Can CBD Help With GERD?

  • Gastroesophageal reflux disorder (GERD) is caused by esophageal dysfunction and unregulated gastric acid secretion (1).  
  • A study posted by Pharmacological Reviews mentioned that cannabinoid receptors (CBR) activities in the endocannabinoid system (ECS) might provide modulatory effects on gastric acid production, GI inflammation, and esophageal function (2)
  • A 2016 review published in the Asian Pacific Journal of Medicine mentioned that CBR activities caused by CBD and THC might reduce gastric acid secretions (3)
  • The British Pharmacological Society published a study demonstrating how CBR activities might help modulate esophageal function (4)
  • Studies acknowledged that the gastric protective and anti-inflammatory properties of cannabinoids might be useful in treating GERD (5)

Can CBD Help With GERD?

Frequent acid reflux can lead to gastroesophageal reflux disease (GERD). This condition is caused by stomach contents flowing back into the esophagus and the mouth.

Common symptoms of GERD include heartburn (burning sensations in the chest), voice hoarseness, sore throat, coughing, and wheezing. 

Over-the-counter medications that can treat GERD include antacids (stomach acid neutralizer) and proton pump inhibitors (PPI), such as cimetidine and nizatidine (acid reducers). 

However, these medications might produce adverse effects, such as nausea, vomiting, constipation, stomach pain, and neurotoxicity. Usually, these side effects were observed among elderly patients (6). These factors are why some individuals are turning to alternative treatments. They can also be very cost-prohibitive over the long-term.

Currently, there is a lack of direct studies on CBD’s efficacy in treating GERD

However, existing studies have shown that CBD’s activity on cannabinoid receptors in the endocannabinoid system (ECS) might provide several modulatory effects on gastric acid production, GI inflammation, and esophageal function (7)

The ECS, which maintains balance by regulating bodily functions, is present in all vertebrates and mammals.

A 2016 review posted in the Asian Pacific Journal of Medicine mentioned that cannabinoid receptor (CBR) activities caused by CBD and THC might reduce gastric acid secretions (8)

In the review, the author cited studies demonstrating how Cannabis sativa extract protected animal subjects from mucosal damage and gastric lesions (9).

Cannabis sativa (hemp) is a plant rich in cannabinoids such as CBD and THC (10)

The author concluded that gastric protective and anti-inflammatory properties of cannabinoids might be useful in treating GERD and peptic ulcer disease (11).  

Lower esophageal sphincter (LES) dysfunction is the principal cause for GERD. The dysfunction may be brought by transient LES relaxation or LES pressure (12).

An animal study posted by the British Pharmacological Society mentioned that CBR activities might modulate GI motility by reducing LES relaxation (13)

Some researchers believe that gastric motility abnormalities might also be linked to the onset of GERD  (14)

A review published by the British Journal of Pharmacology mentioned that CBR activities might modulate upper and lower GI motility (15)

Moreover, GERD is often associated with inflammation and oxidative stress. Researchers mentioned that inflammatory cytokines might cause early inflammation of individuals with GERD (16)

A study using animal and human biopsies have shown that CBD possesses anti-inflammatory and antioxidant effects (17)

The authors added that these therapeutic benefits might be useful in treating GI inflammation conditions (18)

A cross-study from the American Journal of Physiology also observed these benefits. The authors concluded that CBD’s activity on ECS receptors might modulate gut motility and reduce inflammatory diseases (19)

Additionally, esophageal leakage is the primary mechanism of reflux-related cough and constriction of airways in the lungs (bronchoconstriction) (20)

The European Journal of Pharmacology published an animal study demonstrating how receptor activation might reduce microleakage that causes bronchoconstriction (21)

Lastly, researchers mentioned that GERD could be a significant source of anxiety and depression. A clinical study published by Cureus concluded that out of 258 patients, 41.4% suffered from depression, 34.4% suffered from anxiety, and 27.13% suffered depression and anxiety (22)

A study released by Frontiers in Immunology acknowledged that CBD might improve mental health due to its anxiolytic and antidepressant properties (23)

How CBD Oil Works to Help With GERD

The endocannabinoid system (ECS) is studied for its role in maintaining homeostasis in the human body. 

