CBD for Irritable Bowel Syndrome (IBS)
CBD Oil for irritable bowel syndrome
What is irritable bowel syndrome
Irritable bowel syndrome (IBS) is a common condition that affects roughly between 6–18% of people worldwide. The condition affects the digestive system, causing changes in the frequency and/or consistency of bowel movements that are often accompanied by lower abdominal pain. IBS is a lifelong problem that can negatively impact almost every aspect of everyday life, making it difficult to live with.
The exact cause of IBS is unknown, but theories include things like food passing through the gut too quickly or too slowly, oversensitive nerves in the gut, stress and a family history of IBS. Symptoms can be sparked by poor diet, certain foods, stress, poor sleep and changes in gut bacteria, however, each person has different triggers, making it difficult to generalize, and name specific foods, habits and stressors that prompt symptoms to appear.
Symptoms of irritable bowel syndrome
IBS symptoms vary between individuals Symptoms often get worse after meals, with a tendency to come and go over time, and lasting anywhere from a few days, to weeks or even months at a time. Primary symptoms include:
- Abdominal pain and cramping
- Alternating constipation and diarrhea
- Changes in bowel movements such as slow-moving stool, hard stool and mucous or blood int he stool
- Gas and bloating of the abdomen
- Food intolerances
However, in severe cases IBS can affect different parts of the body and can sometimes resemble other diseases and conditions, for instance:
- Fatigue and difficulties sleeping
- Anxiety and depression
- Problems urinating such as needing to urinate often, sudden urges to urinate, and feeling an inability to fully empty the bladder
- Halitosis, or bad breath
- Joint and muscle pain
- Pain during sex in women
- Irregular menses in women
Irritable bowel syndrome Medications & Treatment
There is currently no cure for IBS and treatment focusses on symptom management with changes in diet and certain medications helping control symptoms.
In addition to dietary changes, medications are often recommended to help manage symptoms and IBS flare-ups. These include antispasmodic medications that reduce abdominal cramping and pain by relaxing the muscles in the gut. To help relieve constipation, bulk-forming laxatives are recommended while anti-motility medications reduce diarrhea symptoms. In severe cases, tricyclic antidepressants (TCAs) are prescribed as they can help reduce abdominal pain and cramping.
IBS specific medications include and eluxadoline for severe diarrhea-predominant IBS and alosetron in women only, lubiprostone for constipation-predominant IBS in women only, and the antibiotic rifaximin to reduce diarrhea in people with IBS. However, these medications are usually a last line of defense as their side-effects can be severe. For instance, symptoms can worsen and result in bloody stools, while side-effects like nausea, vomiting, heart palpitations, fever and dizziness are also common.
Usually, the first treatment intervention is to keep a food diary to identify specific foods that trigger individual symptoms. In addition, general dietary changes are also recommended to avoid the triggering of IBS symptoms, involving the elimination of certain foods such as beans, chocolate, milk, and alcohol as these are known to cause either constipation or diarrhea. Other non-pharmaceutical interventions that can help ease, reduce and manage IBS symptoms are:
Managing fiber intake - While some people with IBS need to decrease their fiber intake, others will have to increase it, often having to supplement with fiber such as psyllium husks. In addition, a diet of both water soluble and insoluble fiber can help promote healthy digestion.
Probiotic supplements: People with IBS often have poor gut flora and supplementing with probiotics (beneficial bacteria that support gut health) can help heal gut flora and reduce symptoms.
CBD for irritable bowel syndrome
Research & Scientific Evidence
Researchers are aware of the role that the endocannabinoids system (ECS) plays in the protection of the gastrointestinal (GI) tract from, for example inflammation and abnormally high gastric and enteric secretion. This makes the ECS a new and promising therapeutic target against different GI disorders prompting several investigations into cannabinoids for the treatment of IBS. However, to date, the vast majority of the research investigated either Δ9-tetrahydrocannabinol (THC) on its own, or a combination of THC and CBD with only a handful investigating only CBD for IBS.
