Can Cannabis Help Treat Ulcers?
May 18, 2020
Researchers believe cannabis may have the potential to help those suffering from ulcers, but the research is still in very early phases. While direct studies on ulcers and cannabis haven’t been conducted, we know that the endocannabinoid system is involved in the homeostasis of the gut, including factors related to ulcers like inflammation and gastric acid secretion.
Research also shows that cannabis may be able to help those with irritable bowel conditions (which have ulcers as a symptom), reducing symptoms like abdominal pain, cramping, diarrhea, stress, inflammation, weight loss, and poor appetite. Cannabis has been shown to help with nausea in other research, so may offer nausea relief for those with ulcers as well.
Still, some point out that research also shows cannabis can increase inflammation in some conditions, which could be a risk factor for those with ulcers. In addition, cannabis’ ability to reduce pain could mask ongoing inflammation — so patients using cannabis might not seek the medical help needed to treat ulcers appropriately.
How cannabis works on ulcers
When it comes to ulcers, and gut health in general, the endocannabinoid system may also play a role. In fact, research suggests that the endocannabinoid system is key to maintaining homeostasis in the gut, and in particular, can help modulate its inflammatory responses. The endocannabinoid system’s receptors and the endocannabinoids which activate them can be found throughout the GI tract and are involved in a number of its functions such as relaxation of the lower esophageal sphincter, gastric acid secretion, gastric emptying, gastrointestinal motility and fluid secretion.
When the endocannabinoid system is disrupted, however, it can lead to irritable bowel diseases like crohn’s disease and ulcerative colitis — two conditions associated with the development of ulcers.
In these conditions, researchers have noted that levels of the endocannabinoid anandamide were much lower in inflamed areas of the gut, while CB1 receptors (which are activated by anandimide) and enzymes (which break down endocannabinoids) were increased. Given this, some scientists believe that cannabinoids might be able to help reverse this deficiency, reduce inflammation and prevent ulcers.
And there is some reason to believe that stimulating the endocannabinoid system could help with ulcers. For one thing, activating endocannabinoid receptors CB1 or CB2 can reduce intestinal inflammation, one factor in ulcer development, decreasing pain and sensitivity. And research on animals has also shown that anandamide (as well as with other chemicals that activate CB1) can play a protective role against stomach ulcers caused by alcohol, stress, or NSAID’s, actually preventing the formation of ulcers.
Given these factors, scientists believe targeting the endocannabinoid system with the cannabinoids in cannabis could potentially improve conditions for those with ulcers or ulcer related conditions like crohn’s disease or ulcerative colitis.
Research on ulcer/ulcer symptoms and cannabis
While our understanding of the endocannabinoid system suggests cannabis may be able to help with ulcers and their symptoms, it’s important to review the clinical studies before making a firm determination about whether cannabis can help. Unfortunately, there is very little clinical data looking at this question.
What we do have is a few studies looking at how cannabis use impacts irritable bowel diseases — which can include ulcers as a symptom. For these conditions, at least, the research suggests cannabis may help.
For one thing, population-based surveys suggest that many patients are using cannabis for irritable bowel diseases:
- A 2007 survey on 214 patients in Spain with irritable bowel diseases found that nearly 10% of these patients used cannabis.
- A 2011 survey from Canada on 291 patients found that 47% of patients reported using cannabis to manage their condition — reporting benefits like relief of abdominal pain, diarrhea and poor appetite.
- A 2013 survey in the US found that 12.3% of irritable bowel disease sufferers were using cannabis, and 2014 study found that 91% of patients indicated that their symptoms improved with cannabis use — citing benefits like less abdominal pain and cramping, less stress and high levels of well-being. Some 35.7% even reported that cannabis worked better than corticosteroids.
Observational studies also suggest cannabis may help. In one study on patients with crohn’s disease, for example, all 30 patients reported that cannabis use improved their medical well-being, 21 patients saw notable improvement in their crohn’s disease according to objective measures, and 22 were able to discontinue the use of corticosteroids.
In another observational study, 13 patients with irritable bowel disorders were given cannabis for 3 months. Researchers found that cannabis use improved quality of life, and led to increases in patient’s weight, and decreases in disease activity related to crohn’s disease.
In addition to these studies, other research on humans and animals suggests that cannabis can lower the production of gastric acid output. Since too much gastric acid can be a factor in ulcer development, this could mean cannabis can help protect the gut from this damage. Researchers point out that cannabis seems to help avoid ulcers by both reducing acid output and protecting against the effects of acid (as well as alcohol, stress and NSAIDs) by reducing inflammation.
Cannabis is also well known for its ability to relieve nausea. Since this is a common symptom with ulcers, using cannabis may help reduce this factor as well.
Still, much more research on humans with ulcers should be conducted before we can say for sure what impact cannabis has on ulcers. At this point, the research is very limited and there isn’t enough data to say for sure whether cannabis can help to either prevent or treat ulcers and their symptoms.
CBD and ulcers
While there aren’t many studies looking at CBD for ulcers, some researchers have pointed out that CBD, a cannabinoid in cannabis with less disorienting side effects than THC, may also be able to help those who can’t tolerate THC’s effects. Animal research suggests that CBD can also reduce inflammation in the gut, and thus may be able to help with these conditions with less side effects. CBD’s ability to aid in pain and nausea relief may also make it helpful for relieving ulcer symptoms.
Still, until we have more studies looking at how CBD impacts those with ulcers, it is hard to say whether CBD can help.
While cannabis has potential to help with ulcers and their symptoms, it can also come with a variety of side effects — including temporary psychoactive effects like euphoria, mental confusion, paranoia, memory issues and slowed cognitive skills. It can also cause uncomfortable effects like dry mouth and eyes, increased appetite, heart palpitations, and drowsiness. These were usually rated as mild in patients with irritable bowel diseases using cannabis.