The ECS is composed of receptors that are spread across the human body. These receptors include the G-protein cannabinoid receptors, CB1 and CB2 (24), and G-protein receptor 55 (GPR55) (25).  

These receptors can be found in the immune system, central nervous system, and gastrointestinal system (GI) (26)

Researchers acknowledged that activating the CB1 and CB2 receptors in the ECS might influence bodily functions, resulting in potential therapeutic benefits (27).  

The presence of cannabinoid receptors in the GI system highlights the ECS’ role in modulating GI functions, health, gastric secretions, and inflammation (28).  

The CB1 receptor might have a role in modulating intestinal motility by reducing LES relaxation and promoting esophageal peristalsis (29)

The author added that CB1 activation might reduce acid and intestinal fluid secretions (30)

Aside from antisecretory effects, influencing of the ECS might also provide anti-inflammatory properties (31)

CB2 is mostly distributed in the central nervous system. Researchers also found CB2 receptors in inflammatory tissues and cells in the gastrointestinal tract (32)

Moreover, CB2 activation might further regulate GI tract motility and reduce the uptake of inflammatory diseases (33)

Studies mention that CB2 activation might play a role in inhibiting microvascular leakage and bronchoconstriction on animal reflux models (34)

A 2016 review mentioned that GPR55 might also be involved in GI motility. The authors indicated that the administration of a receptor agonist slowed down the gut transit in mice models (35)

Modulatory effects can be triggered or stimulated by cannabinoids, such as cannabidiol (CBD), tetrahydrocannabinol (THC), cannabichromene (CBC), cannabinol (CBN), and cannabigerol (CBG) (36)

There is evidence that CBD was able to activate GPR55 in an animal study published by the British Journal of Pharmacology (37)

Moreover, even with its low affinity to CB1 and CB2, CBD might also influence how other cannabinoids trigger the receptors. This mechanism allows for receptors to reduce the expression of inflammatory cytokines (38)

Cytokines are signaling proteins that modulate the body’s response to inflammation (39).

Moreover, an in vivo study posted by the British Journal of Pharmacological attributed another cannabinoid, CBC, for its ability to reduce inflammation-induced hypermotility (40)

The author continued that CBC’s ability to modulate GI motility warranted further studies on conditions, such as mucosal inflammation, gastric secretion, intestinal secretion, and visceral pain (41).

Although existing studies acknowledged CBD’s potential in influencing CBR activities, clinical trials are needed to prove CBD’s efficacy on GERD symptoms

The Pros and Cons of CBD Oil for GERD

The Pros

  • CBD might trigger CBR activities in the ECS system, thus, providing modulatory effects on the upper GI system (42)
  • CBD might trigger CBR activities and help reduce gastric acid secretions (43)
  • CBD might also trigger CBR activities and help decrease lower esophageal relaxation (44)
  • A study concluded that gastric protective and anti-inflammatory properties of cannabinoids, such as CBD and THC, might be useful in treating GERD (45)
  • CBD might help alleviate anxiety and depression of individuals suffering from GERD (46).
  • CBD has been acknowledged to have an excellent safety profile for human consumption (47).  

The Cons

  • There are no direct studies on how CBD might help with GERD symptoms. All existing studies are focused on CBD’s potential activities on ECS receptors that might help modulate GERD symptoms.
  • If used in high doses, CBD may cause side effects, such as drowsiness, loss of appetite, and dry mouth (48).
  • A recent animal study discovered that CBD might cause hepatotoxicity (liver damage) (49)

How CBD Oil Compares to Alternative Treatments for GERD

Some individuals may prefer drinking chamomile tea to soothe their digestive tract. Studies have acknowledged that flavonoids in chamomile flowers provide anti-ulcerogenic properties. The flavonoids might also reduce acid output (50).

