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Overview of Cirrhosis

Cirrhosis is the late stage of scarring, or fibrosis, of the liver. It can be caused by a variety of conditions, including hepatitis and chronic alcohol abuse. The scarring associated with cirrhosis develops in response to damage done to the liver and it cannot be undone. The liver is responsible for detoxifying harmful substances within your body and cleaning your blood and making vital nutrients, but the scarring that develops makes it difficult for the liver to function properly. When cirrhosis is advanced, it can be life threatening. If diagnosed and treated early, however, further damage can be limited and prevented.

According to Mayo Clinic, some causes of cirrhosis are inherited, like iron buildup, cystic fibrosis, and genetic digestive disorder, while other causes occur later in life, like chronic alcohol abuse, hepatitis c, hepatitis b and nonalcoholic fatty liver disease.

Patients with cirrhosis commonly experience fatigue, easy bleeding and bruising, itchy skin, loss of appetite and nausea, leg swelling, weight loss, fluid accumulation in the abdomen, and red spider-like blood vessels on the skin.

Treatment for cirrhosis is dictated by the extent of the liver damage upon diagnosis. The goals are to slow further scar tissue progression and prevent or treat associated symptoms. In some cases, if a liver ceases to function, a liver transplant may be required.

Findings: Effects of Cannabis on Cirrhosis

Research regarding cannabis and its potential impact on cirrhosis and other chronic liver diseases is complex. The two major cannabinoids found in cannabis, tetrahydrocannabinol (THC) and cannabidiol (CBD) bind with or influence the cannabinoid receptors (CB1 and CB2) of the endocannabinoid system within the body. Previous studies had actually implicated action of CB1 in the progression of cirrhosis, fibrosis, and other liver diseases. However, CB2 receptor activation has shown beneficial effects on alcoholic fatty liver, hepatic inflammation, liver injury, regeneration and fibrosis and CBD has. Therefore, research suggests that using cannabis to selectively activate the CB2 receptor offers therapeutic potential for cirrhosis and other liver diseases (Mallat, et al., 2011).

Studies suggest that CBD can help combat cirrhosis progression by assisting in the death of hepatic stellate cells (HSCs). When HSCs are activated, they proliferate and produce excess collagen, which causes the accumulation of scarring on the liver. CBD’s activation of the CB2 receptors, however, has been shown to be effective at inducing apoptosis (death) in these activated HSCs (Lim, Devi & Rozenfeld, 2011). Cannabidiol has also been shown to restore liver function in mice experiencing liver failure (Abraham, et al., 2011).

Findings also support that CBD can serve as a protective strategy against ischemia reperfusion, the pivotal mechanism of tissue damage in cirrhosis, by reducing the force of key inflammatory pathways and oxidative/nitrative tissue injury. These effects of CBD are independent of their impact on the CB2 receptors (Mukhopadhyay, Rajesh & Pacher, 2011).

CBD has also proven effective at protecting the liver from steatosis caused by alcohol drinking by preventing an increase in oxidative stress and the autophagy induced by alcohol, thus protecting the liver from progressive damage (Yang, et al., 2014).

Cannabis may also serve helpful in managing symptoms associated with cirrhosis. Cannabis has long been known to limit or prevent nausea and vomiting from a variety of causes (Sharkey, Darmani & Parker, 2014) (Parker, et al., 2015). In addition, if cirrhosis patients are suffering from a loss of appetite, medical marijuana has demonstrated effective at increasing appetite and stabilizing body weight (Beal, et al., 1995).


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