For ulcer patients, it’s also important to note that while cannabis usually reduces inflammation, it has shown pro-inflammatory properties in some research as well. In addition, there is a worry from some researchers that cannabis’ pain relieving properties might mask ongoing inflammation — resulting in patients not seeking adequate care for their ulcers.
The Cannigma content is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Always consult with an experienced medical professional with a background in cannabis before beginning treatment.
Ulcers are open sores that can occur almost anywhere on your body, including inside your body where you can’t see them. In the gastrointestinal (GI) tract these ulcers are usually peptic ulcers, which develop inside the lining of your stomach or small intestine.
There are two types of peptic ulcer:
- Gastric ulcers, which occur inside your stomach
- Duodenal ulcers, which occur inside your duodenum (the upper part of the small intestine)
Peptic ulcers can affect both men and women at any age, and even children, but they are more common in adults. Duodenal ulcers affect men more than women, and mostly appear between 30 and 50 years of age, but stomach ulcers affect more women than men, mostly over the age of 60.
It’s hard to be sure how many people have peptic ulcers because almost 75% don’t have symptoms, so many go undiagnosed. It’s thought that 4 million Americans have peptic ulcers each year, and 10% of the population will have one at some point in their lives.
Peptic ulcers are usually caused either by an infection of the Helicobacter pylori (H. pylori) bacterium or by taking aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil and ibuprofen for too long or sometimes even for a short period of time.
Peptic ulcers can be painful, but they are not usually dangerous. They generally heal within a month or two with the right treatment, although they can come back again.
The most common symptom of peptic ulcers is a burning stomach pain. It can last anywhere from a few minutes to several hours, and it might be felt in your stomach, up your throat, in your back, or radiating to your belly button. It’s most often felt when you have an empty stomach or at night.
Other common symptoms include:
- Feeling full and bloated, or belching
- Intolerance of fatty foods
Some less common symptoms include:
- Loss of appetite
- Unexplained weight loss
Finally, these are symptoms of a serious peptic ulcer or of complications from a peptic ulcer. If you have any of these symptoms, you should go to a doctor immediately:
- Vomiting blood, which could look red or black
- Dark blood in the stools, or black, tarry looking stools
- Feeling faint or having difficulty breathing
- Vomiting at all
- A sudden, sharp pain in the stomach that gets steadily worse
On rare occasions, peptic ulcers can cause life-threatening complications, including:
- Internal bleeding, which can cause a fatal loss of blood
- Peritonitis, when the ulcer eats through the lining of your stomach, letting bacteria infect the peritoneum, which is the lining of the abdomen (Peritonitis can quickly cause multiple organ failure if left untreated)
- Gastric outlet obstruction, which occurs when the ulcer blocks food from passing through your digestive system
The H-Pylori bacteria and gastric ulcers have been linked to a higher incidence of stomach cancer.
Your doctor will usually diagnose peptic ulcers through a physical exam and by asking about your symptoms. The doctor might also do these tests:
- A urea breath test, where you drink something containing a chemical that’s broken down by H. pylori, and then breathe into a bag so that your breath can be analyzed for signs of H. pylori infection
- A stool antigen or blood test to check for the presence of H. pylori
- An endoscopy, when a tube with a tiny camera is passed down your esophagus to check your upper digestive tract (during the endoscopy, the doctor might take a biopsy for further examination)
An upper gastrointestinal series, or barium swallow, when you swallow a liquid containing radioactive barium which makes ulcers show up more clearly on an x-ray
Peptic ulcers are caused when the acid that’s naturally present in your stomach eats away at the inside of your stomach or small intestine, creating a painful open sore. There are two main causes for this:
Infection from the H. pylori bacterium
- pylori lives in the mucous layer that protects the tissues of the stomach and small intestine, and usually doesn’t cause any symptoms. Most people don’t know they are infected. But sometimes, the bacterium can irritate the stomach lining and make it more easily affected by stomach acid. It’s not clear how H. pylori spreads, or why some people are more affected by it than others. It also has been associated with higher levels of stomach cancer.
NSAIDs, including ibuprofen, naproxen sodium, ketoprofen, and aspirin can irritate or inflame the stomach lining. The risk increases if you also take steroids, anticoagulants, selective serotonin reuptake inhibitors (SSRIs), alendronate, or risedronate alongside NSAIDs.
Smoking also increases the risk of getting peptic ulcers and can prevent them from healing. There are also factors that don’t cause peptic ulcers, but can make them worse, including:
- Drinking too much alcohol
- Eating spicy foods
With treatment, the vast majority of ulcers heal without significant complications.
Ulcers caused by H. pylori, or by H. pylori and NSAIDs, are best treated with antibiotics for 2-3 weeks and proton pump inhibitors (PPI). If your ulcer was caused by taking NSAIDs, you’ll usually be prescribed PPI such as omeprazole, lansoprazole, rabeprazole, esomeprazole, or pantoprazole. These reduce stomach acid by blocking the action of parts of the cells that produce stomach acid.
Other options to relieve symptoms include:
- Acid blockers, or histamine H-2 blockers, like ranitidine, famotidine, cimetidine, and nizatidine, which reduce the release of stomach acid in your digestive tract
- Antacids, which neutralize stomach acid and relieve the pain of stomach ulcers, but don’t help to heal the ulcer
- You may also be given cytoprotective agents, medications that protect the lining of your stomach and small intestine
After 4-6 weeks, you might have a repeat gastroscopy or endoscopy to check that your ulcer has healed.