In this review, we discuss the role of cannabis and cannabinoid signaling in visceral pain perception, what is currently known regarding the efficacy of cannabis and its derivatives for managing pain, related symptoms and inflammation in IBD, and what work remains to effectively utilize cannabis and its derivatives in the clinical setting.
Developing a clear scientific understanding of the impact of Cannabis in the setting of IBD has been challenging, however.
Thus, while it is not clear that Cannabis helps IBD-associated inflammation, mounting evidence suggests that Cannabis may be an effective analgesic option for IBD-associated abdominal pain and many patients are already using for this purpose.
The purpose of this review is to highlight recent developments relating to the use of Cannabis and its derivatives for the management of IBD and the abdominal pain associated with these conditions.
The ECS encompasses structures and physiological processes within the body that mediate the effects of cannabinoids.
Additionally, there are nonselective inhibitors, such as JZL195 that antagonize both FAAH and MGL, leading to an overall increase in ECS activity.
Functionally, both CB1R and CB2R are involved in the physiologic control of the GI tract.
As previously described, CB1R and CB2R are expressed on peripheral and central structures which influence sensory function, including extrinsic primary afferent neurons innervating the gut .
Cannabis and many of its derivatives have been associated with a wide array of positive and negative psychiatric effects, many of which can influence abdominal pain perception.
Thus, Cannabis-mediated effects on GI motility could be an important influence on abdominal pain experience of these individuals.
In the clinical setting, there is evidence that cannabinoids can be helpful for acute reduction of nausea associated with a variety of conditions .
Providers need to keep in mind several significant issues when cannabinoids are utilized or are being considered for use in a clinical setting.
Cannabis consumption has been associated with decreased motivation and reaction time, as well as alterations in executive function .
While Cannabis holds significant potential promise in a variety of clinical applications, we clearly need to learn much more about it and its components in order to determine their true efficacy and safety in each setting.
As we have reviewed here, a wide variety and number of animal and human studies have demonstrated not only the positive impact that cannabinoids can have in this context but also the multitude of pathways these agents may work through to induce their analgesic effects.
It is clear that further study is required in order to determine the true potential of Cannabis and its components to manage IBD and its symptoms. Future research considerations should focus more specifically on derivatives of Cannabis and elements of the endocannabinoid signaling system, with the goal of developing and testing therapies that minimize psychotropic side effects, while optimizing analgesia.
developed the primary concept behind this manuscript, performed a comprehensive literature review, and helped to write and review the manuscript.