The Red Section | Published:

Medical Marijuana for Digestive Disorders: High Time to Prescribe?

The American Journal of Gastroenterology volume 110, pages 208214 (2015) | Download Citation

Abstract

The use of recreational and medical marijuana is increasingly accepted by the general public in the United States. Along with growing interest in marijuana use has come an understanding of marijuana’s effects on normal physiology and disease, primarily through elucidation of the human endocannabinoid system. Scientific inquiry into this system has indicated potential roles for marijuana in the modulation of gastrointestinal symptoms and disease. Some patients with gastrointestinal disorders already turn to marijuana for symptomatic relief, often without a clear understanding of the risks and benefits of marijuana for their condition. Unfortunately, that lack of understanding is shared by health-care providers. Marijuana’s federal legal status as a Schedule I controlled substance has limited clinical investigation of its effects. There are also potential legal ramifications for physicians who provide recommendations for marijuana for their patients. Despite these constraints, as an increasing number of patients consider marijuana as a potential therapy for their digestive disorders, health-care providers will be asked to discuss the issues surrounding medical marijuana with their patients.

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Acknowledgements

Chris Puckett (Associate Counsel, University of Colorado Hospital) provided voluntary input on legal issues surrounding marijuana recommendations.

Author information

Author notes

    • Mark E Gerich
    •  & Robert W Isfort

    The first two authors contributed equally to this work

Affiliations

  1. Division of Gastroenterology and Hepatology, University of Colorado, Aurora, Colorado, USA

    • Mark E Gerich
    •  & Robert W Isfort
  2. Department of Medicine, University of Colorado, Aurora, Colorado, USA

    • Bryan Brimhall
  3. Inflammatory Bowel Disease Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA

    • Corey A Siegel

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Competing interests

Guarantor of the article: Mark E. Gerich, MD.

Specific author contributions: Mark E. Gerich: paper concept, literature review, writing, and proofreading/revision; Robert W. Isfort: literature review, writing, proofreading, and table design; Bryan Brimhall: literature review, graphics design, and writing; Corey A. Siegel: paper concept and proofreading/revision.

Financial support: None.

Potential competing interests: None.

Corresponding author

Correspondence to Mark E Gerich.

Supplementary information

Appendices

Appendix

A systematic literature review was undertaken using the MEDLINE/PubMed database to identify randomized controlled clinical trials involving marijuana and gastrointestinal conditions. This was undertaken utilizing the search phrase: “cannabis OR marijuana OR tetrahydrocannabinol OR cannabidiol OR THC OR cannabinoid OR dronabinol OR nabilone OR nabiximols AND _____.” Results were filtered for human studies and clinical trials and were hand-reviewed for relevance. The final search term was variable and included the following: esophagus, stomach, pancreas, gallbladder, biliary, liver, small intestine, colon, large intestine, rectum, anus, cancer, esophageal cancer (adenocarcinoma), stomach cancer (adenocarcinoma), carcinoid, liver cancer, hepatocellular carcinoma, hepatoma, pancreatic cancer (adenocarcinoma), neuroendocrine tumor, cholangiocarcinoma, gallbladder cancer, colon cancer (adenocarcinoma), rectal cancer (adenocarcinoma), anal cancer, polyp, polyposis, esophagitis, gastritis, ulcer, peptic ulcer disease, gastroesophageal reflux disease, heartburn, gastroesophageal reflux disease, pancreatitis, enteritis, colitis, cholecystitis, cholangitis, proctitis, inflammatory bowel disease, Crohn’s disease, ulcerative colitis, regional enteritis, ulcerative proctitis, eosinophilic esophagitis, celiac disease, microscopic colitis, hepatitis, cirrhosis, cholelithiais, gastroparesis, motility, gastric emptying, irritable bowel syndrome, dysphagia, odynophagia, dyspepsia, pyrosis, abdominal pain, nausea, vomiting, early satiety, diarrhea, constipation, ileus, weight, cachexia, anorexia, bulimia, and nutrition.

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DOI

https://doi.org/10.1038/ajg.2014.245

SUPPLEMENTARY MATERIAL is linked to the online version of the paper at http://www.nature.com/ajg

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