Issue: January 2020

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December 02, 2019
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Marijuana Use Linked With Decreased Constipation

Issue: January 2020
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Individuals who recently used marijuana were less likely to experience constipation, according to study results published in The American Journal of Gastroenterology.

Kyle Staller, MD, MPH, of the division of gastroenterology at Massachusetts General Hospital, and colleagues wrote that recreational cannabis use could potentially modify the gastrointestinal system, but there is currently conflicting evidence about its impact.

“Current evidence suggests that cannabinoids slow colonic transit through actions on the CB1receptor,” they wrote. “However, a recent clinical trial reported that hemp seed pills improved constipation symptoms among patients with functional constipation, suggesting that the summative effect of the separate cannabinoids in the marijuana plant might have a unique effect on bowel motility.”

To explore the effect of marijuana use on bowel function, researchers identified adults (aged 20–59 years) who completed a drug and bowel health questionnaire in the National Health and Nutrition Examination survey over a 6-year period from 2005 to 2010 (n = 9,645). They estimated the likelihood of constipation or diarrhea — defined by Bristol Stool Form Scale and/or frequency criteria — according to marijuana use status.

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Individuals who recently used marijuana were less likely to experience constipation, according to study results
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Overall, Staller and colleagues found that the prevalence of constipation was lower among individuals who reported recent marijuana use compared with those with past or never use (7.5% vs. 10.2%; P = .03). Recent marijuana use was also associated with decreased odds of constipation (crude OR = 0.71; 95% CI, 0.56–0.98).

This decrease persisted after adjusting for age and demographic factors (adjusted OR = 0.64; 95% CI, 0.49–0.83), comorbidities, substance use, constipating medication, general health condition, rigorous physical activity and emotional disturbances (aOR = 0.68; 95% CI, 0.48–0.93) and diet (aOR = 0.68; 95% CI, 0.52–0.89).

There was no association between recent marijuana use and diarrhea.

“Our analysis is the first population-based human clinical study of marijuana and bowel function providing important insights into the aggregate effects of the various components of the marijuana plant on constipation,” Staller and colleagues wrote. “Owing to the high prevalence and burden of constipation in combination with the increasing availability of both recreational and medicinal cannabis, further studies are needed to identify how use of whole cannabis, dierent marijuana strains, and frequency of marijuana use exert their apparent effects on constipation.” – by Alex Young

Disclosures: Staller reports receiving research support from AstraZeneca, Gelesis and Takeda. He also reports serving as a speaker for Shire and as a consultant to Bayer and Shire. Please see the full study for all other author’s relevant financial disclosures.