Another alternative treatment option is ginger tea. A clinical study from Food, Science, and Nutrition mentioned that ginger consumption led to improved GI motility. The authors also acknowledged ginger’s anti-inflammatory and anti-ulcer properties (51).

Moreover, researchers acknowledged that deglycyrrhizinated licorice might alleviate acid reflux symptoms by suppressing acid production in the stomach (52)

CBD might be similar to the alternative treatments mentioned due to its anti-inflammatory and acid-reducing properties (53). CBD infused tea may also be taken instead of ginger or chamomile tea.

How to Choose the Best CBD Oil for GERD

The most recommended type of CBD oil for reducing GERD symptoms is full-spectrum

Full-spectrum CBD oil contains all the major phytocannabinoids in hemp, such as CBD, CBC, CBG, CBN, and 0.3% THC. Together, these cannabinoids provide the individual with the “entourage effect.” 

A review published in Frontiers in Plant Science mentioned that the entourage effect (or cannabis synergy) increased the primary activity of the endocannabinoid receptors (54)

The author added that cannabis synergy helped explain why botanical medications display high efficacy compared to isolated compounds (55)

The entourage effect was demonstrated by a controlled trial on patients with uncontrollable pain. In the study, THC-dominant opioid treatment failed to produce significant improvement compared to placebo (56)

However, a whole-plant extract containing both THC and CBD produced remarkably better results (57).  

Broad-spectrum typically contains CBD, CBG, CBC, and CBN. Broad-spectrum is recommended for individuals who want to achieve the entourage effect without the presence of THC.

Lastly, individuals who cannot tolerate other cannabinoids may opt for CBD isolate. CBD isolate typically contains 99% pure CBD

Additional tips to consider before buying CBD:

  • Individuals may find more information about the CBD product by checking customer reviews and testimonials.
  • Individuals with GERD must first consult with a gastroenterologist and discuss treatment options. Doctors may recommend prescription medications.
  • Individuals intolerant to prescription medications side effects must discuss their plan to use CBD with their doctors. 

CBD Dosage for GERD

There is a lack of scientific studies on the appropriate dosage when using CBD for GERD

However, there are existing dosing studies that observed CBD’s therapeutic benefits on other health conditions. 

The British Journal of Clinical Pharmacology shared a review that collected data from clinical population dosing studies. 

The authors mentioned that a dose range of less than 1 to 50 milligrams per kilogram a day was used on various medical conditions, including chronic pain, anxiety, epilepsy, and many more (58)

A study shared in Pharmacology and Pharmacy mentioned that CBD has a bell-shaped curve response. The authors observed that a limited dose range was enough to achieve CBD’s therapeutic benefits (59)

This hypothesis was supported by another study posted in the Frontiers of Pharmacology. The study experimented with dosages using healthy volunteers with public speaking anxiety (60)

The study found that a dose of 300mg was able to reduce anxiety scores better than 100 mg and 900mg dosings (61)

However, individuals must always be cautious when using CBD. A recent study shared by Molecules observed that extremely high CBD doses caused hepatotoxicity in rat models (62)

How to Take CBD Oil for GERD

The recommended CBD administration for GERD is through oral or sublingual delivery. 

Oral administration methods may be available through capsules, softgels, and gummies. These methods may be taken with or without a meal. 

CBD tinctures may be used for sublingual administration. Individuals may use an applicator to put a few drops of CBD under the tongue. CBD tinctures may have an earthy taste due to terpenes (aromatic compounds). 

Both oral and sublingual administration were observed to provide plasma concentrations that lasted three to four hours after intake (63).  

Sublingual administration has also been observed to provide faster results when taken in a fasted state (empty stomach).  However, high plasma concentrations were found when CBD is taken during a fed state (64).

When using CBD for its pain-relieving properties, the recommended administration is through smoke or vapor inhalation. A quick delivery method is recommended for emergencies, such as heartburn.

