Updated on April 7, 2020. Medical content reviewed by Dr. Joseph Rosado, MD, M.B.A, Chief Medical Officer
Ulcers are a painful yet common condition for many. Treatments have expanded over the years to include numerous classes of medicines. And today, thanks to changing laws, medical marijuana is now a part of the arsenal doctors have to help treat ulcers and other stomach problems. Though scientific studies are still in their initial stages for understanding how well weed works for treating ulcers, the preliminary results are promising.
Medical marijuana could help heal your ulcers or other stomach ailments through its action on stomach acid and ability to ease the pain. Ulcers can cause severe discomfort for weeks while they recover, and cannabis can help reduce the ache in your gut. Discover what medical marijuana can do for your stomach pain and how you can get relief from your ulcer with it.
How Medical Marijuana Can Help Ulcers
If you want to add to your doctor’s treatment regime or replace it, discuss cannabis with a marijuana doctor for your ulcers. Some studies have shown smoking marijuana to be linked to reduced stomach acid production. With lower stomach acid levels, ulcers can heal naturally with less irritation and less pain.
Cannabis also helps alleviate nausea and pain, common complications with ulcers. But even more important are the results of animal studies suggesting that endocannabinoids can protect the digestive system from the ill effects of stomach acid and inflammation. Though human studies are still pending, these animal studies have shown promising results for the use of medical cannabis for digestive disorders such as ulcers and irritable bowel syndrome.
A certified cannabis doctor can help you decide if cannabis can help your ulcers. Every medical case is different, and your personal health history and current condition will factor into how your physician determines to treat you. But you can also ask about treatments you are curious about, such as medicinal marijuana. You need a doctor’s recommendation for this treatment, so don’t be afraid to ask.
Best Marijuana Types for Ulcers
For protecting the stomach from irritation by NSAIDS, scientists from West Virginia University studied mice that ingested THC. The study suggests that the THC in marijuana may protect the stomach from NSAIDS, helping to prevent ulcers or even treat existing ones. If you are interested in using medicinal cannabis for ulcers, a strain containing higher amounts of THC may help if the study results hold for humans.
Marijuana Forms for Ulcers
Smoking marijuana could upset your stomach. If you find that it does, consider switching to tinctures, edibles or oil. But make sure you choose a type with higher THC amounts in it, like sativa. The THC is the component that created such promising results in the mouse study. Additionally, consuming edibles may help to settle your stomach if you have a duodenal ulcer in your small intestine that feels better when you eat.
Side Effects of Medical Marijuana for Ulcers
Medicinal marijuana is not without its drawbacks. Always discuss with a physician if the side effects of weed use will offset the symptoms of your ulcer. Smoking has a few side effects not seen with other delivery methods due to the more direct impact the smoke has on the lungs.
- Lung problems: Anything you smoke can damage your lungs, and the same is true of marijuana, whether you use it medicinally or not. If you have lung problems, skip smoking your cannabis and opt for another route instead.
- Increased testicular cancer risk: If you are a male with a close family member with testicular cancer, discuss smoking marijuana with your doctor. You may be recommended a different form, depending on your circumstances.
Many forms of cannabis share some adverse effects, but do not let the side effects put you off trying medical marijuana. As with any medicine, side effects only impact a small number of patients, and if your doctor has recommended you use cannabis, they believe the benefits are more important for you than any minor side effects that you could experience. Always discuss concerns with your physician or dispensary.
- Dependence: If you have had an addiction in the past, you may not be a good candidate for medicinal cannabis due to its risk of dependency. Talk to your doctor about the matter. They can determine if medicinal marijuana will have more benefits than risks for you.
- Increased birth defects risk: Pregnant women could have a higher chance of having a child with birth defects if they use cannabis.
- Raised heart attack risk: People with existing heart disease should not use medicinal marijuana due to the risk of heart attacks. Other risk factors may also come into play. A certified marijuana doctor can help you make the best decision for your health.
- Judgment or concentration problems: You may encounter problems focusing while using medical marijuana.
- Mental health issues: If you or any of your family have ever experienced a psychotic psychiatric illness, medicinal marijuana could cause problems for you.
