Nathaniel Spock - Mar 26 2021
CBD for IBS: Does it really help? [New 2021 Research]
Recent research shows great promise for CBD as a potential treatment for IBS. Some studies indicate that CBD even promotes proper functioning of the brain and body. In this article we look at current IBS treatments and focus on the academic research related to using CBD to treat Irritable Bowel Syndrome and other gut related issues.
WHAT IS IRRITABLE BOWEL SYNDROME (IBS)?
IBS is a medical condition which causes stomach pain, decreased GI motility and digestive distress. Although the medical community has not identified the root cause of IBS symptoms, recent research indicates two potential factors. A study by Dr. Ethan Russo suggests that IBS and Inflammatory Bowel Disease (IBD) may be caused by Clinical Endocannabinoid Deficiency (CED). According to his study, chronic inflammation and IBS symptoms appear when the body is unable to produce endogenous cannabinoids like 2-AG or Anandamide. Other studies indicate a bacterial overgrowth of the small intestinal tract (SIBO) as the potential cause of IBS and other related digestive health conditions. In both cases, the inflammatory response of the body is increased when there is a lack of Endocannabinoids or a bacterial or parasitic infection (possibly created by a lack of endocannabinoid signaling).
- IBS affects between 25 to 45 million people in the United States alone and affects approximately 10 to 15 percent of the global population.
- Statistics show that 60% of IBS patients are women, while 40% are men, although it is likely that women are less hesitant to visit a doctor when experiencing discomfort.
Symptoms vary from mild to severe, yet the majority of IBS sufferers experience:
- Abdominal pain and cramping
- Irregular Bowel Movements
- Increased Diarrhea or Constipation
- Gas and Bloating
- Food Intolerances and Sensitivities
- GERD (Gastroesophageal Reflux Disorder)
- Chronic Fatigue
- Insomnia and Difficulty Sleeping
- Depression and Anxiety
- Headache and Backache
WHAT CAUSES IRRITABLE BOWEL SYNDROME?
Most researchers agree that IBS is linked to chronic stress, gut flora imbalances, and low digestive enzymes in the digestive tract. Although Dr. Ethan Russo agrees that IBS is most likely related to chronic stress and gut flora, he suggests a deeper connection to the endocannabinoid system. He found that the body is unable to manage stress levels when it does not create enough endogenous cannabinoids such as anandamide and 2-AG. This inability to produce a necessary amount of endocannabinoids may cause the symptoms of IBS.
Your body’s GI tract may be telling you that you need more rest, balanced nutrition, and stress-relieving activities to get things back to normal. These may include activities such as walking, exercise, meditation and supplementing with phytocannabinoids like CBD or CBG.
CURRENT TREATMENTS FOR IBS
Depending on the severity of your IBS symptoms, you may benefit from a simple lifestyle or diet change. In severe cases you may try prescription or over the counter medications which are used for the treatment of IBS. Some of these medications come with unpleasant side effects, such as nausea or discomfort, and their long term efficacy has not been determined. It is important to note that while some people find relief from pharmaceutical prescriptions, many others do not. We encourage you to rule out all potential causes of your digestive symptoms with your primary care physician prior to using any pharmaceutical products.
Most doctors recommend dietary changes such as an elimination diet, lifestyle changes, probiotics and fiber supplements as a first trial to improve symptoms. These changes address the symptoms of IBS but may not address the root cause. You can also try an OTC test kit for harmful bacteria or parasites in your digestive tract. These are not uncommon in the era of factory farming.
1. Dietary Adjustments:
Nutrition is a key part of any health strategy and a well-balanced diet can benefit your symptoms in many ways. Depending on your severity level, try the following strategies.
- Mild symptoms: try to eliminate unnatural sugars and processed foods. Get the bulk of your nutrition from lean meats and high omega 3 fish such as wild-caught salmon, anchovies and sardines. Also, include eggs, fermented dairy and other Low FODMAP fruits and vegetables as a part of your daily diet.
- Moderate symptoms: follow the Low FODMAP guidelines or try an elimination diet for high sensitivity foods such as gluten or lactose. Some symptoms of IBS occur due to food allergies and sensitivities.
- Severe symptoms: stick to the temporary B.R.A.T. diet of Bananas, Rice, Applesauce and Toast. You may try to add a vegetable or bone broth if you can tolerate it. After 5 days try to implement a new food suitable for the low-fodmap diet one day at a time. Continue with a low-fodmap diet for at least 1-2 months.
