Can CBD help treat GERD, stomach ulcers, IBS or Crohn's disease?

The human digestive system is responsible for the digestion of food and the absorption of nutrients by the body. Starting from the oral cavity, saliva facilitates the formation of a food bite, which is swallowed and through the esophagus goes to the stomach.

Amylases, contained in saliva and digestive juices, pre-digest nutrients, while peristaltic movements cause food (referred to as mush) to move into the small intestine, where 90% of digestion and absorption of minerals and nutrients take place.

Reabsorption of water and various minerals then takes place in the colon of the large intestine, and undigested food residues pass through the rectum to the anus for defecation and are removed in the form of feces.

The human digestive tract can be divided into two sections: upper and lower. The upper gastrointestinal tract consists of the esophagus, stomach and duodenum. The lower gastrointestinal tract is the greater part of the small intestine and the large intestine. Additional organs in the digestive system are also teeth, tongue, salivary glands, pancreas, liver and gallbladder.

They play an important role in the digestive process: rumination and taste (salivary glands), bile salt synthesis, metabolism of adipose tissue and plasma proteins, detoxification (liver), bile storage (gallbladder) and perform intra- and exocrine functions (pancreas).

The digestive tract houses 70-80% of the cells of the immune system.

Gastroesophageal reflux disease (GERD)

Gastroesophageal reflux disease is a chronic condition caused by regurgitation of the lower esophageal sphincter, i.e. the valve that stops acidic gastric contents, duodenal bile and enzymes from retreating into the esophagus. As a result, inflammation is produced, pain occurs and the mucosa of the esophagus is damaged. Clinical endocannabinoid deficiency in this disease is defined as acquired, but it can also be genetic; it has an effect on CB1 receptors in the gastrointestinal tract. Studies show that the administration of phytocannabinoids can increase the circulation of endocannabinoids, lower the tone of the esophageal sphincter and improve tone, thus protecting the mucous membrane of the esophagus; CBD is recommended for both the prevention and treatment of gastroesophageal reflux disease.1, 2

Irritable bowel syndrome or IBS

Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract affecting colon motility and fecal consistency (categorized as diarrheal, constipation or mixed). Irritable bowel syndrome is characterized by abdominal pain that occurs more than three times a month, which pain is reduced after defecation. As discussed earlier, studies have shown that reactive inflammation in the gut improves with the administration of cannabinoids, which appear to act directly on CB2 receptors in the gut and CB1 receptors in the cerebral cortex, which mediate depression and/or anxiety, essential for the appearance of irritable bowel syndrome and leading to the development of the disease. 3

Crohn's disease and CBD

Crohn's disease is an autoimmune inflammatory bowel disease that can affect any section of the digestive tract. Symptoms include stomach pain, diarrhea, blood in the stool, fever and weight loss. Related parenteral manifestations and complications include dermatitis, arthritis (involving the joints and spine), fatigue, inflammation of the eyeball, and impaired liver and pancreatic function. Inflammatory bowel diseases such as Crohn's disease can also occur with other autoimmune diseases. Crohn's disease predisposes to intestinal obstruction and colorectal cancer. Studies indicate that the binding of cannabinoids to CB receptors, in particular through the administration of CBD, facilitates the relaxation of the lower esophageal sphincter and modulation of colon motility. The administration of CBD also leads to an improved interaction of cannabinoids with central and peripheral CB1 receptors, components of the endocannabinoid system that are essential in preventing and combating vomiting and nausea. 4

Stomach ulcers

Gastric ulcer is the presence of cavities in the gastric mucosa. Symptoms of stomach ulcer are abdominal pain and bleeding. Endoscopic examination of the stomach often shows the presence of Helicobacter pylori, i.e. bacteria present in contaminated food and water. In the treatment of H. pylori, triple antibiotic therapy is usually used, which brings different palliative and curative results. The bacterium is indeed one of the main causes of stomach ulcers, but it is drowning the only reason. Stomach ulcers can arise as a result of an abnormal response of CB receptors in the digestive system. Acid-secreting parietal cells, a subpopulation of cells of the gastric mucosa, secrete an abundant amount of CB receptors. Studies show that the administration of cannabinoids can improve CB receptivity and increase the availability of cannabinoids as a result of improving CB receptors (and gastric acid secretion) associated with stomach defects.

1. Russo, E.B. Clinical endocannabinoid deficiency revisited: can this concept explain the therapeutic benefits of cannabis inmigraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions? Neuroendocrinol. Lett. 25, 31–39 (2004).
2. SC, S. & MS, W. Clinical endocannabinoid deficiency revisited: can this concept explain the therapeutic benefits of cannabis
   in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions? Neuroendocrinol. Lett. 35, 198–201 (2014).
3. Di Carlo, G. & Izzo A, A. Cannabinoids for gastrointestinal diseases: potential therapeutic applications. Expert Opin. Investig.
   Drugs 12, 39–49 (2003)
4. Abalo, R., Vera, G., López-Pérez, A. E., Martínez-Villaluenga, M. & Martín-Fontelles, M. I. The gastrointestinal pharmacology
   of cannabinoids: Focus on motility. Pharmacology 90, 1–10 (2012).