Cannabinoids Improve Gastrointestinal Symptoms in Parenteral Nutrition–Dependent Patient With Chronic Intestinal Pseudo-Obstruction
Intestinal failure occurs when a person’s intestines can’t digest food in order to absorb the fluids, electrolytes and nutrients essential to life and development. As a result, the patient needs to receive calories and nutrients intravenously through parenteral nutrition. Chronic intestinal pseudo-obstruction (CIPO) is a rare and challenging cause of this debilitating condition in pediatric patients. Despite complex and multidisciplinary medical, surgical, and nutritional management, patients with CIPO often experience chronic abdominal pain, nausea, and lack of appetite, all of which negatively impact on their quality of life.
Cannabinoids comprise a group of compounds of different origins including cannabis-derived (for eg, THC or CBD) and synthetic (for eg, dronabinol) with similar molecular structures and biological targets. Very recently, physicians at the Necker-Enfants-Malades Hospital, Paris, France reported for the first time a case of successful use of medicinal cannabinoids in a patient with CIPO. More specifically, the patient experienced a significant reduction of many chronic gastrointestinal symptoms such as abdominal pain, vomiting, and subocclusive episodes, as well as an increase appetite and weight, without major adverse events when given dronabinol (synthetic THC) at the dose of 35mg/week. Noticeably, cessation of use led to recurrence of all symptoms and usage at a lower dose led to decreased efficiency. Although large-scale, controlled clinical trials are required to consolidate these findings and establish official treatment recommendations, these findings suggested medicinal cannabis may be helpful for other patients suffering from the same condition.