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Exploring the Link Between Cannabis Use and Gut Health

by Valerie Polley | Dec 14, 2023 | 0 comments

Cannabis is gaining increased attention for its potential health benefits. However, there is still a lot we don’t know about cannabis, so it can be hard to make specific recommendations for its use.

One area of growing interest is the effect of cannabis on gut health. More specifically, studies are starting to investigate the effect cannabis has on gut motility, or how food moves through the digestive tract.

In this blog post, we’ll review the science behind the use of cannabis for gut health, as well as how cannabis interacts with the endocannabinoid system.

Understanding Gut Motility

To understand the relationship between cannabis and gut health, it’s important to understand what gut motility is.

Gut motility refers to the coordinated contraction and relaxation of muscles in the digestive tract. This is what propels food through the digestive system and is crucial for proper digestion and nutrient absorption.

Gut motility is a finely tuned process influenced by many factors, such as neuronal control, hormonal regulation, and dietary factors.

Disruptions in any of these areas can lead to digestive issues, which emphasizes the importance of keeping these factors in balance for optimal gut health. 

The Endocannabinoid System

The endocannabinoid system is often referred to as the “bridge between the body and the mind.” It plays an important role in maintaining balance within the human body. The system has three key components:

  • Receptors: There are two main receptors in the endocannabinoid system – CB1 and CB2. CB1 receptors are mostly found in the central nervous system (particularly in the brain), while CB2 receptors are typically found in the peripheral nervous system, immune cells, and organs.
  • Endocannabinoids: Endocannabinoids are cannabinoids produced naturally within the body. They bind to CB1 and CB2 receptors to initiate various physiological responses.
  • Enzymes: Enzymes break down endocannabinoids once they’ve fulfilled their purpose.

Functions of the Endocannabinoid System

Some of the primary functions of the endocannabinoid system include:

  • Homeostasis: The endocannabinoid system helps maintain internal balance, ensuring that our body functions within optimal ranges despite external changes.
  • Mood Regulation: CB1 receptors in the brain play a significant role in regulating mood, stress responses, and emotional well-being.
  • Immune Function: CB2 receptors are prevalent in immune cells and are involved in regulating immune responses and inflammation.
  • Neuroprotection: The endocannabinoid system is involved in protecting the nervous system, with potential implications for neurodegenerative diseases.

The Endocannabinoid System and Cannabis

While the endocannabinoid system was discovered through the study of cannabis, its existence predates our understanding of the effects cannabis has on the body.

Cannabis compounds, known as cannabinoids, interact with the endocannabinoid system, mimicking the action of the endocannabinoids. The most well-known cannabinoids include THC (tetrahydrocannabinol) and CBD (cannabidiol).

Connection Between the Endocannabinoid System and Gut Function

There are several connections between the endocannabinoid system and gut function. They include:

  • Regulation of Gut Motility: The endocannabinoid system plays a pivotal role in regulating gut motility. CB1 receptors are abundant in the enteric nervous system (the gut’s nervous system), which influences the movement of food through the digestive system. This ensures digestion proceeds smoothly.
  • Inflammation and Immune Function: CB2 receptors, found primarily in immune cells, are crucial for modulating inflammatory responses in the gut. Activating CB2 receptors helps regulate immune function, preventing the excessive inflammation that can contribute to certain bowel conditions.
  • Intestinal Barrier Integrity: The endocannabinoid system is involved in maintaining the integrity of the gut wall, an important defense mechanism that prevents harmful substances from entering the gut. A well-functioning endocannabinoid system contributes to a healthy gut barrier.

Cannabis and Gut Health: The Science

Since the cannabinoids found in cannabis interact with the endocannabinoid system, it’s thought that cannabis influences gut function.

Cannabis and Gut Motility

Animal studies suggest that substances that bind to CB1 receptors (like the cannabinoids found in cannabis) reduce the motility of the gastrointestinal tract. In other words? They slow down digestion. This could cause constipation to become worse. However, it may be beneficial for people with diarrhea, where gut transit is too fast.

