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Experts clash over cannabis's role in GI care at ACG meeting. At the ACG Annual Scientific Meeting, two gastroenterology experts debated whether cannabis is a "friend" or "foe" for patients with GI disorders. While it may ease pain and nausea through the endocannabinoid system, chronic use carries real risks — including the debilitating cannabis hyperemesis syndrome (CHS).
Cannabis use among patients with GI disorders is on the rise — and so is the debate over whether clinicians should embrace or caution against it. At the ACG Annual Scientific Meeting in Nashville, two experts squared off on the topic, each making a compelling case.
In the "friend" corner, Dr. David Levinthal of UPMC argued that cannabinoids act on receptors throughout the brain-gut axis, helping reduce colonic motility, ease visceral pain, curb nausea, and stimulate appetite. He pointed to the prescription cannabinoid dronabinol as a legitimate tool for patients who haven't responded to standard therapies, and noted that cannabis hyperemesis syndrome (CHS), while real, affects only a small fraction of users and is treatable.
In the "foe" corner, Dr. Thangam Venkatesan of Ohio State countered that chronic daily cannabis use downregulates the body's own endocannabinoid receptors — with some brain changes potentially persisting even after abstinence. She also flagged a wide range of side effects, from anxiety and psychosis to cannabis use disorder.
Key Takeaways:
Why it matters: With cannabis use growing across all age groups, GI clinicians need a clear-eyed view of both its therapeutic potential and its risks — especially as product potency climbs and CHS cases become more formally documented.
