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Gastroparesis

Updated on April 7, 2020. Medical content reviewed by Dr. Joseph Rosado, MD, M.B.A, Chief Medical Officer

Everyone has had an upset tummy before. However, some people experience severe and chronic nausea and vomiting due to certain conditions such as gastroparesis, and this gets in the way of living a quality life. Thankfully, medical marijuana and gastroparesis treatment is available and could be a good option for you to help ease your nausea, vomiting and other gastroparesis-related symptoms.

How and Why Marijuana Can Be an Effective Treatment for Gastroparesis

Published clinical trials don’t yet exist for marijuana and gastroparesis. However, medical weed successfully alleviates digestive complaints like nausea. People have used cannabis derivatives to treat cancer.

Since people historically have smoked marijuana as their ingestion method, some worry about its potential for addiction and harm, like with tobacco smoke. However, one particular patient claimed he made the switch to cannabis and used a vaporizer to smoke it. He claimed the herb helped him keep his food down and he gained back the weight he lost when he was on the medication Marinol.

In February 2015, Current Gastroenterology Reports published a review examining cannabinoids and their place in treating gastrointestinal symptoms such as visceral pain, nausea and vomiting. Researchers in the review found targeted cannabinoid therapy could aid in GI disorder/disease management.

The researchers noted endocannabinoid system (ECS) modulation, particularly the cannabinoid CB1 receptors located in the gastrointestinal system, could regulate:

  • Nausea and vomiting
  • Food intake
  • Stomach protection
  • Stomach secretion
  • The GI disorder-causing inflammation process
  • Ion transport: secretion and absorption such as maintaining adequate electrolyte/fluid balance
  • GI movement/motility: constipation with too little movement, or diarrhea with too much movement
  • The number of GI tract cells: Too many cells could be an indication of cancer or some disease process, while tissue injury can result from too few.
  • Internal organ sensation

The researchers also noted CB2 receptor modulation typically found in immune system cells, which prevent or help your body recover from injury or sickness, can help:

  • Reduce internal sensation and pain
  • Control certain GI illness-related inflammation
  • Regulate movement/motility

What Side Effects and Symptoms of Gastroparesis Can Medical Marijuana Treat?

As noted in the above-published review, cannabis and gastroparesis treatment can help with symptoms such as:

  • Nausea and vomiting
  • Poor appetite
  • Insomnia or other sleeping problems
  • Inflammation
  • Constipation
  • Diarrhea
  • Internal pain
  • Immune system modulation

It also helps with anxiety and depression, thereby improving quality of life.

The THC and CBD cannabinoids directly interact with your body’s ECS receptors to affect things such as your appetite, mood, tolerance to pain and more. A little alteration in the amount of CBD and THC in your cannabis allows you to customize your medical marijuana and gastroparesis treatment to effectively help treat your symptoms.

Several states have approved severe nausea as a qualifying condition for the use of medical marijuana.

Best Strains of Marijuana to Use for Gastroparesis Symptoms and Their Side Effects

Certain weed strains to treat nausea effectively. These include:

  • Blueberry Diesel (Indica-dominant hybrid)
  • Lavender (Indica-dominant hybrid)
  • Blue Dream (Sativa-dominant hybrid)
  • Super Lemon Haze (Sativa-dominant hybrid)

Other potentially helpful marijuana and gastroparesis strains include:

  • Crystal Coma (Sativa): Good for pain, depression and inflammation
  • Black Mamba (Indica): Good for anxiety, depression, pain, insomnia and inflammation
  • Goo (Indica): Good for pain, nausea, insomnia, stress, lack of appetite and gastrointestinal disorder
  • Blueberry Nuken (Indica): Good for a gastrointestinal disorder, nausea, lack of appetite, insomnia, stress and pain

Best Methods of Marijuana Treatment for the Side Effects and Symptoms of Gastroparesis

Along with choosing your cannabis and gastroparesis strain, you also need to decide on the best delivery method. Each delivery method provides its effects. Through trial and error, you’ll be able to find the most suitable method to get the most out of your treatment.