- Seizures: Seizures are a rare but severe side effect you should report to your doctor.
Not everyone will experience all these symptoms. If you find the side effects troubling or if they disrupt your life, talk about the issue with a medical marijuana-certified doctor who knows about your condition and the common side effects of using medicinal cannabis. Do not abruptly stop any medicine, even medicinal marijuana, without first talking to a qualified medical professional.
Find a Medical Marijuana Doctor Today
At MarijuanaDoctors.com, we understand how frustrating it can be to go through weeks of pain with traditional treatment. That’s why we offer a simple means of finding additional treatment options by listing doctors and dispensaries where you live. Search for a cannabis-certified physician in your area who is licensed to recommend marijuana or find a dispensary on our site. Once you find someone qualified to recommend medicinal marijuana to you in your area, you can consult with them to see if cannabis is an option to add to your ulcer treatment regime.
With a quick search, you can get connected to a doctor who has both medical training and knowledge of how to recommend marijuana for health conditions. While medicinal marijuana is never a guaranteed cure, it can help you to feel better while your body heals from the ulcer. Start your path to taking charge of your health today.
What Are Ulcers?
Ulcers are eroded areas in the lining of the stomach or the upper portion of the small intestine. The condition causes pain in the stomach area. This erosion can deepen until it creates a hole in the lining of the stomach or other concerning consequences. Despite their troubling complications, ulcers are a fairly common problem for Americans. In the United States, as many as five million people have this condition, with 500,000 newly diagnosed annually.
Causes of Ulcers
Despite what you may have heard, spicy food and stress do not cause ulcers. But if you already have these erosions, the excess acid production from stress or spices may exacerbate the problem. So, if you don’t currently have an ulcer, pile on the pepper sauce — it will not cause an erosion that you don’t have. The same is true for stress. Don’t blame your ulcer on your high-stress job. Instead, the excess acid secreted from your stomach during stressful situations makes the erosions already in your stomach extra painful.
Ulcers occur for one of two reasons. The first cause of ulcers is from overuse of nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen, naproxen sodium or aspirin. Another reason you may develop ulcers is an infection with the bacteria Helicobacter pylori. Aside from ulcers, the bacteria will not cause any other symptoms. Your doctor will likely do a test for the bacteria to see if you need antibiotics for treatment or if you need to cut down on the NSAIDS in addition to other medications.
Symptoms of Ulcers
Ulcers cause pain in the stomach, but the location of the erosion causes pain at various times. If you have a stomach ulcer, also known as a peptic ulcer, you’ll feel pain when you eat. Duodenal ulcers in the upper part of the small intestine will cause pain that eases when you eat. Heartburn, stomach pain, and fullness are other signs of ulcers. Taking antacids may relieve the pain, but unlike heartburn pain which completely subsides, ulcer pain will return after a short while.
If you have serious complications, you may vomit what looks like coffee grounds or have tarry stools. These symptoms indicate you have bleeding in your digestive tract. Bleeding ulcers need medical attention immediately.
Consequences of Untreated Ulcers
Without treatment, an ulcer can worsen to create several possible complications, all of which create a danger for your health and require immediate medical care. Extreme pain, blood in your stool or vomiting blood are signs that you’ve developed a bleeding ulcer. Left untreated, a bleeding ulcer can deepen until it perforates the stomach lining. A perforated ulcer can lead to severe infection. Inflammation from an ulcer or scarring from repeated erosions can cause a blockage in your stomach. With your stomach blocked, you may find yourself getting full sooner or vomiting after meals. Weight loss is a common consequence of such a complication.
Traditional Ulcer Treatments and Their Side Effects
Currently, doctors treat ulcers through various means. Some medications reduce the amount of acid in the stomach. Lowering acid production reduces irritation on the ulcers, helping them to heal naturally. Other medications kill the bacteria that cause the ulcer. Many doctors will prescribe many medicines to kill bacteria and reduce acid.
Today’s ulcer treatment methods are not without problems. Though doctors have a range of options to prescribe patients, all these drugs have potential side effects for the patient. With ulcers and other stomach conditions so common, medications to treat them are even sold over the counter. But how effective and safe are these medications?
