Does CBD Work for IBS?
- CBD has been found to help in the treatment of symptoms associated with irritable bowel syndrome (IBS). A study in 2016 suggested that CBD might have anti-inflammatory and analgesic effects on mice test subjects(1).
- Another study conducted on rodents reported that the use of a Cannabis sativa extract containing high amounts of CBD helped reduce hypermotility and intestinal inflammation(2).
- The authors concluded that CBD was more effective when used in combination with other Cannabis sativa components. They observed that pure CBD alone did not exhibit therapeutic properties on the inflamed gut.
- An animal study conducted in 2011 has found that CBD had antiemetic (nausea-preventing) properties(3). Nausea is a common symptom observed in people with IBS(4).
- Despite the promising research supporting CBD’s purported therapeutic effects on symptoms associated with nausea, further research is still needed on CBD’s benefits on IBS itself.
Why People Are Turning to CBD for IBS
According to the United States Food and Drug Administration, there is no known cure for irritable bowel syndrome (IBS)(5).
IBS is a chronic condition that largely affects the large intestine(6). Treatments, such as stress management and lifestyle changes, can help alleviate its symptoms.
However, after a period of improvement, these symptoms may suddenly reappear(7). Hence, IBS patients are turning to alternative therapies or complementary treatments(8).
Cannabidiol (CBD), the non-psychoactive component of the Cannabis sativa plant, might be one of these treatments.
Some studies suggested CBD’s promising effects on symptoms associated with IBS. However, further research is still needed regarding CBD’s potential as a treatment for IBS. Regardless, symptom augmentation would be a valuable property of CBD.
A 2016 research conducted in rodents reported that CBD might reduce inflammation and pain-related behaviors associated with arthritis(9). In the study, the transdermal administration of CBD did not cause adverse effects in the test subjects.
Pain, particularly in the abdomen, is one of the most common symptoms of IBS(10).
Another study published in The American Journal of Gastroenterology outlined the therapeutic potential of cannabinoids in treating gastroparesis-related abdominal pain(11).
Gastroparesis, a distinct entity from IBS, is a condition that happens when stomach muscles do not function correctly, resulting in the slow or total lack of movement of food from the stomach to the small intestine(12). The disorder is also known as delayed gastric emptying.
The primary cannabinoids that the authors observed were CBD and tetrahydrocannabinol (THC).
Cannabinoids are compounds that interact with the endocannabinoid system (ECS) to help it regulate several functions, like pain perception, appetite, mood, and memory(13).
THC and CBD are phytocannabinoids that come from the Cannabis sativa plant. Unlike CBD, THC is psychoactive(14).
CBD for Motility
According to John Hopkins Medicine, the causes of IBS have not been determined entirely. However, intestinal motility is believed to be one of the syndrome’s primary features(15).
Motility is defined as food’s movement from the mouth, through the digestive organs, and out of the body(16).
A 2016 study that was published in the journal Frontiers in Pharmacology observed the effects of CBD in rodent test subjects.
The research revealed that the administration of a Cannabis sativa extract with high CBD contents reduced chemically-induced hypermotility and intestinal inflammation in the test subjects(17).
However, the authors discovered that CBD was more effective when combined with Cannabis sativa constituents. In the research, pure CBD alone did not exhibit beneficial effects on the inflamed gut.
CBD for Nausea
The International Foundation for Gastrointestinal Disorders says that nausea is a common symptom observed in IBS patients(18).
A study in 2011 outlined CBD’s antiemetic properties in mice test subjects(19). Researchers suggested that these therapeutic effects might be caused by CBD’s indirect activation of the 5-HT1A receptors located in the brain’s dorsal raphe nucleus.
According to the study’s authors, this activation of the 5-HT1A receptors reduced the release of 5-HT or serotonin in the brain, resulting in CBD’s antiemetic effects.
Serotonin is a hormone involved in several bodily functions, such as nausea, mood, sleep, bowel movements, and blood-clotting(20).
It is also a neurotransmitter found in the central nervous system and other regions of the body(21).
How CBD Oil Works to Alleviate Symptoms of IBS
A 2020 study published in the journal Frontiers in Neuroscience concluded that manipulating the ECS might help treat IBS(22).
