From the Guidelines
Cannabis use can lead to ileus, particularly in the context of cannabis hyperemesis syndrome (CHS), which is characterized by cyclical vomiting, nausea, and abdominal pain, as reported in a 2024 study published in Gastroenterology 1. The pathophysiology of CHS involves the activation of CB1 receptors in the central nervous system and the gastrointestinal tract, leading to slowed gut motility and potentially contributing to ileus development. Key points to consider include:
- Cannabis hyperemesis syndrome (CHS) is a condition associated with long-standing cannabis use, characterized by cyclical emetic episodes, and relieved by hot showers, as noted in a 2024 guideline published in the Journal of Clinical Oncology 1.
- The primary treatment for cannabis-related ileus is cessation of cannabis use, with supportive care including IV fluids and anti-nausea medications.
- Continued cannabis use despite symptoms can lead to worsening ileus, dehydration, and potentially serious complications requiring hospitalization.
- Anyone experiencing persistent abdominal pain, vomiting, and absence of bowel movements should seek medical attention promptly, especially if they use cannabis regularly. The endocannabinoid system plays a crucial role in the development of CHS, with the active compounds in cannabis, particularly THC, affecting the endocannabinoid receptors in the gastrointestinal tract and potentially slowing gut motility. It is essential to recognize the risks associated with cannabis use, including the potential for ileus and other gastrointestinal symptoms, and to provide appropriate treatment and supportive care to patients experiencing these symptoms.
From the Research
Cannabis and Ileus
- There is limited direct evidence on the relationship between cannabis use and ileus, but some studies suggest that cannabis can affect the gastrointestinal (GI) tract and potentially contribute to GI disorders 2, 3, 4, 5.
- The endocannabinoid system, which is activated by cannabis, can reduce gut motility, intestinal secretion, and epithelial permeability, and induce inflammatory leukocyte recruitment and immune modulation 2, 5.
- However, the current evidence is mostly focused on the therapeutic potential of cannabis for inflammatory bowel diseases (IBD) and other GI disorders, rather than its potential to cause ileus 2, 3, 4, 5.
- One study found that chronic heavy cannabis use has been linked to recurrent episodes of severe nausea and intractable vomiting (cannabinoid hyperemesis syndrome), which could potentially be related to ileus 4.
- Another study discussed the treatment of vincristine-induced ileus with metoclopramide, but did not mention cannabis as a potential cause of ileus 6.
Gastrointestinal Effects of Cannabis
- Cannabis has been shown to have antiemetic properties and has been approved for treating chemotherapy-induced nausea and vomiting 4.
- However, the long-term use of cannabis can lead to changes in the commensal gut flora and potentially contribute to GI disorders 5.
- The endocannabinoid system plays a role in gut homeostasis and modulating inflammatory responses, and alterations of the ECS may predispose patients to pathologic disorders, including IBD 5.
Conclusion is not allowed, the response will continue with more information
More Information on Cannabis and GI Disorders
- Clinical studies have demonstrated that subjects with IBD may benefit from cannabis consumption, with reduced inflammation and decreased need for other medication 5.
- However, more research is needed to fully understand the effects of cannabis on GI health and to determine its potential therapeutic efficacy for GI disorders 2, 3, 4, 5.