Many people with irritable bowel syndrome (IBS) already self-prescribe cannabis to alleviate the painful and often embarrassing symptoms. The anecdotal evidence from these patients, which is shared freely in online groups and forums, overwhelmingly shows that cannabis and cannabis derivatives have been an effective, side-effect-free option for IBS relief to them.
The scientific backing for both cannabidiol (CBD) oil for IBS and marijuana for IBS is racing to catch up with these personal experiences. Even though medical research has a long way to go in determining exactly how cannabinoids alleviate IBS symptoms, some preliminary studies have laid the groundwork for confirming this alternative remedy.
Causes and Symptoms of IBS
IBS is a spectrum disorder characterized by recurrent abdominal pain or discomfort at least three days per month, over three months. The pain and discomfort are associated with two or more of the following:
(i) improvement with defecation,
(ii) onset associated with a change in stool frequency and
(iii) onset associated with a change in stool form.[1]
The exact causes of IBS are still not fully understood, but it is generally thought that IBS could be caused by one or a number of the following:
- Hormonal imbalance (Over 70% of IBS cases are women)
- Uncontrolled stress
- Sensitive colon
- Neurotransmitter imbalance (too much or too little serotonin in the gut)
- Abnormal gastrointestinal contractions
- Unusual immune responses
- Disrupted communication between GIT and the brain [2]
What IBS is not, is ‘all in the head’, and it does not cause cancer.
Other symptoms include the following:
- Bloating
- Constipation
- Diarrhea
- Excess gas
- Rectal bleeding
- Weight loss
- Mucus in stool
While there is no known cure for IBS, some medications and therapies help alleviate the symptoms. In most cases, symptoms flare up in painful episodes after the body experiences a trigger.
Besides the fact that many of these symptoms can cause major embarrassment and changes in one’s social life, there is increasing evidence of a more direct relationship between IBS and mental health - it has been linked to depression. This is perhaps another reason why people are using marijuana for IBS.
The past few decades, researchers have been examining an intriguing link between the microbial environment of our gastrointestinal tract and our mental health. There is a tentative connection between poor digestive flora and an increase in depression, anxiety, bipolar disorder, and schizophrenia.
If this sounds absurd to you, consider the fact that the vast majority of a person’s serotonin (which is thought to regulate anxiety, happiness, and mood) is produced within the digestive tract. Significant evidence also shows that low microbial activity in the gut increases the risk for gastrointestinal illness and mental health issues. This connection is under intense investigation.
RELATED: CBD for digestive issues
CBD Oil for IBS or Marijuana for IBS?
The research is still focusing on whether CBD oil or high-potency THC products will help treat the symptoms of IBS. Both cannabinoids (CBD and THC) have known therapeutic benefits, but they are untested in clinical trials.
Small surveys, done in Spain, the U.S., and Canada, of a few hundred people with inflammatory bowel disease (IBD), discovered that an average of 15% percent of those polled actively used cannabis. The respondents listed the reasons they used marijuana as a co-therapy as “ineffectiveness of current therapies, fewer side effects, and a sense of gaining control over the disease.” While IBD is not IBS, the diseases have overlapping symptoms and similarities, which means this information is helpful.[3]
What about CBD oil for IBS? To date, there is little, if any information about CBD specifically for the treatment of intestinal disease, let alone a known CBD dosage for IBS. With that said, CBD is a proven anti-inflammatory compound, even for targeted inflammation in the gastrointestinal tract. It is also often tolerated much better than THC therapies. Cannabidiol is the most abundant non-psychoactive cannabinoid in marijuana.[4]
RELATED: Could CBD Be Inflammation’s Worst Enemy ... Naturally?
Why Marijuana for IBS Might Work: The Gastrointestinal-Endocannabinoid Connection
One of the most popular theories being pursued is that gastrointestinal illness, including IBS, is due to a lack of endocannabinoids within the digestive system. The endocannabinoid system exists in all mammals. It manages a wide variety of processes, including memory, pain modulation, appetite, mood, immunity, and digestion.