2. Lifestyle Changes
The cornerstone of your successful health plan is a daily routine and healthy habits. Try the following activities for stress reduction and general well-being:
- Exercise: exercise helps to remove toxins in the digestive tract that may build up with certain IBS related symptoms. It is also a great way to boost your endorphin levels for pain relief and stress reduction.
- Meditation or yoga: meditation and yoga have been proven to reduce stress levels and anxiety which may benefit some IBS sufferers.
3. Natural Treatments
Make sure that your body is getting all the necessary macro and micronutrients for optimal gut health:
- Natural Fiber Supplements: taking natural fiber such as psyllium husk can help remove blockages in your lower digestive tract and reduce the occurrence of constipation.
- Prebiotics and Probiotics: these micro bacteria are essential to a healthy gut and GI motility. You can find these in naturally occurring sources such as yogurt, natto, or sauerkraut. Prebiotics like Larch Arabinogalactan is another worth looking into supplementing with.
- Epsom Salt Baths: helps to reduce bloating and cramping associated with IBS. Epsom salts also contain magnesium which is beneficial during periods of high stress.
- Slippery Elm: a wonderful herb for gut repair that has been used for centuries in the United States. Slippery Elm has 3 main benefits:
- Increased mucilage content in your digestive tract.
- It stimulates nerve endings which help neutralize excessive acidity in the gut, soothing ulcers.
- Provides antioxidants to relieve inflammation in the body.
- Marshmallow Root: boasting a high mucilage content, this multipurpose herb covers your digestive tract with protective lining and eases inflammation in your gut. Many users report it helps to soothe ulcers, diarrhea, and constipation, as well as other symptoms of the digestive system.
4. Cannabidiol (CBD) and Cannabigerol (CBG) as potential new treatments for IBS
CBD and CBG are gaining new popularity as beneficial treatments for IBS symptoms including pain, inflammation, low GI motility and overall discomfort. Research is starting to show a relation between CBD and CBG and their anti-inflammatory effect for Irritable Bowel Syndrome. Additionally, new research suggests that overtime, CBD and THC may alter the gut microbiome in a positive fashion. This can have positive long-term results on IBS symptoms, and the ECS may be a future route for a IBS cure as well as additional gut diseases. While more research is needed, preliminary research studies suggest CBD and other phytocannabinoids may be able to cure IBS symptoms over time, most likely in combination with additional botanicals shown to help restore gut lining.
WHAT IS CBD? CAN IT CURE IBS?
CBD (cannabidiol) is a phytocannabinoid compound derived from cannabis, and a promising treatment for IBS sufferers. Although there is currently no definitive evidence that CBD can cure IBS, researchers have found that study participants report reduced abdominal pain, decreased gastrointestinal inflammation and less frequent constipation, and cramping after taking CBD to help alleviate the symptoms of IBS.
Additional research now shows that not only does CBD reduce abdominal pain, gastrointestinal inflammation, and constipation, CBD may also alter the gut microbiome. While the research is preliminary, early results bring about hope of CBD not only as an IBS symptom reliever, but also something that may be able to help cure IBS symptoms overtime and restore the microbiome to healthy function and makeup.
CBD RESEARCH FOR IBS
Here is a brief review of recent studies on the effects of CBD as a treatment for Irritable Bowel Syndrome. The first three studies will focus on the inflammatory and symptom reduction of IBS, while studies four through seven will focus on the microbiota effects of CBD and cannabinoids:
Focus: GI Inflammatory Reduction Studies
Study #1 - Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes By Ethan Russo.
In this study Dr. Ethan Russo explains the important role of the endocannabinoid system (ECS) for gut health. We learn that the Endocannabinoid System regulates GI propulsion, secretion and gut inflammation.
Dr. Russo references a previous study from 2004 which found that the Endocannabinoid system contained a powerful pain blocking mechanism which was able to mitigate the pain response in IBS sufferers:
“Cannabinoids have similarly demonstrated the ability to block spinal, peripheral and gastrointestinal mechanisms that promote pain in headache, fibromyalgia, IBS and related disorders.”
- Russo EB. Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes. Cannabis Cannabinoid Res. 2016;1(1):154–165. Published 2016 Jul 1. doi:10.1089/can.2016.0009
This is good news for the majority of people who suffer from chronic pain such as headaches, cramping, or stomach pain.
Study #2 Cannabidiol Reduces Intestinal Inflammation through the Control of Neuroimmune Axis by Department of Experimental Pharmacology, University of Naples FEDERICO II, Naples, Italy.
