Cannabis and irritable bowel syndrome
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- An overview of the research
- Studies on cannabis and IBS
- Medical cannabis patients share their stories
- What the experts say about cannabis and IBS
- Bottom Line
Irritable bowel syndrome (IBS) affects up to 45 million people in the United States, some of whom are coping with a severe form known as Crohn’s disease. IBS can cause a host of symptoms such as constipation, diarrhea, bloating, and abdominal pain. In this article, we’ll examine the research on cannabis and IBS to uncover whether medical marijuana may be able to help patients manage the condition.
An overview of the research
Several recent studies have investigated the effects of cannabis on general IBS as well as Crohn’s disease and ulcerative colitis. The results of these studies suggest that cannabis could benefit individuals diagnosed with IBS, especially those who are seeking pain relief from associated symptoms.
Studies on cannabis and IBS
One 2005 study published in the Journal of Molecular Medicine indicated the body’s endocannabinoid system may have beneficial properties for gut tissue. The endocannabinoid system governs how cannabis interacts with the body while maintaining homeostasis or balance. The researchers stated, “The endocannabinoid system may serve as a potentially promising therapeutic target against different GI disorders, including frankly inflammatory bowel diseases…”
Does the likelihood that the endocannabinoid system can positively impact gut health mean that cannabis can help relieve the symptoms of IBS? According to a review of clinical studies published in 2020 in the Journal of Gastroenterology, the answer may be yes. Researchers found that IBS-related symptoms including abdominal pain, nausea, diarrhea, and poor appetite all improved with cannabinoids. CBD and THC are the two primary cannabinoids in cannabis, but there are more than 100 others that could work in tandem to ease IBS symptoms. However, the researchers emphasized that cannabinoids did not cause IBS to go into remission in the clinical trials studied nor was a reduction in inflammation observed.
Further, the scientific evidence is not consistent across the board. In a 2017 report titled “The Health Effects of Cannabis and Cannabinoids,” a committee of the National Academies of Science, Engineering, and Medicine found some gray area with regard to cannabis and IBS, specifically dronabinol, a synthetic marijuana-derived drug used to treat nausea and vomiting. The scholars wrote, “There is insufficient evidence to support or refute the conclusion that dronabinol is an effective treatment for the symptoms of irritable bowel syndrome.” Results, therefore, will vary from patient to patient and experiences will always be subjective.
In contrast, this same committee concluded that cannabis has proven to be an effective treatment for pain. The researchers wrote, “There is substantial evidence that cannabis is an effective treatment for chronic pain in adults.” Cannabis, then, may address one of the most challenging symptoms of IBS but is not a cure for the disease.
Medical cannabis patients share their stories
In 2019, a team of researchers performed an observational study of IBS patients and published the findings in the European Journal of Gastroenterology & Hepatology. A total of 127 patients participated in the study. The outcome showed that 30 grams of cannabis per month was a good benchmark for the majority of patients who did not experience adverse effects. In addition, researchers observed a decreased usage of other medications as well as clinical improvements in the IBS patients.
Another 2019 observational study, published in the Baltimore-based journal Medicine, considered outcomes for hospitalized patients suffering from ulcerative colitis. The researchers found that cannabis consumption was associated with shorter hospital stays as well as a lower prevalence of bowel obstructions.
IBS patients should consult with their physicians to determine if cannabis may be a viable treatment option and, if so, what an appropriate dosage would be.
What the experts say about cannabis and IBS
In line with the research discussed in this article, Dr. Adie Rae, neuroscientist and scientific adviser to Weedmaps, added, “Some clinical studies show strong promise for cannabis treating IBS, but it’s complicated. Cannabis and its constituents appear to improve the quality of life for these patients, although the severity of their disease may not measurably improve. IBS patients who use cannabis may be able to reduce their other medications and go back to work. They might have fewer complications and shorter hospital stays. However, in randomized clinical trials, the disease itself doesn’t appear to improve much. Lots more research is needed.”
In terms of treating pain, one of the most unpleasant hallmarks of IBS, Rae said, “IBS can be excruciatingly painful. Cannabis, and especially THC, are safe and effective treatments for chronic pain in adults.”
