Medicinal use of cannabis for chronic pain has been reported across a number of conditions. Although not researched as often, cannabis is widely used for abdominal pain and mounting evidence suggests that compounds of the plant may play a therapeutic role.
Abdominal pain
Stomach pain may refer to pain experienced in any one of the organs or muscles within the digestive system, abdominal wall, or abdominal shell. There is a broad range of diagnoses for abdominal cramping and pain and most everyone has experienced one form of it at some point in their lives. As some over the counter pain medications are not recommended for abdominal pain, due to the potential to worsen symptoms, alternative therapy options with lessened side effects are needed.
The ECS and the digestive system
Increasing our understanding of the endocannabinoid system (ECS) helps to define new treatment options for various conditions. Evidence suggests that dysregulation of the ECS may have a role in intestinal disorders including inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). One of the many physiological roles the ECS fulfills is regulation of gastrointestinal function, therefore it is a logical target for the treatment of these conditions. Additionally, endocannabinoids are known to modulate pain through regulation of pain sensation and anti-inflammatory actions, which may further provide symptomatic relief.
Cannabis use and pain
Cannabis use is commonly seen in patients looking for symptomatic relief from conditions associated with abdominal pain; such as IBD, endometriosis, IBS, ulcerative colitis, and gastroparesis. Patients have noted reduced pain coming from bloating, cramping, and inflammation. The most often used cannabinoids from the cannabis plant are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).
Researched findings are revealing that these cannabinoids have a protective effect on the gut, which decreases inflammation and bloating, and further inherently suppress pain receptors serving as a “natural painkiller.”
A 2021 published review looking at completed research on cannabis compounds for IBD found that there is a “great therapeutic potential” in this setting, particularly as potential treatments for abdominal pain and pain-modifying issues like diarrhea and nausea.
Neuropathic pain is often difficult to treat and a symptom of gastroparesis. Due to limited treatment options and the neuromodulating ability of cannabinoids, researchers looked at the effect of prescribed cannabinoids on gastroparesis symptoms in a 2018 published study. Patients were prescribed either cannabis, the cannabis synthetic, Dronabinol, or a combination of both. When analyzed, all methods showed statistically significant improvement in abdominal pain scores.
When observing gut inflammation in biopsies from patients with ulcerative colitis and in rodent models with intestinal inflammation, researchers in 2011 concluded that CBD is a potent compound, able to modulate gut inflammation via the neuro-immune axis.
Terpenes for gut health
In addition to cannabinoids, specific terpenes have shown to have intestinal anti-inflammatory activity as well as block oxidative stress, combat dysbiosis, and restore intestinal permeability.
Among those researched terpenes that are also found in cannabis varieties are:
Alpha-Phellandrene/Phellandrene
This common monoterpene is found in several essential oils for a good reason. It shows extensive biological activity to include anti-inflammatory, anti-cancer, antidepressant, and analgesic properties. Historically used in Chinese medicine for digestive issues, this monoterpene is also found in turmeric and eucalyptus.
Strains of cannabis with phellandrene: Jack Herer and Trainwreck
Borneol
Used in traditional Chinese medicine, Borneol has shown pharmacological activity as an anti-inflammatory, vasorelaxant, and neuroprotectant.
Borneol is considered a secondary terpene in cannabis due to minor amounts, however is found in Sour Diesel, OG Kush, and Amnesia Haze.
Carvacrol
This monoterpene has several pharmacological activities such as antioxidant, antibacterial, anti-inflammatory, cardioprotective, antinociceptive, and gastroprotective. Findings from one study indicated that administration of carvacrol reduced inflammation and oxidative damage in the model studied.
Strains of cannabis with Carvacrol: Gorilla Glue and Chemdawg/Chemdog.
Geraniol
Found in essential oils of aromatic plants, including Cinnamomum tenuipilum and Valeriana officinalis, Geraniol holds antioxidant and anti-inflammatory properties, gastroprotective activity, and gastric healing. Results from a study showed that when administered daily, Geraniol was a powerful antimicrobial agent, able to prevent dysbiosis associated with colitis and reduce the inflammatory profile of colictic animals.
Strains of cannabis with Geraniol: Harlequin, Lemon G, Strawberry Diesel, Tahoe OG, Dutch Hawaiian, Kimbo Kush
Limonene
Limonene is one of nature’s most common terpenes, found in orange, lemon, mandarin, lime, and grapefruit, it can decrease oxidative stress and inflammation, has potential benefits for colon cancer, antibacterial activity, and anti-nausea properties.
Strains of cannabis with Limonene: Dosidos, Gush Mintz, Jet Fuel, Kush Mints, LA Kush Cake, Pink Runtz, Sour Diesel, Strawberry Banana, Wedding Cake
Cannabinoid Hyperemesis Syndrome
Cannabinoid Hyperemesis Syndrome (CHS) is a condition that leads to repeated and severe bouts of vomiting. It seems “paradoxical” that a medicine used as an antiemetic for several conditions could be responsible for vomiting episodes, however the hypothesis stands that an overstimulation of endocannabinoid receptors may be responsible for development of CHS. Over time, the market has seen an increase in the content of THC compared to other cannabinoids and terpenes. This is believed to be a factor in the genesis of CHS because the body builds a tolerance to THC. So, as tolerance increases, the amount of THC consumed increases, and therefore overstimulation of receptors may take place.
If you feel you have taken too much THC, there are options available to you to help remedy the situation. At times a tolerance break may also be beneficial if you feel your current dosage is more than you would like to be consuming.
Finding Support
There is a lot to consider when starting cannabinoid therapy, but, as always, a Realm of Caring care specialist is here to help with free one-on-one support to answer your questions. Contact us today by calling (719) 347-5400 or emailing info@realmofcaring.org.
