GERD (gastroesophageal reflux disease) is a chronic problem that happens when the sphincter between the stomach and the esophagus stays open and allows stomach acid to flow backwards. When stomach acid refluxes into the esophagus it can irritate the lining, which causes burning (aka heartburn). As many as 10% of adults have episodes once a day and 44% at least once a month. Other symptoms include hoarseness or nocturnal cough.
Erosion of the lining of the upper gastrointestinal system, the stomach or the duodenum is called an ulcer. Increased stomach acid is associated with the formation of ulcers. With an ulcer, you feel a burning stomach pain (epigastric) that occurs 1-3 hours after eating.
GERD/Ulcer and Cannabis
NOTE FOR FIRST TIME READERS: Cannabinoids – such as THC, CBD – and terpenes are the main medically active components in cannabis (aka marijuana). For more information on these components, and much more about the plant, see our section on the Science of Cannabis.
There is a question as to whether cannabis makes this condition better or worse. Popular belief has it that acid reflux and heartburn are caused by high levels of stomach acid. If this is the case, then there is evidence that cannabis may help. However, some experts suggest that low stomach acid and too much abdominal pressure may actually be the underlying issue. With low stomach acid, it’s possible that cannabis may aggravate the issue. An early study published in the 1970s found that consuming cannabis more than twice a week was associated with low stomach acid. This is potentially good news for those with peptic ulcers, yet the news isn’t so great for those who have the opposite problem. The stomach contains cannabinoid receptors that are part of the endocannabinoid system in all humans, which bind with cannabinoids in marijuana. When this happens, the CB1 receptor tells the stomach to stop producing stomach acid.
As far back as 1978, it was shown that acute and long-term cannabis treatment reduced the rate of gastric ulceration in rats that put under stress using restraints. A review of the gastrointestinal effects of cannabinoids in 2001 states “The digestive tract contains endogenous cannabinoids (anandamide and 2-arachidonylglycerol) and cannabinoid CB1 receptors can be found on myenteric and submucosal nerves. Activation of CB1 receptors inhibits gastrointestinal motility, intestinal secretion and gastric acid secretion.” The study concludes that “The enteric location of CB1 receptors could provide new strategies for the management of gut disorders.
In addition to affecting stomach acid, the muscle relaxant properties of cannabis make it useful for treating GERD. The stomach sphincters become more relaxed thereby reducing reflux. Cannabis can reduce stress and help patients relax, which is also beneficial in the treatment of ulcers. A tincture is a good method of delivery to treat upper digestive disorders because it is absorbed directly into submucosal tissues upon swallowing.
Hornby PJ, Prouty SM. Involvement of cannabinoid receptors in gut motility and visceral perception. Br J Pharmacol. 2004, 141(8): 1335–1345.
Nalin DR, et al. Cannabis, hypochlorhydra, and cholera. The Lancet. 1978, 312(8095): 859-862.