The Sensitive Gut

Understanding IBS

High on a hill; could weed help your IBS?

high on a hill.jpg

A few weeks ago, James offered this pithy piece of advice on The IBS Network’s Facebook page.      

‘Baked cannabis cookies made with organic coconut oil, that will sort it out. It’s good for IBD and IBS, I wouldn’t take a pharma pill again for stomach.’  Research it! It works!

Never one to ignore a challenge, I did just that.

The first recorded mention of cannabis was by the Greek historian Herodotus in the fifth century BC. He wrote that how the cannabis steam baths made the Scythian peoples of Central Eurasia made them shout for joy.  Knowledge of the magical properties of cannabis must have been known much earlier, since it was found, remarkably preserved, in the leather pouches of a Chinese shaman, buried in about 2700 BC.

In recent times, most cannabis is used recreationally to induce relaxation, mild euphoria, introspection and a capacity for philosophical thinking, though its potential for psychosis and association with other harder drugs has made it illegal in many countries.  Nevertheless, it has been estimated that an amazing 147 million people regularly take cannabis and 10 million Kg is produced in America every year.

My own encounters with the weed involved smuggling a cache out of Morocco in 1964, a very giggly Christmas with my brothers in 1969, and as a young doctor, being appointed custodian of the chill-out tent at Glastonbury in 1971.  I knew nothing of its medical properties back then.

Now, thanks to Mr Google and the wonders of Wikipedia, I have discovered that cannabinoids have been used successfully to reduce pain in Multiple Sclerosis and Rheumatoid Arthritis and to treat anxiety,  depression and sleep disorders.  There are also reports that it may be useful for treating ‘disorders of sensitivity’, including fibromyalgia, migraine and IBS,  all poorly explained medical disorders, which can overlap with each other.  A recent report suggests that these conditions may arise because of a deficiency of endogenous cannabinoids. It is only about 20 years since the endocannabinoid system was discovered

Δ9-Tetrahydrocannabinol (the active ingredient of marijuana), as well as endogenous and synthetic cannabinoids, exert many biological functions by activating two types of cannabinoid receptors, CB1 and CB2. CB1 receptors are mainly found in the brain and gut whereas CB2 receptors are largely confined to the immune system.  CB1 activation influences other neurotransmitters, such as serotonin, dopamine and glutamine and affects mood, memory , cognition, movement, coordination, as well as gastroprotection and suppression of intestinal motility and secretion. The brain and gut also contain endogenous cannabinoids including  anandamide (name derived from the Sanskrit meaning ‘bliss’) and 2-aracidonylglycerol and mechanisms for endocannabinoid uptake and enzymatic degradation.  Cannabinoid receptors, endocannabinoids and the proteins involved in endocannabinoid inactivation are collectively referred as the ‘endogenous cannabinoid system’, which could be a potent target for drug development. Some cannabinoids are already in use clinically.  These include Nabilone as an anti-emetic and Sativex for pain.  Rimonabant, a CB1 antagonist, enjoyed a brief exposure as an appetite suppressant for obesity, but was withdrawn because of psychological side effects.  It has been suggested that modulation of this system could provide new drugs for treatment of a number of gastrointestinal diseases, including Irritable Bowel Syndrome, especially if there are ligands that do not cross the blood brain barrier.

But as far as I am aware, there are no new cannabinoids on the horizon for IBS.  This raises the question, how many people are taking cannabis illegally for IBS?

The concern about cannabis involves its recreational use by teenagers, where it may affect brain development and unmask psychosis, but cannabis includes a mix of compounds, some of which protect against side effects.  Recent reports of increases in anxiety among cannabis users may be related to selectively breeding out more protective cannabinoids.   While cannabis use generally has beneficial effects on the gut, there are some reports of some serious side effects, which include excessive vomiting and very rarely, acute pancreatitis. 

A few weeks ago I sat opposite a lady of about my age from West Virginia over breakfast at 22 York Street, the most friendly BnB in London.  She informed me that she relaxed with a spliff every evening when she came back from work.  ‘It calms my brain and also my gut,’ she told me, ‘but it’s illegal in West Virginia and I have to get it ‘under the counter’ from a dealer.  Nevertheless, a recent report from the Illinois Medical Cannabis Advisory Board recommended IBS be a qualifying condition for the Compassionate Use of Medical Cannabis program.

James puts cannabis in cookies.  Is it less potent taken orally?  Does it have more calming effect on the gut?  The answer seems to be that although smoking gives you a hit more quickly, it also wears off quickly.  In contrast, it can take up to two hours before you feel anything after a meal of ganja brownies or pot infused salsa, but the effects can accumulate and last for 6 to 10 hours.

Although cannabis is an interesting substance and the development of safe cannabinoids may well be helpful for people with IBS, The IBS Network cannot endorse the consumption of illegal drugs, no matter how enticing the presentation.

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This entry was posted on August 21, 2016 by in Brain and Gut, drugs, herbs and spices, Research, Treatment and tagged , , .

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