Should gastroenterologists prescribe cannabis? The highs, the lows and the unknowns

Figure 1 Different routes of cannabisy.

Figure 2 Role of cannabis on the gastrointestinal tract. GI: Gastrointestinal; IBD: Inflammatory bowel disease; IBS: Irritable bowel syndrome; GERD: Gastroesophageal reflux disease; CB1: Cannabinoid receptor type 1; CB2: Cannabinoid receptor type 2.

Figure 3 Pathway of cannabis hyperemesis syndrome. CNS: Central nervous system; THC: Tetrahydrocannabinol; CBD: Cannabidiol; CB1: Cannabinoid receptor type 1; CB2: Cannabinoid receptor type 2.

Figure 4 Algorithm to prescribe or not to prescribe cannabis. ¹Gastrointestinal (GI) disorders and symptoms: Inflammatory Bowel Disease, Motility, Ileus, Irritable Bowel Syndrome, Abdominal pain, GI cancer-related pain, Gastroesophageal Reflux Disease, Non-cardiac chest pain, Nausea and Vomiting, Anorexia, Obesity. ²Discuss patient goals individually, and risks and benefits of cannabis before initiation.