  • Smoking or vaping: Inhaling cannabis gives you the fastest effect, and when you’re feeling nausea, you want instant relief. Keep in mind, both smoking and vaping release harmful toxins, but vaping doesn’t produce as much as smoking. If you can wait a little bit for the effects of your treatment to kick in, you might want to try a different method, such as the following.
  • Patches: Patches release medication directly into your bloodstream. You’ll need to wait for the buildup of the effect, but this buildup makes them an excellent extended-release treatment.
  • Tinctures: Try using a cannabis tincture in a tiny proportion, like two milliliters. Before and after each meal, take a teaspoon of the cannabis tincture to help decrease indigestion and aid in a healthy tummy.
  • Edibles: Edibles can take more than an hour for you to feel their effects. However, if your stomach is causing your nausea, consuming edibles will go straight to the source.

Start the Medical Marijuana and Gastroparesis Relief Process

Becoming educated is a great way to begin your marijuana and gastroparesis treatment experience. After you’ve learned all the essentials, you can increase your knowledge about medical cannabis, either through doing further research or by contacting a marijuana specialist.

Once you’re ready, look up your state’s laws on medical weed. Then, it’s time to select a cannabis doctor who works closely with you to find the perfect medical cannabis treatment and continue an ongoing relationship with you. Then choose your dispensary you wish to get your marijuana products from — try out our huge database.

If you’re interested in getting more information on how to use medical weed to treat your gastroparesis or other stomach problems, book your appointment today with one of our recommended cannabis doctors in your area.

What Is Gastroparesis?

Gastroparesis is a disorder affecting your stomach’s motility, or spontaneous muscle movement. You usually have strong muscle contractions capable of pushing your food through your body’s digestive tract. When you’re suffering from gastroparesis, this motility slows down or might not even work altogether, which keeps your body from being able to empty your stomach properly.

Antidepressants, opioids and other specific medications can cause slow gastric emptying and induce similar symptoms. Allergy medications and high blood pressure can, as well. These medicines can worsen the condition for those with gastroparesis.

Gastroparesis can lead to symptoms such as:

  • Nausea and vomiting
  • Interference with normal digestion
  • Problems with nutrition
  • Problems with blood sugar levels

The cause of gastroparesis isn’t clear. In some cases, it’s a diabetes complication, while some individuals develop it following surgery. While there isn’t a cure for the disorder, you can find some relief with medication and dietary changes.

Potential causes of gastroparesis include:

  • Multiple sclerosis
  • Uncontrolled diabetes
  • Medications like some antidepressants and narcotics
  • Gastric surgery with vagus nerve injury
  • Parkinson’s disease

Rare disorders like scleroderma — a connective tissue condition that affects your skeletal muscles, skin, internal organs and blood vessels — may also cause gastroparesis.

Types of Gastroparesis

There are several ways to categorize gastroparesis.

  1. Diabetic gastroparesis: Around 20 to 50 percent of lifelong diabetic patients experience gastroparesis — usually linked with other diabetes complications. In fact, diabetes mellitus is probably the most common condition leading to gastroparesis.
  2. Post-surgical gastroparesis: Some patients experience symptoms after upper gastrointestinal tract surgery.
  3. Idiopathic gastroparesis: There isn’t any noticeable abnormality causing the symptoms patients experience, although, in some situations, the symptoms started after an infectious event such as diarrhea, nausea and vomiting.

History of Gastroparesis

The incidence of gastroparesis-related hospitalizations in the U.S. significantly increased between 1995 and 2004 — especially after 2000.

Symptoms of Gastroparesis

With gastroparesis, you may experience:

  • Nausea
  • Vomiting
  • Feeling full for quite some time following a meal
  • Feeling full shortly after beginning a meal
  • Excessive belching or bloating
  • Poor appetite
  • Upper abdomen pain
  • Heartburn

The symptoms you experience can be severe or mild. Each person’s experience is different.

Effects of Gastroparesis

Several complications can arise from gastroparesis, including the following.

  • Malnutrition: Vomiting may hinder your body’s ability to absorb enough nutrients, since it prevents you from taking in adequate calories.
  • Severe dehydration: Dehydration results from ongoing vomiting.
  • Unpredictable changes in blood sugar: While gastroparesis doesn’t lead to diabetes, frequent alterations in the amount and rate of food passing into your small bowel can lead to unusual blood sugar level changes. These blood sugar level changes worsen diabetes, exacerbating the gastroparesis.
  • Undigested, hardened food stays in your stomach: When undigested food remains in your stomach, it can harden into a solid mass called a bezoar. These often cause nausea and vomiting and could threaten your life if they’re keeping food from reaching your small intestine.
  • Poor quality of life: Acute flare-ups of symptoms can keep you from working properly and being able to handle all your responsibilities.