A study posted by Biomedical and Environmental Mass Spectrometry shared that CBD inhalation can deliver plasma concentrations within three minutes (65).  

This evidence was supported by another study that acknowledged the lungs to be very efficient in delivering CBD into the bloodstream. The authors explained that vapor inhalation could deliver plasma concentrations within 10 minutes or less (66)

However, individuals must be aware that smoke or vapor inhalation could have side effects, such as chest pain, shortness of breath, chemical irritation, and allergic reactions (67). By and large, it is generally reasonable to assume that inhalation of volatile substances will cause some degree of pulmonary inflammation.

What Is the Difference Between Acid Reflux and GERD?

Acid reflux occurs when the LES muscle lets stomach acid flow back into the esophagus. This condition is caused by transient lower esophageal sphincter relaxations (TLESR). 

The sphincter muscle opens when food is swallowed. During TLESR, the sphincter opens even when the individual is not swallowing. Gastric acid in the esophagus may lead to inflammation (esophagitis). 

GERD is a more severe form of acid reflux disease. Similar to GERD, acid reflux symptoms include heartburn, coughing, and wheezing.

Untreated GERD may also cause esophageal mucosal damage (68) and hiatal hernia (69) brought by prolonged gastric acid exposure on the lining of the esophagus.  Moreover, individuals with GERD have a higher risk of esophageal cancer.

Aside from OTC and prescription medication, surgical intervention is also an option to treat GERD

Studies have shown that 40% of GERD patients do not respond to antacid and acid reducers. Thus, some individuals opt for the anti-reflux laparoscopic procedure to improve their quality of life (70)

However, GERD patients must meet qualifying criteria before they are considered for the procedure. 

Risk Factors and Other Causes of GERD

Some lifestyle factors may contribute to the prevalence of GERD symptoms and cause further irritation to the esophagus. Risk factors and causes include:

  • Eating large meals, spicy foods, and fatty foods 
  • Eating late at night
  • Smoking
  • Drinking alcoholic beverages and coffee
  • Taking aspirin 
  • Obesity
  • Pregnancy
  • Hiatal hernia (bulging of the stomach)

How Is CBD Oil Different From Medical Marijuana?

CBD oil is extracted from Cannabis sativa (hemp) using CO2, steam, or a solvent. The extraction’s purpose is to create a concentrated version of Cannabis sativa. The cannabinoid concentrations can be added into carrier oils, edibles, capsules, and vape juice.

Also, the extraction methods allow the manufacturers to control the amount of THC

In the United States, CBD products are prohibited from having more than 0.3% THC in the concentration.

In medical cannabis or marijuana, the plants are harvested and dried. Recreational and medicinal marijuana use is only legal in 11 US states (71), while CBD is legal in all US states and territories (72)

However, CBD remains unregulated. Brands are not held accountable for inconsistent cannabinoid concentrations. Thus, individuals are advised to research before buying CBD products

Legitimate CBD brands provide customers with a certificate of analysis (COA). The COA is a third-party test result produced by ISO certified laboratories. The lab test for cannabinoid concentrations and the presence of harmful chemicals, such as heavy metals, pesticides, microbial, and fungal contaminants.

The COA is the determining factor if the product is safe for human and animal consumption. 


Studies acknowledged that CBD might influence gastric production by triggering receptors in the ECS system. This activity might help in alleviating acid reflux symptoms (73).

CBD‘s receptor activities might help modulate the esophageal function and prevent gastric acid leakage into the esophagus (74).

Moreover, cannabinoids, such as CBD and CBC, have been shown to possess gastric protective and anti-inflammatory properties that might alleviate GERD symptoms (75).

CBD has also been acknowledged for its ability to reduce anxiety and depression (76).

However, more clinical studies are needed to support CBD’s efficacy in treating GERD

Whatever treatment is chosen, one must make the necessary lifestyle changes to alleviate GERD symptoms.

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