In a 2010 study published in Pharmacology & Therapeutics reviewed scientific literature related to the ECS and the specific cannabinoid receptors, molecular targets and mechanisms underlying the efficacy of cannabinoids such as THC and CBD in the treatment of inflammatory disease of the GI tract such as IBS.
The investigators concluded that CBD affects several mechanisms underlying IBS. For instance, CBD has been shown to inhibit acetylcholine- induced contractions in the ileum, suggesting a direct action the smooth muscle of the gut. Similarly, data from the literature showed that CBD is a prostaglandin inhibitor that reduces gut inflammation and inflammation-induced hypermotility. CBD also inhibited intestinal transit and inhibited FAAH expression in inflamed intestine. They also found that studies on intestinal epithelial cells suggest that CBD prevents oxidative stress, an underlying factor that leads to mucosal protection.
The authors concluded that CBD has been the most thoroughly investigated of all the cannabinoids and also show the greatest potential as an effective treatment option for inflammatory gastrointestinal diseases by reducing oxidative stress and counteracting hypermotility and mucosal inflammation.
Investigating the effect of CBD on intestinal inflammation on intestinal biopsies from patients with a certain type of inflammatory bowel disease and from intestinal segments of mice with induced intestinal inflammation, researchers published their data in a 2011 paper published in PLOS One.
Through histological, biochemical and immunohistochemical analysis they found that CBD controlled both inflammatory response during intestinal inflammation, and enteric glial cells (EGC) activation. EGCs are thought to maintain the integrity of gut mucosa and act as a component of immune system cells that fight against infections. In addition, they also found that CBD is capable of modulating the immune system’s response to inflammation by controlling the cells responsible for the inflammatory response.
They concluded that the results from their two experiments show that CBD should be considered as a promising therapeutic agent that modulates the neuro-immune axis which is a target in the treatment of inflammatory bowel disorders such as IBS.
The anecdotal evidence for cannabinoids as an effective symptom management tool for IBS is numerous. Medical practitioners report that patients who suffer from IBS with symptoms ranging from mild to severe find relief in cannabinoid based medicines. However, they do find that symptom relief is better with cannabis extracts or CBD oils that are derived from cannabis and contain higher amounts of THC. However, there are reports of people who use hemp-derived CBD oil to manage their IBS symptoms effectively.
CBD as a complementary treatment
Scientists know that ECS plays an integral role in the pathophysiology and treatment of irritable bowel syndrome. And although CBD for treating the symptoms of IBS is limited, we do know that CBD acts on the ECS either directly or indirectly via the CB1 and CB2 cannabinoid receptors located throughout the body, including the gastrointestinal tract. Therefore, although there are limited researcher pertaining to CBD and IBS directly, the implication is that CBD can help manage and reduce the severity of various IBS symptoms by CBD activating and modulating both CB1 and CB2 receptors.
So, for instance, CBD can:
- Regulate gastric secretion, gastric emptying and intestinal motility by modulating the CB1 receptor
- Limit visceral sensitivity and pain by activating the CB2 receptors
- Reduce GI inflammation associated with IBS and other gastrointestinal disorders by activating the CB2 receptors
- Reduce in spasmodic episodes in IBS patients by regulating TRPV1 activity
CBD can help in other ways as well. Nausea and a loss of appetite are symptoms often associated with both IBS and side-effects of IBS medications. CBD can help reduce the symptoms of nausea, and for some people also increase appetite. Similarly, CBD in addition to reducing inflammation and abdominal spasms, it also reduce pain by blocking pain signals. CBD can also aid in relieving feelings of depression and help improve sleep, another two symptoms that IBS patients suffer from.
Bottom Line: Can CBD Oil help for IBS?
For some IBS can be bothersome while for others, it is something that affects almost every aspect of their lives. CBD has the potential to help relieve and manage many of the symptoms of IBS, but more research is needed. Until then, CBD’s role in the treatment of IBS is primarily as an adjunct or complementary therapy that should be used with dietary and lifestyle changes and/or medications. Always consult a medical practitioner before using CBD. Your physician can monitor dosage, symptom severity, contraindications, and other clinical parameters to ensure that your CBD treatment is both safe and effective.