4.7 Review

Targeting the endocannabinoid system for the treatment of abdominal pain in irritable bowel syndrome

Journal

NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY
Volume 20, Issue 1, Pages 5-25

Publisher

NATURE PORTFOLIO
DOI: 10.1038/s41575-022-00682-y

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This review provides an overview of the potential of the gastrointestinal endocannabinoid system as a therapeutic target for the management of pain in irritable bowel syndrome. It discusses the role of endocannabinoid system in regulating gastrointestinal function and pain processing, compares cannabinoids to other treatment modalities, and explores emerging therapeutic candidates targeting the endocannabinoid system for pain relief in irritable bowel syndrome.
There are limited available treatment options for the management of abdominal pain in irritable bowel syndrome (IBS). This Review provides an overview of the gastrointestinal endocannabinoid system and its potential as a therapeutic target for the treatment of pain in IBS. The management of visceral pain in patients with disorders of gut-brain interaction, notably irritable bowel syndrome, presents a considerable clinical challenge, with few available treatment options. Patients are increasingly using cannabis and cannabinoids to control abdominal pain. Cannabis acts on receptors of the endocannabinoid system, an endogenous system of lipid mediators that regulates gastrointestinal function and pain processing pathways in health and disease. The endocannabinoid system represents a logical molecular therapeutic target for the treatment of pain in irritable bowel syndrome. Here, we review the physiological and pathophysiological functions of the endocannabinoid system with a focus on the peripheral and central regulation of gastrointestinal function and visceral nociception. We address the use of cannabinoids in pain management, comparing them to other treatment modalities, including opioids and neuromodulators. Finally, we discuss emerging therapeutic candidates targeting the endocannabinoid system for the treatment of pain in irritable bowel syndrome.

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