Over-the-counter antacids include calcium carbonate tablets or aluminum-containing products. These solutions are cheap but only provide relief for a couple of hours. However, they are not highly useful for treating ulcers because the comfort they bring is temporary. The antacids neutralize some acid already in the stomach without reducing production. The acidity will rebound, causing pain after the antacid wears off.
While these common medicines are shaped like candy tablets, they are still medications that have benefits and harms. Antacids have several side effects depending on their ingredients. Magnesium-based antacids can cause diarrhea whereas aluminum-containing products can cause constipation. More worrisome are the effects on blood mineral levels. Taking too many calcium-containing antacids can cause excessive levels of calcium in the blood, leading to kidney function problems.
2. H2 Blockers
H2 blockers bind some of the excess acids in the stomach, reducing its effect on the ulcer. But these drugs are not without problems. H2 blockers have side effects that include sleeping trouble, diarrhea, constipation, dry mouth, headaches, dry skin, and urination problems. Some rarer but more severe side effects of H2 blockers include confusion, irregular heartbeat, wheezing and difficulty breathing. Often, H2 blockers are a preferred treatment option for ulcers, but if you experience troubling side effects, you may need to discuss other options.
3. Proton Pump Inhibitors
Proton pump inhibitors (PPIs) stop some of your stomach’s acid production. Because they stay the production of some stomach acid, these are potent drugs. Over time, less acid in your stomach could have adverse effects.
Long-term effects of PPIs are concerning. You may not absorb the vitamin B12 as well as you should. You may also have a higher chance of getting infected with Clostridium difficile in the intestines. Osteoporosis is also a real possibility with long-term use of PPIs. Some studies have linked use over the years to low magnesium levels and heart attacks. In the short term, PPIs could cause side effects such as a headache, diarrhea, rash, vomiting, nausea and abdominal pain.
Since the cause of most stomach ulcers is an infection with the H. pylori bacteria, antibiotics are usually part of the treatment regime. Most antibiotics tend to cause diarrhea, abdominal pain, bloating, nausea and vomiting. If you do vomit or have severe diarrhea while taking any medication, talk to your doctor about an alternative that won’t sicken you. Vomiting too soon after taking medication could prevent it from being fully absorbed, reducing its effectiveness.
5. Cytoprotective Agents
Cytoprotective agents, such as misoprostol and sucralfate, help protect the lining of your stomach and small intestine while you heal from the ulcer. They bind to the ulcer to create a barrier between the ulcer and stomach acid. While these drugs cannot prevent ulcers, they can effectively allow the ulcers to heal. Think of these medications as bandages for the ulcer. Like other drugs, cytoprotective agents also have side effects. For instance, when taking sucralfate, you may experience nausea, insomnia, dizziness, stomach pain, back pain, vomiting, diarrhea or constipation.
Medical marijuana can be used to help treat ulcers and stomach problems. Scientific studies are early but initial results for marijuana helping with ulcers.
Unusual side effect of cannabis use: acute abdomen due to duodenal perforation
Sevgi Buyukbese Sarsu
Department of Pediatric Surgery, Gaziantep Cengiz Gokcek Obstetrics and Children’s Hospital, 27560 Sehitkamil, Gaziantep Turkey
The chronic use of synthetic cannabinoids (SCs) which has become an increasingly prevalent problem can rarely cause gastric and duodenal ulcer because of their effects on gastric secretion and emptying.
Since peptic ulcer disease (PUD) is a rarely seen entity in patients who consult to the emergency service with complaints of abdominal pain, most of the physicians do not suspect of this clinical diagnosis. Perforation is a mortal complication of PUD, and early diagnosis and emergency surgery are life-saving procedures.
A 16-year-old male patient was referred to our emergency service from another center with abdominal distension, complaints of abdominal pain, and bilious vomiting. His medical history revealed that he had been regularly using bonsai for the past 3 years. Plain abdominal radiograms of standing position revealed subdiaphragmatic free air, then we performed laparotomy which disclosed perforation of the first part of the duodenum. Surgical intervention with omental patch and primary closure (Graham patch) was successful. The patient who underwent nasogastric decompression and received antibiotherapy had not experienced any complication during the postoperative follow-up period.
