Samuel S, Michael M, Tadros M. Should gastroenterologists prescribe cannabis? The highs, the lows and the unknowns. World J Clin Cases 2023; 11(18): 4210-4230 [PMID: 37449231 DOI: 10.12998/wjcc.v11.i18.4210]
Corresponding Author of This Article
Micheal Tadros, MD, Associate Professor, Doctor, Department of Gastroenterology and Hepatology, Albany Medical Center, 43 New Scotland Avenue, Albany, NY 12208, United States. tadrosm1@amc.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 26, 2023; 11(18): 4210-4230 Published online Jun 26, 2023. doi: 10.12998/wjcc.v11.i18.4210
Should gastroenterologists prescribe cannabis? The highs, the lows and the unknowns
Sonia Samuel, Mark Michael, Micheal Tadros
Sonia Samuel, Mark Michael, Department of Internal Medicine, Albany Medical Center, Albany, NY 12208, United States
Micheal Tadros, Department of Gastroenterology and Hepatology, Albany Medical Center, Albany, NY 12208, United States
Author contributions: Samuel S and Michael M wrote the paper; Samuel S, Michael M and Tadros M edited and revised the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Micheal Tadros, MD, Associate Professor, Doctor, Department of Gastroenterology and Hepatology, Albany Medical Center, 43 New Scotland Avenue, Albany, NY 12208, United States. tadrosm1@amc.edu
Received: January 10, 2023 Peer-review started: January 10, 2023 First decision: March 26, 2023 Revised: March 31, 2023 Accepted: April 14, 2023 Article in press: April 14, 2023 Published online: June 26, 2023
Abstract
Cannabis, commonly known as marijuana, is a drug extracted from the Cannabis plant known for its psychotropic and medicinal properties. It has been used for healing purposes during ancient times, although its psychoactive components led to its restricted use in medicine. Nonetheless, cannabis is found to have modulatory effects on the endocannabinoid system exhibiting its medicinal role in the gastrointestinal (GI) system. Emerging animal and human studies demonstrate the influential effects of cannabis on a variety of GI diseases including inflammatory bowel disease, motility disorders and GI malignancies. It also has a regulatory role in GI symptoms including nausea and vomiting, anorexia, weight gain, abdominal pain, among others. However, both its acute and chronic use can lead to undesirable side effects such as dependency and addiction, cognitive impairment and cannabinoid hyperemesis syndrome. We will discuss the role of cannabis in the GI system as well as dosing strategies to help guide gastroenterologists to assess its efficacy and provide patient counseling before prescription of medical marijuana.
Core Tip: Cannabis is becoming increasingly popular in the management of a variety of gastrointestinal disorders due to its active role in the endocannabinoid system. It provides anti-inflammatory, anti-emetic and analgesic effects indicating its potential use in treatment and symptom control. There is rising evidence on the therapeutic efficacy and short-term safety profile of cannabis but its long term safety profile remains to be explored. Before gastroenterologists consider prescribing medical marijuana, gaining understanding of the benefits and associated risks and having an open and individualized discussion with patients are essential.
