At the 2026 Journées francophones d'hépato‑gastroentérologie et d'oncologie digestive (JFHOD), the French‑language conference on hepatology, gastroenterology, and digestive oncology, gastroenterologist Fabien Wuestenberghs, from France's Greater Paris University Hospitals, addressed the question, "Is cannabis dangerous for the digestive tract?" At the start of his talk, Wuestenberghs reminded listeners that "cannabis encompasses all derivatives of the Cannabis sativa plant, mainly consumed as dried flowers, but also as gummies (edibles) or resins. The active substances are the phytocannabinoids, notably tetrahydrocannabinol, which is responsible for the psychoactive effects."
Non-Digestive Effects
Before discussing cannabis' harms to the digestive tract, Wuestenberghs reviewed the substance's non‑digestive effects: "Major side effects include addiction; psychiatric disorders, notably the risk of psychosis; cognitive deficits in attention and memory; respiratory problems related to inhalation; cardiovascular effects such as tachycardia; and accidents due to reduced alertness. Vulnerable populations, such as pregnant women and adolescents with developing brains, are particularly at risk."
Inhibitory Effect on the Digestive System
On the digestive side, cannabis has an overall inhibitory effect, Wuestenberghs said: "At the level of the esophagus, it has been shown to reduce the tone of the lower sphincter and decrease transient sphincter relaxations after meals. In addition, it slows gastric emptying."
Nausea
Regarding nausea, cannabis can have beneficial effects in some cases: Low doses can improve this symptom, as observed in certain studies of diabetic gastroparesis and chemotherapy‑induced nausea and vomiting. However, prolonged use can cause nausea and vomiting.
Small Intestine
At the level of the small intestine, data from animal models suggest improved barrier function, reduced inflammation, and inhibition of colonic motility, which can sometimes lessen certain functional pains, Wuestenberghs continued.
Cannabinoid Hyperemesis Syndrome
The main adverse effect is cannabinoid hyperemesis syndrome, characterized by recurrent episodes of nausea and vomiting and abdominal pain, similar to cyclic vomiting syndrome. "This syndrome occurs exclusively in heavy, regular cannabis users; its diagnosis is based on symptom resolution after complete cessation of use, although the process can be delayed because cannabis accumulates in adipose tissue. A distinctive sign reported by patients is symptom relief from hot baths or showers," Wuestenberghs said. The underlying pathophysiology is not yet fully elucidated, but it may be related to peripheral desensitization of CB1 receptors in the enteric nervous system, changes in gastric motility, psychological and genetic factors, and overexpression of the TRPV1 receptor, he said. There are experimental topical treatments aimed at targeting these mechanisms.
Cannabidiol (CBD)
"The cannabidiol (CBD) has shown symptomatic benefit in some cases of idiopathic or diabetic gastroparesis, despite worsening gastric emptying," Wuestenberghs said. Its therapeutic use remains controversial.
Diagnosis and Management
"It's important not to attribute digestive symptoms too quickly to cannabis without ruling out other diagnoses. The timing between consumption and symptoms is essential to assess. A trial of stopping cannabis for at least one month is recommended to confirm a causal link," Wuestenberghs recommended. He also said clinicians should consider the frequent possibility of co‑use of other substances — for example, cocaine or opioids — that can influence digestive symptoms. The therapeutic approach favors cessation of use and referral to addiction specialists when necessary. "Disorders related to use are common; it is essential to check patients' substance‑use histories. The principal effects are inhibitory on the digestive tract, with cannabinoid hyperemesis syndrome as a notable condition," he concluded.
https://www.medscape.com/viewarticle/cannabis-and-digestive-health-clinical-risks-2026a1000b1g
