From the Desk of Adam Abodeely, MD MBA FACS FASCR
In 2010, I was approached by my first patient asking my professional opinion regarding the use of cannabis as they were undergoing chemotherapy. This experience began my journey into realizing the benefits of cannabis for patients with not just cancer, but also for a variety of gastrointestinal ailments. Over the years, I have gained an appreciation for cannabis as a therapeutic option as an alternative to conventional western medicines and how it can be effectively incorporated into a holistic wellness lifestyle. I have been inspired to educate on ways cannabis can be responsibly consumed through presentations, educational seminars, along with authoring a variety of publications including a book titled “A Surgeon’s Perspective on the Science and Truth of Cannabis”.
In early 2023 I joined Cannim as the Medical Director for North America. I am proud and excited to be assisting in the launch of Lumir Mission which we expect to answer some of the most challenging questions surrounding the ways to use cannabis most effectively for medical conditions. The team assembled at Cannim possess the skill set, passion, commitment, and moral compass required to succeed in such a challenging and controversial market. Through research, real world experience, and technology, Cannim is well-positioned to help society answer numerous unanswered questions surrounding the medical use of cannabis.
As a gastrointestinal and cancer surgeon, I have developed a breadth of knowledge and experience in treating patients with a variety of conditions affecting the gastrointestinal system with cannabis. Here I present some of the more common indications and clinic applications of medical cannabis for gastrointestinal conditions.
Nausea and vomiting are some of the oldest documented indications for cannabinoid medicine. As a result, in 1985 the FDA approved dronabinol (Marinol) for the treatment of chemotherapy induced nausea and vomiting (CINV). This medication is a form of synthetic THC, and with the increased legalization of medical cannabis has been falling out of favor. Patients largely prefer the variety of delivery methods and preparations, along with reported increased efficacy which whole cannabis products can provide. In addition to CINV, cannabis is used by patients to treat nausea from a variety of causes including gastroparesis, cancer, gallbladder disease, and can also be used as a general appetite stimulant.
Diarrhea is a result of numerous factors including infection, functional bowel disorders, autoimmune conditions, and inflammation. Irritable Bowel Syndrome (IBS) is broadly classified in three categories: 1) Diarrhea predominant (IBS-D), 2) Constipation predominant (IBS-C), and 3) Mixed variety (IBS-M). Patients with IBS-D appear to benefit the most with cannabis being used to help alleviate diarrhea and the associated cramping. Patients with a variety of diarrheal conditions report decreased bowel movements and pain along with improvements in overall quality of life. This is likely due to the ability that THC has on slowing motility of the gastrointestinal tract. Cannabis might also decrease diarrhea by decreasing inflammation, regulating exocrine hormone release, and possibly enhancing the complex interaction which exists between our endocannabinoid system and the bacteria which make up our intestinal microbiome.
Abdominal cramping, pain, bloating, and diarrhea are all hallmarks of intestinal inflammation and can be caused by infections, lack of blood flow, or autoimmune conditions. Conditions such as Crohn’s disease and ulcerative colitis are forms of inflammatory bowel disease (IBD) which in addition to intestinal symptoms, can also lead to a variety of other complications. Given the ability of cannabis to decrease symptoms of diarrhea, abdominal pain, and nausea, while increasing appetite has made it a versatile medicine for these purposes. Additionally, cannabinoids might be assisting symptoms by directly decreasing inflammation.
- Chronic abdominal pain
Pain remains the most reported indication for medical cannabis consumption. Pain can be broadly categorized into 1) cancer related and 2) pain related to conditions other than cancer. Besides cancer related pain, gastrointestinal conditions are commonly associated with a variety, and chronic pain syndromes. Patients with chronic abdominal pain from IBS, IBD, chronic pancreatitis, endometriosis, and fibromyalgia frequently report using cannabis to alleviate symptoms.
Whether from terminal cancer, or diseases affecting the gastrointestinal system, some conditions simply defy our ability as physicians to provide an effective treatment or cure. When Western modern pharmaceuticals and medical technology fail, cannabis remains a viable option (even critics have difficulty denying this). Cannabis can provide relief of many symptoms associated with terminal conditions. Much remains unknown about cannabis’ ability to truly affect the course of a particular disease. Despite this, a consistent finding in the literature emphasizes improved quality-of-life scores when cannabis is used regardless of whether treating malignant or non-cancer conditions.
In summary, a great deal remains unknown on ways to best optimize cannabis use for medical conditions while also minimizing unwanted side effects. Despite this, ancient history has documented its use for a variety of gastrointestinal conditions and to this day cannabis continues to show promise as a therapeutic agent. We are merely at the beginning of our ability to fully utilize cannabinoids and manipulate the endocannabinoid system in beneficial ways that not only improve disease outcomes, but also improve overall health and wellness.
Medical Director of both Coral Cove Wellness In Jamaica and Lumir Clinic here in the USA. We are in the early stages of planning our experiential medical cannabis retreats for health professionals and look forward to being able to offer these in 2024
A SURGEON’S PERSPECTIVE ON THE SCIENCE & TRUTH OF CANNABIS
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