Overall, there is a lack of human studies that look at the effects of cannabis on gut motility. While some animal studies suggest that cannabinoids reduce gut motility and therefore help with diarrhea, more studies in humans are needed before we can recommend cannabinoids such as THC and CBD as treatments for diarrhea.

Cannabis and Gastroparesis

There is also some evidence that cannabinoids can help with gastroparesis (delayed stomach emptying). Studies have shown that inhaled cannabis and oral extracts led to significant improvements in gastroparesis. Another study looking at the effects of CBD on gastroparesis found that CBD provided symptom relief in people with gastroparesis, improving their tolerance of liquid nutrition.

Cannabis and Inflammatory Bowel Disease

There is emerging evidence that cannabis can be beneficial for people with Crohn’s Disease. One study showed that medical cannabis use was associated with an improvement in disease activity and a reduction in use of other medications.

Another study found that people in the group receiving cannabis achieved complete remission more frequently than the placebo group. However, a different study looking at the effects of low-dose CBD found that it did not have any effect on Crohn’s Disease activity. This highlights the need for more studies to determine which cannabinoids are effective, and at what dose.

Considerations and Caveats

While the science behind cannabis and gut health is promising, it’s important to understand that there are individual variations in how a person responds to cannabis.

Plus, factors like dosage, frequency of use, and a person’s unique physiology can impact how cannabis affects them. Moreover, cannabis use is not without risk, including potential side effects and legal considerations.

Anyone considering cannabis for gut health should do so under the guidance of a licensed healthcare professional.

Final Thoughts

The relationship between cannabis use and gut health is a complex and evolving field of study. While initial research is promising, it’s important to approach cannabis use for digestive health cautiously, as more research is needed to determine which cannabinoids and which doses are effective.

As we await further scientific exploration on the relationship between cannabis use and gut health, people interested in exploring cannabis use as part of their gut health strategy should consult with a healthcare provider first. 

If you’re interested in improving your gut health, it’s important to work with a healthcare provider like a dietitian who has experience with helping people manage their gut symptoms. Click here to get in touch with Blue Tree Nutrition and get support with your gut health.

Our gut microbiome (the community of trillions of microbes that live in our gut) plays a key role in maintaining metabolic and immune health. Gut dysbiosis occurs when the composition and diversity of our gut microbiome shift. This could include overgrowth of harmful bacteria or a decrease in beneficial bacteria. Gut dysbiosis has been linked to a wide range of negative health outcomes, including increased levels of inflammation and changes in metabolism.

Many people switch to non-nutritive sweeteners like sucralose, aspartame, and stevia for health reasons, and for decades, we've believed that they pass through our bodies without affecting us. But emerging research shows that these compounds interact directly with our gut microbiome and may have potential negative effects on our health. 

This article will review what we currently know about the relationship between non-nutritive sweeteners (including artificial sweeteners and calorie-free natural sweeteners) and the gut microbiome, plus practical advice for navigating sweeteners.

Sucralose

Sucralose (Splenda) is an artificial sweetener commonly used in baked goods, gums, and sugar-free beverages and is approximately 600 times sweeter than sucrose (table sugar). However, recent research has linked it to adverse health effects such as systemic inflammation, metabolic disease, and gut dysbiosis. For example, a 2022 study found that sucralose consumption increased harmful bacteria and reduced beneficial bacteria, which was associated with changes in insulin and glucose levels.

Additionally, a 2025 randomized controlled trial examining the effects of replacing added sugars with sucralose found that people with type 2 diabetes who consumed sucralose experienced reductions in both alpha diversity (the number and types of species present in a single person) and beta diversity (differences in microbial composition between people). Interestingly, the people with overweight and obesity without type 2 diabetes did not experience the same changes.

Overall, animal studies and limited human studies suggest that sucralose may trigger intestinal inflammation, likely through its effects on the gut microbiome. However, since most of the evidence we have comes from test tube or animal studies, these results should be interpreted cautiously.

Aspartame

Aspartame is another commonly used artificial sweetener that is about 200 times as sweet as sucrose. While it does contain some calories, because you don't need much of it to reach the same sweetness levels as sucrose, these calories are negligible.