The authors reported that targeting ECS receptors cannabinoid (CB) receptors, particularly CB1 and CB2 receptors, might be therapeutic for IBS patients.
According to the researchers, CB1 receptor activation reduced small and large bowel muscle tone and inhibited gastrointestinal motility.
Muscle tone is the amount of tension in a muscle. It helps keep the body in a particular posture(23).
The study also reported that the activation of CB1 receptor attenuated intestinal peristalsis.
Peristalsis is defined as a series of muscle contractions that enable food to move to several processing stations in the digestive tract(24).
The researchers of the 2020 study also found that CB2 receptor activation slowed down gut transit and decreased inflammation by reducing cytokine and chemokine production in activated immune cells(25).
Cytokines and chemokines are signaling proteins that have an essential role in inflammation(26).
A 2014 study suggested that IBS was highly linked to stress. The researchers concluded that IBS treatment should include stress management strategies(27).
In the study, researchers observed that IBS was strongly correlated with psychiatric disorders, such as depression and anxiety. They reported that IBS symptoms might aggravate these psychological conditions(28).
Studies have found that CBD might have promising effects in the treatment of anxiety and depression. This may be a mechanism by which CBD aids IBS patients.
In a 2015 study, researchers reported that CBD might contribute to the alleviation of several anxiety disorders. These conditions include panic disorder, social anxiety disorder, and generalized anxiety disorder(29).
Another study conducted in animals found that CBD had anxiety-reducing and antidepressant effects in the test subjects(30).
IBS is characterized by the following symptoms(31):
- Abdominal pain, cramping, or bloating
- Excessive gas
- Diarrhea or constipation
- Stool mucus
Its causes are unknown, but several factors have been identified to contribute to the development of IBS. These include(32):
- Muscle contractions in the intestine
- Abnormalities in the nervous system
- Inflamed intestines
- Severe infection
- Gut bacteria changes
IBS vs. IBD
According to the Crohn’s and Colitis Foundation, IBS and inflammatory bowel disease (IBD) are distinct(33).
IBS is classified as a syndrome, a group of symptoms, while IBD is a disease.
IBS does not cause inflammation. Meanwhile, IBD can result in inflammation that may destroy and harm the intestines permanently, and even cause cancer.
During a colon examination, signs of IBS cannot be diagnosed instantly. Meanwhile, IBD signs can be observed during diagnostic imaging.
IBS sufferers are not prone to developing colon cancer or IBD. Meanwhile, those who have IBD have higher risks of having colon cancer.
The types of IBD include Crohn’s disease and ulcerative colitis(34).
The Pros and Cons of CBD Oil for IBS
- Human and animal studies have discovered CBD’s therapeutic effects on the symptoms of IBS.
- CBD is regarded as generally safe to use(35). Its safety profile is more favorable than the safety profile of some conventional medications prescribed for IBS treatment.
Among these traditionally prescribed IBS drugs are antidepressants, which have serious side effects, including dizziness, erectile dysfunction, heart rhythm problems, and insomnia(36).
- It is suggested that CBD is non-addictive. Currently, no case of CBD dependence has been reported in humans(37)
- Aside from CBD’s apparent benefits on IBS symptoms, CBD may have promising effects on mental health and related medical conditions, like anxiety and depression.
- More research needs to be done on whether CBD helps treat IBS. To date, studies are limited to CBD’s suggested benefits on IBS symptoms, such as pain relief.
- Despite the reported therapeutic effects of CBD, it is essential to note that CBD has side effects, like diarrhea, tiredness, and changes in weight or appetite (38).
- The US FDA has not approved the use of medical marijuana and even CBD in the treatment of disorders and diseases except for epilepsy.
- There is a proliferation of mislabeled CBD products in the market due to the lack of FDA regulation(39). Hence, patients with IBS are encouraged to seek the medical advice of medical professionals before adding CBD to their medication regimen.
How CBD Oil Compares to Alternative Treatments for IBS
Treatments prescribed for IBS include dietary changes and traditional medications, like antidepressants and pain medications(40).
Harvard Medical School says that IBS patients are exploring alternative treatments for their condition(41). Treatment through probiotics (live microorganisms) and prebiotics are seen as promising alternative treatments for ailments associated with the gastrointestinal tract (gi tract).