Rae continued, “Because cannabis can produce euphoria and relieve pain, it’s not surprising that IBS patients report a higher quality of life when they use cannabis. However, the role of the endocannabinoid system in gut health is indisputable, and the anti-oxidative and anti-inflammatory effects produced by cannabinoids are undeniable; there has got to be something happening at the cellular level.”
According to Rae, these answers only create more questions which scientists are still attempting to resolve. She stressed, “The question is, what kinds of cannabis, for which kinds of patients. There are countless varieties of whole-plant cannabis in the world, with varying levels of THC, CBD, and other bioactive molecules. There are also several ways to consume cannabinoid medicines, and it is unclear which administration methods are most effective. It will take decades of research to figure out which molecules, in what ratio, on what treatment regimen, are good for treating chronic diseases, including IBS.”
The bottom line is that cannabis may help manage the symptoms of IBS, notably pain, but further research is crucial to pinpoint the best methods for administration.
In this article, we’ll examine the research on cannabis and IBS to uncover whether medical marijuana may be able to help patients manage the condition.
Medical Marijuana and IBS Relief
Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York, where he is also a professor. He was the founding editor and co-editor in chief of Inflammatory Bowel Diseases.
With many U.S. states passing laws that legalize the use of marijuana for medicinal purposes, you may be wondering if medical marijuana would be a helpful treatment option for your irritable bowel syndrome (IBS). Learn about the potential benefits and risks of marijuana and what is known about its usefulness in addressing the symptoms of IBS.
Marijuana itself is typically a mixture of the dried leaves and flowers (and less typically the seeds and stems) of Cannabis sativa, also known as the hemp plant. Its effect on the body is primarily due to a cannabinoid chemical called delta-9-tetrahydrocannabinol (THC), which creates its mind-altering effects.
People have used marijuana for centuries in order to feel high, as part of a spiritual practice, or to ease symptoms of pain, nausea, and vomiting. Its use for medicinal purposes is controversial and remains a matter of great debate among users, scientists, and governing bodies.
The term “medical marijuana” was coined to describe the use of the Cannabis plant, either in whole or extract form, to treat symptoms or diseases.
Medical Marijuana and IBS Relief
It might be interesting to learn that we have cannabinoid chemicals within our bodies as part of our endocannabinoid system. The system is not perfectly understood, but we know that it consists of cannabinoid receptors and endocannabinoid chemicals.
The receptors are located all throughout our central and peripheral nervous systems, and a large number of them are also located within our digestive system, which has led scientists to investigate ways to use them to help with conditions like Crohn’s disease, ulcerative colitis, and peptic ulcer disease.
The first researcher to make a connection between marijuana and IBS was Ethan B. Russo who, in 2003, theorized that IBS and other health conditions were the results of a deficiency in the amount of the body’s own cannabinoid chemicals.
As support for his theory, he pointed to the fact that IBS is frequently seen alongside fibromyalgia and migraine headaches, two health conditions that Russo also theorized might involve the endocannabinoid system of the body.
Further research has lent some support to Russo’s theories. Research on animals, for example, has shown that endocannabinoids affect gut motility and visceral hypersensitivity, both of which are factors that have long been highlighted as contributing to the pain, bloat, feelings of fullness, and bathroom problems associated with IBS.
Endocannabinoids also protect the digestive system from inflammation and stomach acids. This line of inquiry thus seems to lead naturally into the question of whether medical marijuana might be an effective treatment for IBS symptoms.
As of now, there do not seem to be many research studies on the use of smoked marijuana for IBS. From the few randomized controlled trials that do exist, one theory is that cannabinoids in marijuana affect acetylcholine and opioid receptors in addition to cannabis receptors, in this way providing IBS symptom improvement.
Other studies suggest that those with diarrhea-predominate irritable bowel syndrome (IBS-D) and alternating IBS may benefit from dronabinol (a type of cannabinoid often used with cancer patients) because it decreases gut transit and increases colon compliance.
As for the prescription forms of medical marijuana, a few studies have looked at the effectiveness of Marinol, a synthetic form of THC. Results have not been overwhelmingly positive. Although there was some limited evidence that the medication reduces large intestine contractions, results on pain relief have been mixed.
However, due to the fact that the endogenous cannabinoid system is involved in so many digestive system symptoms, such as nausea, vomiting, ulcers, reflux, and diarrhea, it is thought that further development of pharmaceutical medications targeting the endocannabinoid system of the body is certainly warranted.
