CBD’s analgesic, axiolytic, and anti-inflammatory properties offer hope to GI sufferers.
CBD treatments for gastrointestinal issues such as GERD (gastroesophageal reflux), Crohn’s, irritable bowel syndrome, and ulcerative colitis are common.
A 2016 study published in Current Neuropharmacology examined the role of cannabinoids in treating GI conditions. The authors reported that regulating the endocannabinoid system (ECS) impacts several gastrointestinal processes and the ECS receptors CB1 and CB2 and their related enzymes.
Phytocannabinoids, such as synthetically or naturally produced cannabidiol (CBD), have implications for decreasing gastric acid secretion and activity through the direct or indirect stimulation of the EC S’ CB1 and CB2 receptors.
Other benefits of the receptors’ indirect activation help with intestinal inflammation and hypersensitivity in rodent models. Experimental data also show that CB1 receptors suppress secretions and regulate the functions of the gut lining. Stimulating the ECS receptors through the use of CBD may have positive implications for GI issues.
The GI tract
The gastrointestinal tract has 2 essential functions, digestion and host defense. We all know about digestion: the process that breaks down our chewed food through enzyme actions to nourish our bodies. Our stomachs’ hydrochloric acid sterilizes invading viruses, toxins, antigens, and bacteria. That host defense protects us from potentially dangerous bacteria and viruses.
Our ECS receptors are distributed throughout the GI system, and they regulate GI function. Found in the enteric nervous system (the nerves in the gut) and in immune system cells, the ECS keeps gastric motility (the muscle process that moves food through the intestine) balanced. It’s also responsible for modulating intestinal inflammation and pain signaling, as well as maintaining the gut’s barrier lining.
Doctors theorized that intestinal issues originate in the enteric nervous system. Utilizing the system’s receptors in the treatment for these illnesses seems logical. When CB1 and CB2 receptors increase their activity, they may be signaling a problem in the GI tract and responding to it.
When your ECS doesn’t work as it should, it can’t respond appropriately to GI system imbalance. People with a gene mutation in the ECS are more prone to irritable bowel syndrome and chronic pain. This link is evidence that a dysfunctional ECS is one of the causes of intestinal illnesses.
GERD and CBD
Gastroesophageal reflux affects nearly 20% of all adults. Characterized by heartburn, chest pain, or swallowing difficulties, medications and other interventions are used to treat GERD. There are, however, reports that show the drugs may have increased risks for dementia and cancer.
Studies conducted on animals show that phytocannabinoids, such as CBD, stimulate CB1 receptors to inhibit acid secretions. CBD reacts with the GI system’s soft muscle tissue to calm peristalsis—food movement through the gastrointestinal tract. CBD also regulates spasms and irregular functions of the lower esophageal sphincter, which is the gatekeeper responsible for keeping stomach contents (especially stomach acids) from regurgitating into the esophagus.
CBD’s analgesic and anti-inflammatory properties also reduce the reflux pain and soothe the inflammation of soft esophageal tissues.
CBD and Inflammatory Bowel Disease
IBD is a catchall phrase for 2 chronic conditions, Crohn’s and ulcerative colitis, that refers to chronic bowel inflammation. Crohn’s disease can occur anywhere in the intestinal tract, but it’s usually found in the small intestine. Ulcerative colitis, which affects the large intestine, has symptoms similar to Crohn’s. ECS dysfunction may be the underlying cause of IBD. Increased risk for colorectal cancer is associated with both illnesses.
Several global studies appear to show CBD, THC, and other phytocannabinoids help alleviate symptoms and improve overall health. In most cases, cannabis users reported they had less abdominal pain, nausea, diarrhea, and improved appetite compared to non-users.
Two reports drawn from the National Inpatient Sample database and published in 2019 compared the outcomes of Crohn’s patients who used cannabis against those who did not. Cannabis users had less incidence of intestinal scarring and narrowing, bowel obstruction, blood transfusion, abscesses and fistulas. They also tended to have shorter hospital stays and require fewer transfusions and nutrition IVs.
As a result of an Israeli randomized, placebo-controlled study, researchers concluded that Crohn’s patients received more relief from a CBD/THC treatment than from treating intestinal inflammation alone. Study participants underwent a placebo regimen or a mixture of 15% CBD and 4% THC. Compared to placebo recipients, the CBD group showed a reduction in their symptoms, 65% of whom achieved clinical remission.
CBD and Irritable Bowel Syndrome
Clinicians have begun to believe a chronic stress-induced endocannabinoid deficiency is the most likely cause behind IBS. In addition to changed bowel habits, the syndrome is characterized by excessive gas, abdominal pain, and bloating. Frequently, those with IBS also suffer from TMJ, fibromyalgia, migraine, anxiety or depression, and chronic fatigue.
Many IBS patients report they have benefitted from CBD to treat symptoms and underlying causes of IBS. Also, there is a growing body of research that supports patients’ subjective claims. By modulating a host of GI functions—gut motility, enzymatic secretion, inflammation, and more—CBD provides relief from the syndrome’s debilitating symptoms.
CBD, how it works for gastrointestinal issues
There is a strong correlation between GI conditions and inflammation, stress, and anxiety. And, there’s plenty of research that demonstrates CBD’s effectiveness in treating chronic pain. The 4 physiological and mental health hallmarks of gastrointestinal issues—anxiety, stress, pain, and inflammation—are prime candidates for CBD treatment because of its known benefits in these areas.
CBD works to relieve gastrointestinal symptoms on several fronts:
- modulates the immune system
- calms the inflammatory effects of cytokines
- decreases the porousness of the GI tract
- relieves anxiety and stress
- alleviates vomiting and nausea
Gastrointestinal conditions are complex problems that involve not only the GI tract but also the enteric nervous system. CBD’s effects on the symptoms of GI problems have great potential for sufferers. Often, traditional medications have side effects or aren’t as effective in providing relief, whereas CBD has few side effects.
Taking CBD for GI issues
It’s always best to begin a CBD regimen at a low dose, usually 25 mg or less, twice a day. After a week or so, incrementally increase each of the two doses until you reach an optimal dose of 100 mg/day—the upper limit that most of the subjects in various studies received. Dosage levels will also vary depending on the severity of symptoms. It may take several weeks to feel CBD’s effects, and a few weeks after that, to obtain continuing relief.
Consider a pure CBD oil with a mix of terpinolene, beta-caryophyllene, pinene, and limonene terpenes to maximize the entourage effect’s benefits. Select a reputable retailer who can show you a certificate of analysis from an independent lab. The analysis will rate the product’s purity and identify the percent by volume of CBD and terpenes. It will also have information on the number of doses, and the amount of CBD delivered per dose.
As always, talk to your medical provider before changing your medications or adding CBD to your regimen.