Like sucralose, most of the research into the gut effects of aspartame has been done in animals. However, we do have some very small human studies. A 2022 randomized controlled trial (RCT) involving 20 healthy adults found that participants taking aspartame showed changes in both probiotic (beneficial) and pathogenic (harmful) bacteria, but the changes were specific to each individual. 

Why the differences? It's likely due to the "responder vs. non-responder" phenomenon. We all have differences in our "baseline" microbiome. While certain bacterial species are common in healthy populations, our microbiome is as unique as a fingerprint. Whether an artificial sweetener has positive or negative effects on our microbiome may depend on which species are already present in our gut, as well as on our habitual diet. This difference in responses makes it very challenging to draw firm conclusions about whether artificial sweeteners are harmful.

Stevia

Many people choose stevia because it's a "natural" zero-calorie sweetener. Studies have shown mixed results regarding the effects of stevia on the gut microbiome. For example, while some in vitro (test tube) and in vivo (animal) studies have reported potentially harmful effects of stevia on the gut microbiome, others have found no impact, and some even reported beneficial effects through inhibition of inflammatory pathways.

Additionally, a 2024 human study found that stevia had no significant effect on the gut microbiome. This highlights the importance of not forming conclusions based solely on test tube and animal studies. Overall, it appears that stevia is a potentially less-harmful alternative to artificial sweeteners like sucralose and aspartame.

Practical Advice for Navigating Sweeteners

Since the research on artificial sweeteners is still evolving, the decision to include or avoid them comes down to personal preference. Here are some tips for including them in your diet in moderation:

  • Try gradually reducing the amount you use: If you typically use two packets of sweetener in your coffee or tea, try gradually reducing to one packet. Our taste buds are highly adaptable, and you may find that one packet is sweet enough once you get used to it.
  • Check your labels: Low- or no-calorie sweeteners (such as sucralose, aspartame, and sugar alcohols like erythritol) are often hidden in low-sugar foods like protein bars, yogurt, and diet sodas. Awareness is the first step to reducing your intake.
  • Rotate your sources: If you do use artificial sweeteners, try switching up the types you use. Since different sweeteners may affect your gut microbiome in different ways, this may reduce the concentrated impact on your gut.
  • Switch to stevia: While animal and test-tube studies show mixed findings, human research indicates that stevia has a limited effect on the gut microbiome, making it a better choice for people seeking to support their gut health.

Another way to support your gut if you regularly use artificial sweeteners is to rebuild gut diversity with fiber and fermented foods, while focusing on whole-food sweeteners.

  • High fiber prebiotic foods (like legumes, whole grains, garlic, onions, asparagus, and under-ripe bananas) act as "fuel" for your healthy gut microbes. Aim to include a variety of these foods in your diet to support the microbes already in your gut.
  • Add fermented foods, like unpasteurized sauerkraut and kimchi, kefir, or kombucha, to your diet. Some fermented foods contain live, beneficial bacterial cultures, while others are rich in "postbiotics" (beneficial compounds like short-chain fatty acids, which are produced when bacteria break down prebiotics).
  • Try using whole-food sweeteners instead of artificial ones. For example, sweeten plain yogurt with vanilla extract and berries or add dates to smoothies or homemade energy bites.

Final Thoughts

Emerging research suggests that certain low- or no-calorie sweeteners, including sucralose and aspartame, may affect the gut microbiome, whereas stevia appears to have a less negative effect. While individual responses can vary with a person's unique baseline microbiome, certain artificial sweeteners may increase inflammation or reduce gut microbiome diversity.

If you need personalized support navigating sweeteners or supporting your gut health, Blue Tree Nutrition can help. Click here to get in touch!

 

 

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Hello, I am

Valerie

My name is Valerie Polley. I am a Indianapolis-based registered dietitian and owner of Blue Tree Nutrition. I consult with clients both local and far away.
I have a bachelor’s degree in nutrition from Purdue University and I have been practicing for 20 years.
I thoroughly enjoy helping clients through their gut health journey. I see a range of GI issues including, but not limited to celiac disease, IBS and SIBO. I also specialize in the FODMAP elimination diet.

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