Herein, as an unusual manifestation, a patient who developed duodenal perforation following chronic SC use has been reported.
In adolescent patients admitted with PUD or its complications to the emergency services, it is important to inquire for the use of addictive substances which are increasingly prevalent in order to determine the etiology.
Cannabinoids (also called) cannabis are plant-derived addictive substances which have been used widely for thousands of years . Despite their known therapeutic effects, because of their addictive properties, they cause the most prevalent health problem in the world.
The widespread use of cannabinoids or their synthetic derivatives exert many adverse effects on the health of human beings including pulmonary, endocrine, and cardiovascular pathologies, as well as cognitive and behavioral disorders. Synthetic cannabinoids (SCs) first emerged in the year 2004, and in a short time, it has become popular especially among adolescents . In Turkey, it is known as “bonsai” .
Their widespread effects on the gastrointestinal system manifest themselves through their specific receptors in the brain and bowels. As a result of their chronic use, delay in gastric emptying and hyperemesis can be enumerated among their other harmful gastric effects. In the literature, development of acute pancreatitis following cannabinoid use has been reported . In patients with acute pancreatitis, increased probability of developing peptic ulcer disease (PUD) has been found. In this case report, we indicated unusual clinical condition of an adolescent who was admitted to the emergency service with symptoms of acute abdomen.
A 16-year-old male patient was referred to our emergency service from another center with abdominal distension, complaints of gradually increasing abdominal pain, and bilious vomiting persisting occasionally for the previous 15 days. The patient came from Southeastern Anatolia. His medical history revealed that he had been regularly using bonsai for the previous 3 years. His family was not aware of his addiction. On physical examination, abdominal distension, widespread tenderness, abdominal guarding, and washboard abdomen were detected on palpation. His biochemical parameters at his admission into the hospital were as follows: white blood cell count, 8.42 × 10 9 /μL (neutrophils, 64.6 %; lymphocytes, 29.4 %); CRP, 0.23 mg/L; hemoglobin, 10.3 g/dL; Htc, 33.2 %; platelet count, 589 × 10 9 /μL; glucose, 114 mg/dL; Na, 135 mEq/L; K, 4.17 mmol/L; Cl 100 mmol/L; aspartate transaminase, 18 U/L; alanine transaminase, 7 U/L; lactate dehydrogenase, 261 U/L; BUN, 10.3 mg/dL; and creatinine, 0.81 mg/dL. History of trauma, alcohol consumption, regular drug use, and chronic disease could not be elicited.
Plain abdominal radiogram in standing position demonstrated subdiaphragmatic free air (Fig. 1 ). In nasogastric decompression, bilious drainage was observed. In abdominal ultrasound (US), free fluid collections were detected between bowel loops and also between the liver and the duodenum. Exploration through midline incision revealed the presence of diffuse pus and free fluid in the abdominal cavity. All bowel loops were covered with fibrin, and a perforated area on the first part of the duodenum measuring nearly 1 cm in diameter was detected (Fig. 2 ). Primary closure was performed using an omental patch (Graham patch), and abdominal cavity was irrigated with physiologic saline. A drain was placed in the subhepatic region, and the abdomen was closed in compliance with proper surgical principles. Postoperative course progressed without any complication. Antibiotherapy and gastroprotective medication were used. On the 5th postoperative day, oral alimentation was started, and his drain was removed on the 7th postoperative day. He was discharged with the prescription of oral antibiotherapy and proton pump inhibitors.
Plain abdominal radiogram: subdiaphragmatic free air
Perforated area of the first part of the duodenum
Since PUD is a rarely seen entity in adolescents, most of the physicians do not suspect the presence of this clinical diagnosis in a child who is referred to the emergency service with complaint of abdominal pain. Acid and pepsin are important factors in the development of PUD. Stress, trauma, major surgeries, Helicobacter pylori infection, burns, familial predisposition, systemic diseases, and some drugs (NSAIDs and steroids) are other predisposing factors . However, in our case, none of these predisposing factors were found. From the patient’s history, it was learnt that he was a bonsai user for 2 years. Perforation is one of the serious complications detected in bonsai users, and diagnosis is usually made following the development of a complication.