The primary goal of the endocannabinoid system appears to be to create a stable internal environment that supports life at all levels, and it manages this homeostasis by releasing various endocannabinoids in response to internal and external stressors. These cannabinoids interact with receptors, of which high concentrations are found in the gastrointestinal system.
One hypothesis is that there seems to be an endocannabinoid deficiency in people suffering from IBS. However, this is a very tentative theory and only tested on a small sample.[5]
RELATED: Endocannabinoid System Explained
In a roundabout way, scientists had already discovered that increasing certain cannabinoids could influence both IBS and depression. In some cases, doctors have begun prescribing serotonin replacement therapy for people suffering from IBS.
This specific treatment doesn’t work for everyone, but an alternative such as CBD oil for IBS could offer better results.
CBD Oil for IBS
Cannabis contains dozens upon dozens of phytocannabinoids that, just like endocannabinoids, easily interact with our cannabinoid receptors. Each cannabinoid has individual characteristics; cannabidiol (CBD) is one of the most interesting ones being explored.
While the research on CBD for the treatment of IBS is lacking, there is a significant amount of research into CBD’s application for IBD, which has similar symptoms as IBS.
Cramping and Diarrhea
One of the most difficult IBS symptoms to manage is the spontaneous and unpredictable instances of abdominal cramping and diarrhea. People often find themselves in embarrassing situations because of this symptom. The cramping is thought to be caused by something called hypermotility, which is when food moves far too quickly through the digestive tract.
Under normal circumstances, the gastrointestinal tract expands and contracts in a fluid, timed movement meant to process food from one end to the other slowly. However, IBS seems to throw this timing out of whack, leading to food moving (or sometimes not moving) quickly from start to finish. This disrupted timing leads to cramping and loose stools.
Cannabinoid therapy has been shown to slow down this process, relaxing the cramping, and promoting a return to normal digestive function in an animal study. While preliminary, more research should uncover just what CBD oil for IBS related diarrhea can do.[6]
RELATED: CBD Vs THC: Which One Is Better for Pain?
Depression
While there is a link between mental and gastrointestinal health, it is currently still poorly understood. Does depression cause digestive issues, or is it the other way around? In either case, there is a major link between the IBS and major depression. Cannabidiol therapy has been shown to reduce social anxiety and related depression, often in only one dose.[7][8]
It also is being studied as an antidepressant because it has so few side effects. Since many people with IBS also carry around the burden of depression, using CBD therapy may kill two birds with one stone - both the gastrointestinal and mental health problems.
Abdominal Pain
Cannabis and its many derivatives are under study for their pain reducing capabilities, including for gastrointestinal and inflammatory pain. Among some of the many patient surveys and observational trials, is a small, three-month observational, single-arm trial on patients with IBD. The authors discovered that cannabis was able to noticeably reduced their pain and improve quality of life. They concluded that “three months’ treatment with inhaled cannabis improves quality of life measurements.”[9]
Conclusion
As far as researchers currently understand, CBD reduces visceral perception or nerve pain perception. This simply could be a reduction in pain because CBD is proven to reduce inflammation, but CBD oil for IBS remains under scrutiny.
Cannabidiol has proven successful in treating pain and inflammation within the gastrointestinal tract. Because IBS typically increases pain sensitivity, CBD may help to reduce abdominal pain associated with IBS.
For anyone looking for information on CBD dosage for IBS, there are no concrete answers to date. Everyone has a different ‘sweet spot’ when it comes to cannabinoid therapy, and finding it takes a bit of trial and error while CBD oil for IBS, and many other applications, remain the subject of scientific study.
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Sources:
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704116/
[2] https://www.webmd.com/ibs/what-is-ibs#1
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5193087/
[4] https://www.sciencedirect.com/science/article/abs/pii/S1043661809000838
[5] http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.661.940&rep=rep1&type=pdf
[6] https://bpspubs.onlinelibrary.wiley.com/doi/abs/10.1038/bjp.2008.177
[7] http://psycnet.apa.org/record/1996-30733-001
