Cannabis preparations were applied as palliatives to treat a wide array of health problems, including gastrointestinal disorders, and extracts from this plant were still indicated for diarrhea a century ago, whereas anecdotal reports exist for their use during dysentery and cholera.
Although the medicinal as well as psychoactive properties of Cannabis were both ascribed, until a few years ago, to the same major component of this plant, i.e., we now know that several other cannabinoids with fewer psychotropic actions, such as, for example, cannabidiol, may contribute to its pharmacology.
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Studies on the molecular mechanism of action of THC were instrumental in identifying in vertebrates an endogenous signaling system, known as the endocannabinoid system.
This system is active in several tissues, including the GI tract, and comprises at least two G-protein-coupled receptors, the cannabinoid CB1 and CB2 receptors, their endogenous ligands, the endocannabinoids anandamide and 2-arachidonoylglycerol The reports published in Neurogastroenterology & Motility and included in this special collection, together with related studies published in other journals over the last 2 years, confirm that the ECS and related emerging signaling systems may play a fundamental role in the control of all aspects of GI physiology and pathology.
As with pathological states affecting other vital functions,5 the available data allow us to predict that strategies that either enhance or curb the activity of the ECS might be both employed for future therapies targeting various GI disorders.
The new data discussed in this article allow for speculations on what could be novel physiological and pathological functions in the GI tract of the ECS, particularly at the level of CB2 receptors and TRP channels, and of endocannabinoid-related molecules, while opening the way also to future investigations on non-THC cannabinoids and plant natural products that do not necessarily directly modify the activity of CB1 and CB2 receptors.
Future research will tell us if these ‘gut feelings’ about the ECS will eventually translate into new knowledge of basic and clinical importance.