In the last decade, we’ve learned a lot about how cannabis affects digestion. Thanks to the numerous studies that have been done over the years, we’ve gotten valuable insight on how this ultra-beneficial plant can be used to treat a range of diseases and conditions. Although a lot of anecdotal evidence and multiple studies exist on the topic, we’ve still only scratched the surface of unlocking its full potential.

But before we delve into what it can treat, how exactly does cannabis affect our digestive system? Like many of our body’s processes, including our mood, sleep, immune function and reproduction, the regulation of our digestion, appetite, and metabolism are done by the endocannabinoid system (ECS_. To understand how cannabis affects our digestion, the ECS is a crucial part of the puzzle.

Active compounds in cannabis, called phytocannabinoids such as THC and CBD, interact with the body through the ECS via cannabinoid receptors (CB1 and CB2) that are distributed throughout the digestive system and in regions of the brain that are considered essential for the gut-brain axis. It takes the phrase ‘going with your gut’ to a whole new level.

Both CB1 and CB2 receptors can be found in the digestive tract, with the former of the two the more abundant. The ECS plays a number of roles in digestion, including regulating stomach acidity, motility (the speed in which matter passes through the intestines), satiety, inflammation, pain, as well as visceral sensation, which affects our ability to perceive bodily organs. High levels of endocannabinoids are found throughout our digestive system and also contribute to stimulating our appetite.

Hunger pangs aren’t actually generated in the stomach but in the brain. When our stomach is empty, the hormone ghrelin is released, which stimulates the GI tract’s vagus nerves, which then travel up to the brain along the gut-brain axis to reach the brain’s hypothalmus, where hunger pangs originate.

According to some animal studies, synthetic THC can active ghrelin receptors, sending signals to the hypothalmus, which then cause hunger pangs even when the stomach isn’t empty. This leads to the phenomenon we all know as ‘the munchies.’

Meanwhile, according to a 2008 review, when the GI tract is inflamed, as is the case with bowel-related diseases, scientists found that cannabis increases the levels of CB2 receptors, which work on our immune cells. This points to why cannabis, specifically THC, can be so helpful in treating these kinds of diseases and conditions. It also shows us why it’s so beneficial to those undergoing chemotherapy, which often affects a person’s appetite and can cause nausea.

In addition, some experts have speculated that diseases like IBD, IBS, and fibromyalgia may be the result of clinical endocannabinoid deficiency, a condition in which a person doesn’t produce enough cannabinoids or cannabinoid receptors. These diseases are promoted by spinal gastrointestinal, and peripheral mechanisms that research suggest cannabis has the ability to block. Cannabis may also decrease inflammation related to IBD, reduce intestinal motility, and reduce fluid secretions caused by inflammation, in turn helping to sooth nausea, and prevent diarrhea and vomiting.

Here’s a rundown of the diseases and conditions that benefit from cannabis treatment:

Crohn’s - A type of inflammatory bowel disease (IBD), it causes inflammation of the digestive tract, leading to bouts of abdominal pain, severe diarrhea, fatigue, malnutrition and weight loss. It may affect any or all segments of the GI tract, from the mouth to the anus.

How cannabis helps: In a 2013 study, almost half of the patients involved in the study achieved complete remission with cannabis treatment. Five out of 11 patients had a lot of success with cannabis and 10 out of 11 patients showed a clinical response to it. In another study, patients saw improved quality of life and reduced Crohn’s symptoms, were able to reduce prescription medication and reduced their need for surgery after beginning their cannabis treatment.

Celiac disease - An immune disease wherein an individual cannot consume gluten as it damages their small intestine. It causes symptoms such as diarrhea, abdominal pain, bloating, and weight loss.

How cannabis helps: Research shows that cannabinoid receptors can help heal damage to the intestinal lining for those with diverticulitis and celiac disease.

Irritable Bowel Syndrome (IBS) - A common disorder that affects the large intestine. Symptoms include cramping, bloating, gas, abdominal pain, diarrhea, constipation or both. Most IBS sufferers deal with the condition their whole lives and are only able to manage their symptoms.

How cannabis can help: A 2005 study showed that cannabis can help reduce intestinal motility and reduce stomach-related spasms in those with IBS. Meanwhile, a 2016 review published in the journal Gastroenterology found that mutations in genes responsible for CB1 receptor coding are linked to several types of IBS. Researchers also theorize that some types of IBS are linked to endocannabinoid deficiency.