All posts tagged: Gastrointestinal Effects

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The Canadian Association of Gastroenterology Requires Guidance when Recommending Medical Cannabis

April 24, 2020 , , ,

Canadian Association of Gastroenterology position statement- use of cannabis in gastroenterological and hepatic disorders

In summary

The Canadian Association of Gastroenterology has stated that guidance is required on the issues of relevance for gastroenterologists who discuss cannabis benefits and harms with patients. In their statement, they reviewed the current evidence for cannabis use among common gastroenterological and hepatic disorders providing a brief statement and commentary.  Inflammatory bowel disease is not thought to benefit from cannabis use. Alcohol liver disease, nonalcoholic fatty liver disease, and GI symptom control are thought to benefit from cannabis due to the anti-inflammatory and anti-nociceptive effects. Further evidence is needed before the association can fully sign off on the medical use of cannabis for their patients but they acknowledge the potential of cannabis-based medications. 

Despite the fact that cannabis is now legal for medical and recreational use cannabis is not an approved therapeutic substance by Canada’s governing medical body. The legalization for recreational use across the country was recent (2018) and it should be interesting as a country where legalization is varied to watch the research and other policies that come out in the near future. Perhaps the findings of the Canadian government will provide American politicians the evidence they need to support or reject the medical benefits of cannabis.

The study is available for review or download here

Canadian-Association-of-Gastroenterology-Position-Statement-Use-of-Cannabis-in-Gastroenterological-and-Hepatic-DisordersDownload

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Benjamin Caplan, MDThe Canadian Association of Gastroenterology Requires Guidance when Recommending Medical Cannabis
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Cannabinoids Treat Chronic Gastrointestinal Disorders

July 16, 2019 , , , , , , , , , , , , , , , , , , , , , ,

Title: Nabilone administration in refractory chronic diarrhea- a case series

A new study reveals the efficacy of treating chronic gastrointestinal disorders with cannabinoids, such as Nabilone. Researchers followed case studies in which patients were given nabilone which greatly reduced symptoms of chronic diarrhea and weight gain, over a period of three months.

The cannabinoid treatment also reduced the abdominal pain felt by patients and improved their overall quality of life. Considering the favorable safety profile of cannabinoids and the effectiveness demonstrated in the patients, cannabinoids were deemed an appropriate and clinically beneficial method for the treatment of chronic gastrointestinal disorders, such as chronic diarrhea. 

Highlighted by this article are the many symptoms cannabis used to treat before the prohibition of cannabis and the scheduling of the medication under the Controlled Substances Act. Cannabis has been used in eastern medicine, for thousands of years, and used to be a prevalent medication in the late 19th and early 20th centuries, and has just recently been re-recognized as an option to treat anorexia associated with human immunodeficiency virus (HIV), nausea and vomiting due to chemotherapy, and various sleep disorders. Cannabis was once a well-recognized medication, but it has been mercilessly slandered by politicians. The rise and fall of cannabis have largely been politically driven pushes, and the plant and its effects deserve further study to examine the scope and efficacy of its therapeutic benefits. 

View this review (yellow link) or download:

Nabilone administration in refractory chronic diarrhea- a case seriesDownload

This paper is also stored here:     http://bit.ly/2jP1ocV    inside the CED Foundation Archive

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Benjamin Caplan, MDCannabinoids Treat Chronic Gastrointestinal Disorders
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Maintain a Balanced Diet when Consuming Oral Cannabidiol

July 13, 2019 , , , , , , , , , , , , ,

Title: Food effect on pharmacokinetics of cannabidiol oral capsules in adult patients with refractory epilepsy

Researchers have recently revealed the importance of maintaining a balanced diet, when consuming cannabidiol (CBD). Consuming oral capsules containing CBD may be a more consistent method of consumption than blending CBD into liquids or solid foods, but unfortunately, capsules do not prevent a high degree of potential fluctuation of dosing. The fat content of a meal may vary widely, and so may change the active concentrations of CBD which become active in the bloodstream. In other words, the effects felt by a consumer may be either stronger or weaker, and differ in duration, related to the method of consumption, and the product make-up taken. Patients considering CBD as a therapeutic intervention, who also want a consistency of effect, would be wise to be mindful to maintain a diet with a balanced amount of fat (oils, butter, etc.) when consuming CBD capsules. 

This article highlights the variation of effects felt when altering consumption methods. For example, edibles and inhaled cannabinoids of the same dosage have extremely different effects, because of how they are processed in the body processes. When inhaled, tetrahydrocannabinol (THC) diffuses across structures in the lungs known as alveoli, and are then transmitted to circulate throughout the bloodstream. Edibles introduce THC into the system by first metabolizing with liver enzymes, resulting in an altered metabolite of THC circulating throughout the body. This subtly-altered metabolite of THC can be more potent than the starting material, although the onset is delayed due to the process of consumption, digestion, and metabolism. All consumers would do well to research their consumption method of choice and proceed carefully when switching between methods. 

