Cannabidiol beneficial to patients with gastroparesis

For patients with gastroparesis, the use of cannabidiol (CBD) provides symptom relief and improves the tolerance of liquid nutrient intake, despite a delay in gastric emptying of solids (GES), as shown in a study.

The study included 44 patients with idiopathic or diabetic gastroparesis with slowed GES. These patients were randomly assigned to receive pharmaceutical cannabidiol twice a day (escalated to 20 mg/kg/day) or placebo for 4 weeks.

Researchers used Gastroparesis Cardinal Symptom Index Daily Diary (GCSI-DD) to measure symptoms. GES and gastric volume measurements and Ensure satiation test (1 kcal/mL, 30 mL/min) were performed at the end of treatment to assess volume to comfortable fullness (VTF) and maximum tolerance (MTV). Patients also underwent specific FAAH and CNR1 genotyping.

Of the patients, five did not tolerate full dose escalation while three (two in the placebo group and one in the CBD group) withdrew from the study before completing 4 weeks’ treatment. In total, 95 percent of the patients completed 4 weeks of treatment and diaries.

Compared with placebo, CBD treatment reduced total GCSI score (p=0.008), helped with the patients’ inability to finish a normal-sized meal (p=0.029), decreased the number of vomiting episodes/24 hours (p=0.006), and improved overall symptom severity (p=0.034).

The CBD group had higher VTF and MTV but slower GES. FAAH rs34420 genotype had a significant effect on nutrient drink ingestion.

The most frequent adverse events reported included diarrhoea (n=14), fatigue (n=8), headache (n=8), and nausea (n=7).