Other alternatives include relaxing activities, such as yoga and meditation, as these treatments relax muscles and reduce activity in the nervous system(42).
Compared to these alternative treatments, CBD may also protect gut health due to its purported contribution to reduced intestinal inflammation in human test subjects(43).
Like yoga and meditation, CBD has been shown to reduce anxiety, as supported by a clinical study done in humans(44).
Compared with these treatments, CBD has other reported therapeutic uses. These purported benefits range from neuroprotective properties(45) to pain-reducing effects that may help treat conditions like chronic pain(46).
How to Choose the Right CBD for IBS
CBD oil types can be classified as full-spectrum CBD oil, broad-spectrum CBD oil, or CBD isolate.
A full-spectrum oil is believed to be a more effective treatment than broad-spectrum oils and CBD isolates.
Full-spectrum oils make use of all the ingredients of a cannabis plant, including less than 0.30% THC, flavonoids, fatty acids, terpenes, and essential oils.
Cannabis sativa’s components are believed to synergize for maximum therapeutic effect. This phenomenon is called the entourage effect.
The downside of using full-spectrum oils is that they contain THC.
Some drug tests may detect THC. Select individuals may also experience mild psychoactive effects, even if THC amounts in a full-spectrum oil are minimal.
Those who want to avoid THC consumption may go for broad-spectrum CBD. It has all the ingredients of a full-spectrum oil, except for THC.
Individuals who prefer to use CBD purely may purchase isolated cannabidiol. However, as reported in a 2016 study, pure CBD might not be useful in the treatment of some IBS symptoms, like intestinal inflammation(47).
Before using any CBD product, patients should check CBD’s legality according to their state laws.
The US FDA states that CBD and other products that contain less than 0.30%
THC are no longer controlled substances under federal law(48).
CBD Dosage for IBS
Because the US FDA does not regulate CBD, there is no standard dosing chart for CBD. However, patients are encouraged to start low and slow.
Begin with small amounts of CBD. If there are no adverse effects, the dosage may be increased until the patient finds the right CBD dose.
Once the dosage appropriate for users has been found, IBS patients should use CBD consistently. Effects should be observed in two or three weeks as long as intake is regular.
Patients are encouraged to document their bodies’ reactions to the use of CBD through a journal. Before taking CBD, IBS patients should consult with their doctor first.
How to Take CBD for IBS
CBD has various formats that allow patients to use it for IBS in several ways. These include:
- CBD oils and tinctures (drops) – CBD may be applied under the tongue for more efficacy. More experienced users prefer this type of administration because they have control over their CBD dosage.
- CBD capsules, gel caps, gummies, or edibles – CBD may be mixed with food or beverages. This approach is helpful for those who dislike the grassy taste of CBD.
- CBD vape pens – Effects are instantaneous when CBD is inhaled. However, vaping may cause lung damage(49). IBS patients who also take CBD via vape pens have no way of determining the amount of CBD they take for each draw.
- CBD topicals – These CBD formats include salves, balms, lotions, and creams. IBS patients may apply CBD topically during massages to help alleviate abdominal pain. However, it is challenging to apply consistent doses of CBD when an individual uses CBD topicals.
The use of medical cannabis and CBD may be helpful in the alleviation of IBS symptoms. However, THC may get users high.
Currently, no treatment can cure IBS entirely. For this reason, more IBS patients are exploring alternative therapies that may help with their gastrointestinal system conditions.
Conventional approaches include dietary and lifestyle changes. IBS patients are also prescribed pain medications and antidepressants.
Popular alternative remedies for IBS include treatment through probiotics and prebiotics, yoga, and meditation.
Compared with these treatments, CBD may have promising therapeutic effects on the relief of pain, motility, and nausea. These conditions are some of the most common symptoms of IBS.
It is suggested that the interaction of cannabinoids, like CBD, with the ECS cannabinoid receptors might help treat IBS.
Currently, studies that have been done are limited to CBD’s benefits on the symptoms of IBS. Further research should be done on CBD’s benefits on IBS alone.
Before using CBD in the treatment of IBS flare-ups, patients should seek professional counsel from their doctors first.
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