Medical Marijuana and Getting High
Depending on the strain that is used, you might get a feeling of being “high.” In addition, you may experience feelings of having sensations feel altered, your mood may change, your thinking skills (judgment, problem-solving, memory) may be impaired, and you may experience diminished control over your muscles.
It is the THC in marijuana that causes all of these central nervous system changes. Another component of marijuana, cannabidiol (CBD), offers symptom relief but without causing brain and motor functioning changes.
Medications or strains of medical marijuana that are high in CBD but low in THC will not cause you to experience “high” sensations.
For medicinal effects, non-prescription forms of marijuana are best smoked or vaporized. Vaporizing reduces the risk of damage to the lungs that can occur with smoking.
And although therapeutic benefits are slower to occur and may be lessened, marijuana can also be consumed through edibles, including cookies, brownies, lollipops, and teas. For optimal effects and safety, prescription medical marijuana may be the best option.
Risks of Marijuana Use
Although proponents of marijuana argue that it can be used safely, it is not without risks. This does not mean that all people who use medical marijuana will experience these problems. But risks are heightened for people who are older or for those who are suffering from an illness that affects the immune system.
These risks are also heightened in street forms of the drug, due to a lack of purity. And your susceptibility to these risks is also increased with the heavier use of the drug.
The potential negative effects of marijuana, whether in a plant or synthetic form, include the following:
- Addiction or dependence
- Interference with normal brain development
- Lung damage (when smoked)
- Cognitive problems, with negative effects on judgment, concentration, memory, and balance
- Increased risk of testicular cancer (when smoked)
- Increased risk of heart attack
- Birth defects (when used by a woman who is pregnant)
- Mental health problems
Many of these potential negative effects hold true for the synthetic forms of medical marijuana.
Severe side effects associated with the use of prescription medical marijuana medications include an increased risk of seizures, hallucinations, arrhythmias, and tachycardia.
If any of the following applies to you, you should not use marijuana for any reason, medical or otherwise:
- You are not yet age 25 or older—due to concerns about your brain development.
- Have a current or history of a substance abuse disorder, including addiction or dependence on marijuana
- If you or any member of your family has a history of a psychotic psychiatric disorder
- If you are pregnant, planning on getting pregnant, or breastfeeding an infant
- You have heart disease
- You have any kind of a lung disease
As of this writing, the federal government considers marijuana use in any form to be illegal. However, a number of states have either made the use of recreational or medical marijuana legal.
In states that have legalized the use of medical marijuana, there are often restrictions on the amount allowed and the conditions for which it can be used. Here are some resources:
- State Medical Marijuana Laws
- Legal Medical Marijuana States
- State Marijuana Laws Map
Where It Stands
Having IBS can be a very frustrating experience as its symptoms can be quite difficult to get under control. And although there are some prescription medications for the disorder and its symptoms, the relief from these treatments is often incomplete and unsatisfying. This unfortunate state of affairs has led people who have IBS to seek alternative remedies, one of which is the use of marijuana.
The use of marijuana as a viable treatment for IBS has not yet been supported by research. The uses of prescription forms of medical marijuana have neither been shown to have clear benefits for IBS nor have they been approved by the FDA for use as a treatment for IBS.
The last factor to consider is the legality of medical marijuana for IBS as most, if not all, state laws have not yet necessarily included IBS as a specified allowed condition.
A Word From Verywell
The good news is that there does appear to be a connection between the endocannabinoid system and its receptors and digestive symptoms. This suggests that the potential exists for a pharmaceutical medication that targets these receptors may provide relief from IBS symptoms.
As pharmaceutical companies are now seeing the potential profits of effective IBS medications, due to the sheer number of people who have the disorder, there is hope that they will focus their research efforts on the development of medications that target the endocannabinoid system and that are proved to be effective for IBS.
It’s also important to note that ongoing research may discover other useful components of marijuana, apart from THC. The chemical complexity of marijuana may also be why the few studies on its benefit for IBS have returned mixed results.
The bottom line is that more research is needed which will clarify the role of cannabis as a treatment for IBS, and what dosages could help with digestive issues. In the meantime, your best course of action is to work with your doctor on a symptom management plan that is right for you.
Have you considered trying marijuana to ease your IBS symptoms? Learn all about the safety, effectiveness, and legality of medical marijuana for IBS.