Can CBD Help With IBS?
CBD has shown promising results in helping to alleviate inflammation across the body. The medical community is now attempting to assess how far and to what extent these anti-inflammatory features can help with Irritable Bowel Syndrome (IBS).
What is IBS?
IBS is a disorder affecting the large intestine, causing its inflammation. Its main symptoms are cramps, abdominal pain, bloating, excessive gas, diarrhoea, and constipation—sometimes swaying between the two.
As the name suggests, IBS is not a disease but rather an unpleasant condition. It can make people change their lifestyles and dietary patterns. Sometimes, it can even lead to anxiety and depression. Sufferers of IBS can’t eat what they want and need to always be careful in their life choices so as not to trigger a bout of IBS.
How do you regulate IBS?
Sufferers usually manage their condition by being careful about what they eat and avoiding anything that can trigger their symptoms. The quality and frequency of their meals have to be closely monitored. Moreover, there is some strong indication that stress and tense conditions can cause a flare-up of IBS.
All these restrictions and careful food planning can be exhausting. The knowledge that there is no specific medication causes some people to despair, sometimes leading them to depression.
The frustrating part of IBS is that people have to live with it throughout their life. IBS episodes can last for a few days to a few weeks. Then episodes disappear until they reappear again. Many find it impossible to definitively establish the trigger that sets off an IBS episode.
Can you cure IBS?
There is no cure for IBS at the moment. The recommended treatment for bouts of IBS tends to be antispasmodics, laxatives, and medicines that limit the motility of the GI, therefore alleviating bouts of diarrhoea.
All these, however, cover up the symptoms without treating the real cause: inflammation.
Until that is cured, IBS continues to cause people pain and disorder. They have to live with the knowledge that their condition will accompany them through their lives.
It’s no wonder, then, that many IBS sufferers try CBD to alleviate their symptoms and simplify their everyday life.
What causes IBS?
Amazingly, the medical community is still unclear as to the exact causes of IBS.
A few commonalities of IBS sufferers have allowed scientists to establish some possible causes of IBS. However, no definitive cause has been identified yet.
One cause of IBS is the defective functioning of the gastrointestinal (GI) tract. It would appear that in IBS, muscles in the GI contract either too quickly, causing diarrhoea, or too slowly, causing constipation.
Another suspect is the connection between the brain and the gut, also called the brain-gut axis. It seems that our GI is closely connected to our nervous system. Sometimes, the GI does not understand properly the signals sent by the nervous system, therefore causing bloating or pain during digestion.
Finally, another suspected cause is an over-sensitive immune system. This triggers bouts of IBS in an attempt to get rid of imaginary intruders. Alternatively, it causes an over-reaction of the GI to some real intruders. This over-sensitive immune system has been linked to intestinal inflammation, causing pain and diarrhoea.
IBS and gut bacteria
In exploring the causes of IBS, several studies have focused on the role of bacteria in the GI tract. This is due to the GI tract’s immense interaction with the brain and its connection with our immune system.
IBS has been linked to an increased or abnormal proportion of bacteria in the gut.
Our gut contains various bacteria. These are in a fine balance between them, keeping our system working.
Our gut bacteria (also called gut flora) protect us from nefarious bacteria entering our body and keep our GI immune system working. They also provide important nutritional elements to our bodies.
However, it is relatively easy to disrupt this fine balance. The disruption usually includes a change in the proportions of the various bacteria populations in the GI and colon.
It is yet unclear what causes our gut flora to become unbalanced. Doctors and researchers have speculated about antibiotics, infections, food allergies, stress, genetic predisposition, or hormones.
While the causes are still unclear, the consensus is that IBS occurs when our gut flora is out of balance.
What is CBD? Can CBD oil help with IBS?
CBD is one of the hundreds of cannabinoids in the cannabis plant. The cannabis genus of plants contains marijuana and hemp. CBD is extracted from the hemp plant’s flowers. Hemp flowers contain very little THC—the psychotropic cannabinoid which causes marijuana’s ‘high.’
CBD products are legal in the UK as long as they contain only CBD and less than 0.2% of THC, making them safe to take (read more on CBD’s legal status here).
The reason researchers and medical scientists are looking into CBD for treating IBS is CBD’s possible effectiveness in alleviating inflammation.
The gut flora imbalance causes inflammation in the GI. This, in turn, leads to the aforementioned symptoms of IBS. What if sufferers could take CBD to treat their IBS?
How does CBD help with Irritable Bowel Syndrome?