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View this review (yellow link) or download:

Food effect on pharmacokinetics of cannabidiol oral capsules in adult patients with refractory epilepsyDownload

This paper is also stored here:    http://bit.ly/2Ju8KfY     inside the CED Foundation Archive

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Benjamin Caplan, MDMaintain a Balanced Diet when Consuming Oral Cannabidiol
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Standardized Registries may Improve Our Knowledge about Cyclic Vomiting Syndrome

July 13, 2019 , , , , , , , , , , ,

Title: Cyclic vomiting syndrome- Pathophysiology, comorbidities, and future research directions

A recent article has called for the establishment of a multicenter registry in order to learn more about cyclic vomiting syndrome and related disorders. Creating such a registry would provide a database of patients for clinical trial recruitment, research on patient outcomes across different treatment methods, the underlying mechanism for the disorder, and the ability to identify potential biomarkers for the disorder. The registry would expand our understanding of the disorder, on all fronts, and hopefully, reveal the most effective treatment method. 

Could such a registry be created while still safeguarding patient privacy?

Highlighted in this article is the similarity of cyclic vomiting syndrome and cannabinoid hyperemesis syndrome (CHS). CHS is often misdiagnosed or goes undiagnosed for an exorbitant amount of time. By creating this registry for cyclic vomiting syndrome and related disorders, including CHS, the same information about genetics, underlying mechanisms, and effective treatments could also be determined.

Finding a genetic basis for cannabinoid hyperemesis syndrome would support patients looking into cannabis-based medicine to decide if cannabis would even be an effective treatment, by allowing them to discover possible side effects to which they might be more susceptible.

View this review (yellow link) or download:

Cyclic vomiting syndrome: Pathophysiology, comorbidities, and future research directionsDownload

This paper is also stored here:     http://bit.ly/2JtDAFm    inside the CED Foundation Archive

See the full available literature on Cannabinoid Hyperemesis Syndrome here: http://bit.ly/2XHfdrI

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Benjamin Caplan, MDStandardized Registries may Improve Our Knowledge about Cyclic Vomiting Syndrome
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Current Numbers for Cannabis Use Among Pregnant Women in the United State

July 9, 2019 , , , , , , , , , , ,

Self-reported Medical and Nonmedical Cannabis Use Among Pregnant Women in the United States 

An observational study has revealed that the prevalence and frequency of cannabis use in pregnant women have increased over the past two decades.

No trends were seen although except a slight decrease in fetal growth in women who frequently used during the first two trimesters. The data concerning fetal growth, such as length and weight, were not statistically significant and would require further studies to appropriately indicate a correlation between cannabis use and decreased fetal growth.

The authors acknowledge that cannabis use may suffer from recall bias as women may underestimate the amount of cannabis they consumed or purposely withheld some information due to stigma, although some of the surveyed women were using recommended medical cannabis.  

This article highlights the large issue surrounding women consuming cannabis while expecting. Cannabinoids are able to cross the placenta and therefore affect the fetus during development. The American College of Obstetrics and Gynecologists recommend the cessation of any cannabis consumption while pregnant although there has been limited data discussing the actual effects on fetal development. A previously featured article on this blog stated that cannabis use had no effect on birth outcomes but also noted uncertainty in the possible effect on fetal growth. Considering this uncertainty, physicians should push for more research so that women who take medical cannabis can accurately discern whether or not to cease consumption while pregnant. 

View this review (yellow link) or download:

Self-reported Medical and Nonmedical Cannabis Use Among Pregnant Women in the United StatesDownload

This paper is also stored here:    http://bit.ly/2Xoo0mW     inside the CED Foundation Archive

To explore related information, click the keywords below:


Benjamin Caplan, MDCurrent Numbers for Cannabis Use Among Pregnant Women in the United State
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Video: The Endocannabinoid System’s Intriguing Role in Gut Health

June 26, 2019 , , , , , , , , , , , , , , , , , ,

A 2018 literature review summarizes the findings on cannabis and gut health. The endocannabinoid system plays a key role in gut motility, obesity, and inflammatory bowel disease (IBD). Targeting the endocannabinoid system with CBD oil or other cannabinoids seems to reduce colonic inflammation and relieve stress, at a microscopic level, inside the gastrointestinal tract. Watch our video adaptation of the effects of cannabis on IBD:

View this review (yellow link) or download:

The Endocannabinoid System’s Intriguing Role in Gut HealthDownload

This paper is also stored here:    http://bit.ly/2IQCNy1     inside the CED Foundation Archive

To explore related information, click the keywords below:

Benjamin Caplan, MDVideo: The Endocannabinoid System’s Intriguing Role in Gut Health
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