Pathognomonic findings of this condition which was firstly defined by Travers in the year 1817 are sudden onset of abdominal pain, generalized peritonitis, and washboard abdomen which were also present in our case. In nearly 90 % of the patients, subdiaphragmatic free air is found, as is the case with our patient . In the US, we also detected intraabdominal free fluid.
In addition to their some therapeutic effects, SCs can demonstrate many deleterious effects. More than ten kinds of SCs have been produced so far, and bonsai is just one of them . As is known, it is widely used among youngsters. According to the World Drug Report released from the United Nations Office on Drugs and Crime, SCs have been the most prevalently used new psychoactive substances worldwide . SCs were imported in Turkey in the year 2010, and their use is gradually increasing .
By binding to cannabinoid binding (CB) receptors, SCs imitate the effects of natural cannabinoids. CB1 and CB2 receptors are mainly found in neurons and immune-mediated cells; however, their presence in GIS has been also confirmed. In animal studies, inhibitory effects of cannabinoids and CB1 receptor agonists on gastric motility and contractility have been demonstrated. In clinical use, they exert their therapeutic effects via CBI receptors in the treatment of hyperemesis in patients receiving chemotherapy. Paradoxically, Choung et al.  emphasized the presence of a correlation between their chronic use and hyperemesis.
Besides, cannabinoids bind to CBI receptors in nucleus tractus solitarius with potential resultant effects on lower esophageal sphincter. Their diverse effects on the stomach have been also demonstrated. They also delay gastric emptying. In the literature, a patient who developed acute gastric dilation and hepatic portal venous gas was also reported . Administration of a cannabinoid receptor antagonist anandamide to mice with cerulein-induced pancreatitis increased the severity of pancreatitis, a phenomenon which cannot be explained clearly.
Effect of cannabinoids on the pancreatic canal and Oddi’s sphincter may contribute to aggravation of pancreatitis . The effect of cannabinoids on gastric secretions and emptying could be the cause of gastric and duodenal ulcers present in our patient. We think that cannabinoids binding to CB1 receptors led to the development of this condition. As is seen in our case, in the literature, duodenal perforations due to formation of ulcerations generally had small sizes (0.5–1 cm), and they could be treated easily. In this case report, we presented an unusual manifestation of chronic SC use.
In our case, Naranjo score was +3; the mean of this score is possible adverse drug reactions .
We achieved this score from the answers of the questions shown below.
Are there previous conclusive reports on this reaction? = yes (+1 point).
Did the adverse reaction improve when the drug was discontinued? = yes (+1 point).
Are there alternative causes that could have caused the reaction? = no (+1 point).
The other questions answers were as follows: do not know or not done (0 point).
Development of duodenal perforation due to the chronic use of SC is an unusual condition. These patients can consult to the emergency service with recurrent abdominal pain. Since their use is forbidden by law, the patients do not tell that they are using SC in their anamnesis. In order to determine etiology, it is important to investigate the use of addictive substances which are increasingly popular among adolescent cases admitted to the emergency services with PUD or its complications.
Written informed consent was obtained from the patient’s legal guardian(s) for the publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
I would like to thank all the members of Gaziantep Cengiz Gokcek Obstetrics and Children’s Hospital. Particular thanks go to all the nurses working in our hospital. The author obtained permission to acknowledge all those mentioned in this section.
The author did not receive any financial support during the conception, design, acquisition, analysis, interpretation, and critical review of the data contained herein.
She declares that she has no competing interests.
SBS participated in the design and conception of the study and revised it critically for important intellectual content. SBS have read and approved the final manuscript.
Unusual side effect of cannabis use: acute abdomen due to duodenal perforation Sevgi Buyukbese Sarsu Department of Pediatric Surgery, Gaziantep Cengiz Gokcek Obstetrics and Children’s