Back in the 1990s, researchers found that our body contains an internal endocannabinoid system. This includes two main natural cannabinoid molecules: anandamide and 2-AG.
Our endocannabinoid system has a vast array of responsibilities, including appetite, metabolism, mood, regulating inflammation, sleep, memory, motor control, temperature sensation, and fertility, among others. It keeps our body in balance, checking every single second that all its responsibilities are harmonized.
If something is out of synch, our endocannabinoid system either repairs the problem itself or sends a signal to our brain to let us know that we need to fix something. For example, when we get hungry, our endocannabinoid system tells our brain that we should eat something.
The system works by sending its two cannabinoids (anandamide and 2-AG) which attach to specific receptors. Anandamide attaches to CB1 receptors and 2-AG attaches to CB2 receptors, thus triggering our body to act.
Interestingly, 2-AG mainly acts on the immune system and is closely linked to inflammation-fighting. It is also very similar to CBD.
We are still not sure how CBD interacts with our endocannabinoid system. It would appear that it does not attach to CB2. Instead, it stimulates our own cannabinoids—in this case, 2-AG—to work better and more efficiently (read more on the effect CBD has on the endocannabinoid system here).
Naturally, doctors have wondered if CBD can enhance the work of 2-AG in treating inflammation, including IBS. What has intrigued researchers is that the CB2 receptors found in our immune cells are mostly located in our digestive system.
Since our digestive system is the epicentre of IBS, doctors are exploring how CBD can affect the inflammation in the GI.
Can CBD help with digestive issues?
Unfortunately, there is little large-scale research on CBD’s effectiveness. Even fewer studies concern CBD’s efficiency in treating particular conditions like IBS.
Even so, several studies suggest that yes, CBD can help with digestive issues and IBS in particular.
A 2008 review showed that people suffering from IBS seemed to have lower levels of endocannabinoids in their system, including 2-AG. The speculation was that these low levels of endocannabinoids resulted in GI inflammation. Further speculation would be that CBD ‘pushes’ our body to produce more endocannabinoids, hence fixing the balance in our GI tract.
A 2016 study concluded that when giving CBD to IBS patients, there was improved intestinal motility and fewer spasms.
A 2007 study showed the presence of CB1 and CB2 in the GI tract and explored their role in diminishing intestinal inflammation. CBD oil seems to have an indirect link on triggering these receptors. The theory is that CBD makes our own endocannabinoid system work better, hence the indirect effect. This is supported by another review, which displayed the effectiveness of CB1 receptors in protecting again inflammation.
Finally, a 2011 study found that IBS sufferers had increased levels of a type of bacteria called LPLs in their gut. The study showed that taking CBD decreased the inflammation caused by this overpopulation of bacteria.
Apart from a direct effect on inflammation, CBD could also help alleviate some other symptoms of IBS, like loss of appetite. It may also help regulate pain and cramps and reduce the anxiety, stress, and discomfort caused by the condition.
How much CBD oil should I take for IBS?
CBD has few side-effects, namely nausea, diarrhoea, low blood pressure and changes in appetite. These side-effects seem to stem by either pollutants in the oil carrier of CBD or high dosage. Therefore, they can usually be avoided by either changing the dosage or changing the brand of CBD you are taking.
However, CBD also interacts with some medication you might be taking. This includes antidepressants, blood thinners, some antibiotics, and some chemotherapy medication among others. So, before trying CBD, discuss with your doctor any other medication you are taking, even if it’s over the counter.
The general agreement is to start with a low dosage and increase it slowly over the days until you have reached a dosage that works for you. There is very little risk of overdosing in CBD, so this should not be a concern.
How can I choose CBD?
If you wish to try CBD for your IBS, here are a few pointers to help you choose the right brand for you:
- Find a reputable brand. One that clearly states how much CBD it contains and make sure it contains less than 0.2% of THC.
- CBD oil and hemp oil are two very different things. Make sure you are buying CBD oil and not hemp oil.
- Check where the hemp comes from and whether the producer does third-party lab tests on the products, checking for purity and safety.
- Do not trust manufacturers who make impossible claims about how CBD can cure pretty much anything. The research is still ongoing and there is nothing definitive about its effectiveness.
- Trust producers who display batch numbers on their products. Even better, trust those who publish the test results online. These are all signs they are taking their business seriously and can track their products.
- Confirm you are buying natural CBD, which is made from the hemp plant, rather synthetic CBD which is produced in a lab. Synthetic CBD has been associated with more side-effects.