Mental Effects

There’s a connection between gastroparesis, poor quality of life and significant psychological distress. Furthermore, symptoms of the condition adversely link with heightened depression and anxiety, as well as impaired quality of life. One study showed the rates of psychopathology in groups of individuals with gastroparesis ranged between 21.8 and 50 percent.

Gastroparesis Statistics

  • Around 5 million people in the U.S. have gastroparesis.
  • Around 100,000 of them suffer from a more serious form of the condition.
  • Around 30,000 individuals don’t respond to treatment.
  • Twenty percent of Type 1 diabetes patients develop gastroparesis.

Current Treatments Available for Gastroparesis and Their Side Effects

To treat gastroparesis, the doctor first needs to identify and treat the underlying condition. For instance, if you have diabetes and it’s causing your gastroparesis, the doctor will give you treatment to help you control diabetes.

Changes to Your Diet

Proper nutrition plays a huge role in treating gastroparesis. Many individuals can keep their gastroparesis symptoms under control with simple changes to their diet. Your doctor may give you a referral to a dietitian who works closely with you in finding foods you can digest more easily, so you’re getting enough nutrients and calories from the food. The dietitian may recommend you:

  • Chew your food thoroughly.
  • Eat smaller meals more often.
  • Try pureed foods and soups if it’s easier to swallow liquids.
  • Avoid well-cooked vegetables and fruits like broccoli and oranges, since they could cause bezoars.
  • Eat a mostly low-fat diet, adding small servings of fatty foods if you can tolerate them.
  • Avoid alcohol, carbonated drinks and smoking.
  • Go for walks or exercise gently after eating.
  • Don’t lie down for a couple of hours after each meal.
  • Take a multivitamin every day.
  • Drink lots of water every day.

Medications

Your doctor may prescribe you medications to treat the disorder, such as stomach muscle-stimulating medications like erythromycin and metoclopramide.

Side effects of erythromycin may include:

  • Slurred speech
  • Blurred vision
  • Unusual tiredness
  • Muscle weakness
  • Hearing loss
  • Signs of liver disease like yellowing skin or eyes, nausea or vomiting, abdominal pain or dark urine
  • Drooping eyelids

Erythromycin can become less effective over time.

Side effects of metoclopramide may include:

  • Fatigue
  • Insomnia
  • Restlessness
  • Confusion
  • A headache
  • Drowsiness
  • Dizziness
  • Mental depression with thoughts of suicide

Domperidone, a newer medicine, is also available, but it comes with restricted access. It does have fewer side effects, though, which may include:

  • Abdominal cramps
  • Dry mouth
  • Rash
  • Hives
  • Itching
  • Nausea
  • Diarrhea

Your doctor may prescribe you medicine to keep your nausea and vomiting under control, such as diphenhydramine and prochlorperazine.

Side effects of prochlorperazine may include constipation, dizziness, anxiety, drowsiness, weight gain and more. Diphenhydramine may have side effects as well, such as drowsiness, dizziness, loss of coordination, dry eyes, upset stomach, blurred vision and more.

Finally, there’s another class of medications to help with nausea and vomiting. One example is ondansetron. Side effects may include:

  • Fever
  • A headache
  • Diarrhea
  • Weakness
  • Dizziness
  • Drowsiness
  • Lightheadedness

Surgical Treatment

Some gastroparesis patients cannot tolerate any liquids or food. In these circumstances, the doctor will likely suggest inserting a feeding tube into your small intestine. They may also suggest a gastric venting tube that works by relieving gastric pressure.

The doctor can insert the feeding tube through your skin directly into your small intestine, or pass it through your mouth or nose. It’s typically temporary and only necessary if you can’t control your blood sugar levels with another method or if your gastroparesis is severe. Some individuals have to have the feeding tube through an IV going directly into their abdominal area and into a vein.

Alternative Treatments

Some people benefit from alternative treatments, but there aren’t a lot of studies on these. A few alternative treatments include the following.

