a control group to find out how the ECS responds in the presence of bowel inflammation. We already know that the ECS has a large role to play in the gut by helping regulate appetite and immunity, and by reducing intestinal permeability—also known as “leaky gut.” The new study teased out more detail on interactions between the ECS and GI conditions, finding significant differences in markers of ECS activity between those with GI conditions and the control groups. 

Researchers also found that the parts of the ECS in the gut that respond to inflammation do so differently depending on the condition. For instance, ulcerative colitis and Crohn’s disease are both types of inflammatory bowel disease (IBD) that share certain common markers of ECS activity in the gut—but they differ in others. Colorectal cancer, too, shares some of the characteristics of ECS activity with the two types of IBD, but shows its own set of reactions, too. 

This finding is significant for medical marijuana researchers seeking targeted therapies for people with GI diseases. The bottom line here is that one type of cannabinoid therapy will not necessarily fit all kinds of bowel disease; more research is needed to determine the best course of treatment for each one.