Gastroparesis is a disease caused by damage to the vagus nerve, which is responsible for tightening the stomach muscles to push food through the digestive system. When this nerve is damaged, the stomach is unable to empty itself properly, which can cause undigested food to ferment. This can cause symptoms of heartburn, nausea, weight loss, dehydration, and poor blood sugar control. In extreme cases, food can harden into solid masses that can block the intestines.
Traditional medicine has struggled to treat this condition effectively, and over 10 percent of patients suffering from gastroparesis report being disabled by their condition and unable to work. Hospitalizations for this disease have increased by more than 300 percent between 1997 and 2013, and gastroparetics are often hospitalized longer than patients suffering from other gastrointestinal conditions.
A team of gastroenterologists from across the US decided to investigate whether cannabinoids could treat this condition more effectively than traditional medications. The new study, published in the Cureus journal, notes that “gastroparesis is a neuromuscular disorder and neuropathy plays a large role in its pathogenesis.” Noting that prior research has found cannabinoids to effectively treat both neuropathy and gastrointestinal conditions, the researchers hypothesized that cannabinoids could help treat this challenging disease.
Researchers recruited 24 patients with gastroparesis from one gastroenterology practice and asked them to fill out a standard questionnaire evaluating their symptoms and pain levels. Patients were then asked to use medical marijuana for 60 days, after which they filled out the form again. Some patients were asked to use medical cannabis purchased from licensed New York dispensaries, which was either vaped or taken as sublingual drops. Other patients used 2mg to 10mg of dronabinol, a synthetic cannabinoid, two to four times daily.
Researchers found that “cannabinoids dramatically improve refractory gastroparesis symptoms, including abdominal pain.” Before the treatment, patients self-reported an abdominal pain score of 3.97 on a scale of one to five. After taking medical cannabis, the average score dropped to 2.34, a significant improvement. When comparing natural cannabis with its synthetic counterpart, researchers found that “marijuana was superior to dronabinol in improving all symptoms, with statistical significance seen in the abdominal pain score and the total symptom composite score.”
“Cannabinoids represent a new treatment in this difficult-to-treat, burdensome condition with minimal data-supported treatment options,” the researchers concluded. “We demonstrated that cannabinoids dramatically, and significantly, improve all symptoms of gastroparesis. Furthermore, abdominal pain was significantly improved with cannabinoids. This role in pain management represents a breakthrough for gastroparesis-associated abdominal pain treatment, for which there are currently no validated therapies.”
This study has a number of limitations, particularly the small subject size and the fact that all subjects were treated at one specific institution. The researchers also note that the subjects who used medical cannabis acquired different products at different dispensaries, which made it impossible to control the ratio of CBD to THC that each subject was consuming.
To overcome these limitations, the researchers recommend that “further studies should be conducted to confirm the efficacy of cannabinoids in refractory gastroparesis, and focus should be applied to optimal THC:CBD dosing, long-term efficacy, and sustainability of symptom improvement, as well as the side-effects of chronic cannabinoid use.”