  1. STW 5 (Iberogast): A German herbal formula containing nine various herbal extracts. It eases digestive symptoms slightly better than a placebo.
  2. Electroacupuncture and acupuncture: The specialist inserts very thin needles at strategic points of your body through your skin with acupuncture. With electroacupuncture, the specialist uses a small electrical current that passes through the needles.
  3. Rikkunshito: A Japanese herbal remedy also containing nine herbs. It’s supposed to help decrease the feeling of being full after a meal and reduce abdominal pain.

See how medical marijuana could help relieve Gastroparesis symptoms. Find patient reviews on local doctors and information on treatment options.

Marijuana Use in Patients with Symptoms of Gastroparesis: Prevalence, Patient Characteristics, and Perceived Benefit

Abstract

Background

Marijuana may be used by some patients with gastroparesis (Gp) for its potential antiemetic, orexigenic, and pain-relieving effects.

The aim of this study was to describe the use of marijuana by patients for symptoms of Gp, assessing prevalence of use, patient characteristics, and patients’ perceived benefit on their symptoms of Gp.

Methods

Patients with symptoms of Gp underwent history and physical examination, gastric emptying scintigraphy, and questionnaires assessing symptoms. Patients were asked about the current use of medications and alternative medications including marijuana.

Results

Fifty-nine of 506 (11.7%) patients with symptoms of Gp reported current marijuana use, being similar among patients with delayed and normal gastric emptying and similar in idiopathic and diabetic patients. Patients using marijuana were younger, more often current tobacco smokers, less likely to be a college graduate, married or have income > $50,000. Patients using marijuana had higher nausea/vomiting subscore (2.7 vs 2.1; p = 0.002), higher upper abdominal pain subscore (3.5 vs 2.9; p = 0.003), more likely to be using promethazine (37 vs 25%; p = 0.05) and dronabinol (17 vs 3%; p

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Funding

The NIH/NIDDK Gastroparesis Clinical Research Consortium (GpCRC) is supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (grants U01DK073975 [Parkman], U01DK073983 [Pasricha], U01DK074007 [Abell], U01DK073974 [Koch], U01DK074035 [McCallum], U01DK112193 [Kuo], and U01DK074008 [Tonascia]).

Author information

Affiliations

NIH Gastroparesis Clinical Research Consortium, Bethesda, MD, USA

Henry P. Parkman, Emily P. Sharkey, Linda A. Nguyen, Katherine P. Yates, Thomas L. Abell, William L. Hasler, William Snape, John Clarke, Ron Schey, Kenneth L. Koch, Braden Kuo, Richard W. McCallum, Irene Sarosiek, Madhusudan Grover, Gianrico Farrugia, James Tonascia & Pankaj J. Pasricha

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Consortia

Frank A. Hamilton for the NIH Gastroparesis Consortium

Contributions

HPP was involved in the study conceptualization, patient recruitment, data interpretation, and writing of the manuscript; EPS contributed to the statistical analysis, data interpretation, and writing of the manuscript; LN was involved in the study conceptualization, patient recruitment, and revision of the manuscript; KY was involved in the statistical analysis, data interpretation, writing of the manuscript; TLA was involved in the study conceptualization, patient recruitment, and revision of the manuscript; WLH contributed to the study conceptualization, patient recruitment, and revision of the manuscript; WJS was involved in the study conceptualization, patient recruitment, revision of the manuscript; JC was involved in the patient recruitment and revision of the manuscript; RS contributed to the study conceptualization and revision of the manuscript; KLK was involved in the study conceptualization, patient recruitment, and revision of the manuscript; BK was involved in the patient recruitment and revision of the manuscript; RWM was involved in the study conceptualization, patient recruitment, and revision of the manuscript; IS was involved in the study conceptualization, patient recruitment, and revision of the manuscript; MG was involved in the study conceptualization and revision of the manuscript; GF was involved in the study conceptualization, revision of the manuscript; JT contributed to the study conceptualization, statistical analysis, data interpretation, and revision of the manuscript; PJP was involved in the study conceptualization, patient recruitment, and revision of the manuscript; FH contributed to the study conceptualization and revision of the manuscript.

Marijuana may be used by some patients with gastroparesis (Gp) for its potential antiemetic, orexigenic, and pain-relieving effects. The aim of this study