Edibles are cannabis products consumed orally that can sometimes lead to acid reflux. Acid reflux occurs when stomach acid flows back into the esophagus, causing a burning sensation. This issue stems from both the pharmacological action of cannabinoids and the physiological effect of the edible’s food ingredients.
How Cannabinoids Influence the Esophageal Sphincter
The body’s endocannabinoid system (ECS) regulates functions throughout the gastrointestinal tract, including motility and sensation. Cannabinoids like Delta-9-tetrahydrocannabinol (\(\Delta^9\)-THC) interact with the ECS by binding to cannabinoid receptors found in the gut.
This interaction affects the muscular ring separating the esophagus from the stomach, called the lower esophageal sphincter (LES). Studies show that \(\Delta^9\)-THC can reduce the basal pressure of the LES, making the muscle looser. When LES pressure is lowered, stomach contents, including acid, can flow back into the esophagus, causing reflux.
The effect of \(\Delta^9\)-THC on the LES is dose-dependent; higher concentrations are more likely to cause muscle relaxation. This pharmacological mechanism suggests the compound itself can trigger or worsen reflux symptoms. However, other studies suggest that \(\Delta^9\)-THC may reduce the frequency of transient LES relaxations, which are the main triggers for reflux events.
The Contribution of High-Fat Edible Ingredients
While cannabinoids have a direct physiological effect, the common ingredients used to create edibles also play an independent role in triggering reflux. Edibles are often baked goods, chocolates, or candies that contain high levels of fat and sugar to bind extracts and improve flavor.
High-fat foods are well-known triggers for acid reflux because they delay gastric emptying, meaning the stomach remains full longer. A fuller stomach creates more pressure, increasing the likelihood of contents pushing past the LES. Fats also independently signal the LES to relax, compounding the effect of any cannabinoid-induced muscle loosening.
Many edibles are chocolate-based, and chocolate contains methylxanthines, compounds that directly decrease LES pressure. Other common flavorings in edibles, such as mint, are also recognized reflux triggers that can exacerbate symptoms. Therefore, the edible’s food base can act as a standalone cause of reflux, separate from the actions of the cannabis compounds.
Managing and Preventing Reflux Symptoms
For individuals who experience reflux after consuming edibles, several practical adjustments can help mitigate the symptoms. Choosing different edible formats, such as low-fat gummies or tinctures, over high-fat baked goods can reduce the contribution of dietary triggers. Tinctures and capsules, which avoid high-fat food bases, may be gentler on the digestive system.
Managing the dosage is also an effective strategy, as higher concentrations of \(\Delta^9\)-THC are more likely to reduce LES pressure. Starting with a low dose and increasing gradually allows the user to find a balance that avoids triggering symptoms. Simple behavioral changes, such as avoiding lying down immediately after consuming an edible, can prevent stomach acid from easily flowing back into the esophagus.
If reflux symptoms do occur, over-the-counter antacids can provide temporary relief by neutralizing stomach acid. Dietary modifications, like avoiding other reflux-triggering foods such as spicy foods or citrus fruits around the time of consumption, can also minimize the risk. If symptoms persist or become severe, consulting a healthcare professional is advisable to discuss long-term management options.