After legalization in the US (medical use of marijuana is legal in 33 US states, recreational in 11 states) and many other countries, its use for medical and recreational purposes has increased significantly over the past decade. This was also facilitated by numerous studies of the effects of cannabis on the gastrointestinal tract (GIT).

It has been established that cannabis and its derivatives affect many gastrointestinal processes by affecting the endocannabinoid system (ECS), providing anti-inflammatory, antinociceptive and antisecretory effects. It is believed that some gastrointestinal disorders can be treated with cannabinoids: relieve chronic pain, nausea, vomiting caused by chemotherapy, improve the course of non-alcoholic fatty liver disease (NAFLD) and inflammatory bowel disease (IBD). Research has also shown the important role of the ECS in metabolism. Despite the potential benefits of cannabis, the side effects have so far limited its medical use.

Cannabis contains many reactive compounds, including cannabinoids, terpenoids, flavonoids, and alkaloids. The most important of these are Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). In addition to them, more than 100 active cannabinoids are known, each of which is capable of modulating the ECS. The latter is a network of cannabinoid receptors, their ligands, and regulatory synthesizing and degrading enzymes that function on demand. Ligands include anandamide and 2-arachidonoylglycerol, lipids formed during the metabolism of arachidonic acid.

While cannabis may benefit patients with some disorders, unfortunately, there has been a parallel increase in cannabis-related disorders such as cannabinoid vomiting syndrome. Therefore, it is important to analyze not only the beneficial effects and therapeutic potential of cannabis, but also its harmful side effects.

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