A group of scientists from Naples studied the effects of CBD on the immune system’s inflammatory response system. They found that CBD can prevent intestinal damage by reducing the inflammatory response.
“Taken together all these results suggest, for the first time, that CBD, by modulating the glial-immune axis, regulates the fire up of the inflammatory reaction in the intestine thereby preventing the detrimental intestinal damage.”
“Our results indicate that CBD is a key modulator molecule that may interfere with the enteroglial-mediated interactions in an intestinal inflammatory environment. Its activity, markedly focused on S100B protein downregulation, leads to consequent reduction of intestinal damage occurring during acute and chronic intestinal inflammatory status and highlights the importance of glial cells control during these pathological conditions.”
By regulating the inflammatory reaction, CBD helps to limit the damage caused by the body’s immune system as it tries to protect itself from the effects of irritable bowel syndrome and leaky gut.
Study #3 Therapeutic Use of Cannabis in Inflammatory Bowel Disease by Waseem Ahmed , MD and Seymour Katz , MD
Dr. Seymour Katz and Dr. Waseem Ahmed studied 30 individuals who were diagnosed with Crohn's disease. All of the 30 patients reported an improvement in their general well-being due to cannabis use and 22 patients reduced their use of corticosteroids after treatment with cannabis.
“The authors conducted a retrospective, observational study of 30 CD patients in Israel who were legally using cannabis due to a lack of response to conventional treatments and chronic intractable pain. Disease activity before and after cannabis use was estimated using the Harvey-Bradshaw index for CD......All 30 patients rated their general medical well-being as improved after cannabis use via a visual analog scale. Twenty-one patients had a notable improvement after treatment with cannabis use, and the average Harvey-Bradshaw index for all patients improved from 14 to 4.7 (P<.001)......Whereas 26 patients required corticosteroid therapy prior to cannabis use, only 4 patients were still maintained on corticosteroids after cannabis use, suggesting a possible corticosteroid sparing effect of cannabis.”
Of the 10 studies we reviewed on pubmed, we found that most of the current research indicates that CBD promotes reduced inflammation and pain in people who have Irritable Bowel Syndrome and related symptoms.
Focus: Impact of Phytocannabinoids on Microbiota
Study #4 Muccioli GG, Naslain D,Bäckhed F, Reigstad CS, Lambert DM, Delzenne NM, Cani PD. The endocannabinoid system links gut microbiota to adipogenesis.
A team of Belgian researchers revealed that altering the gut microbiome of obese mice through prebiotics, found that the promoted growth of beneficial bacteria, altered ECS expression in fat tissue with implications for lipid metabolism and fat cell formation.
While this is a preliminary study not done in humans, it does suggest there is a link between microbiota and the Endocannabinoid System (ECS).
Study #5 - Prevention of Diet-Induced Obesity Effects on Body Weight and Gut Microbiota in Mice Treated Chronically with Δ9-Tetrahydrocannabinol
Researchers in Canada administered a daily dose of THC to mice on a strict high-fat diet. Gut microbiome health in these animals improved in 3-4 weeks to resemble more closely that of animals fed a healthy and balanced diet.
This study looks at the opposite pathway of study #4. Instead of showing that the ECS is impacted by changes in microbiome, this study suggests the opposite is true as well. That cannabinoids stimulate the ECS and thus impact the microbiome makeup.
Study #6 - Endocannabinoids — at the crossroads between the gut microbiota and host metabolism
In 2018 researchers used anal swabs to assess the microbiome of HIV positive individuals. They found that cannabis use was associated with a decrease in abundance of a certain bacterial strain linked to obesity.
Study #7 - Administration of Δ9‐Tetrahydrocannabinol (THC) Post‐Staphylococcal Enterotoxin B Exposure Protects Mice From Acute Respiratory Distress Syndrome and Toxicity
A June 2020 study published in Frontiers in Pharmacology, Nagrkatti and colleagues demonstrated that administering THC to mice affected with acute respiratory distress syndrome (ARDS) could stop the condition. A severe consequence of runaway immune response known as cytokine storms. ARDS occurs in a small percentage of COVID-19 patients, but it is often fatal.
They concluded that THC alters the microbiome in the gut in a way that is beneficial in suppressing inflammation because bacteria that are favored by THC seem to produce short-chain fatty acids that suppress inflammation.
“We have a mouse model of ARDS where we inject bacterial toxins into the mice, and they die within four to five days because of cytokine storms. We found if you give THC, it cures the mice. They are just running around and healthy. That was amazing.”
While most would assume this study only shows the immune suppression activities of phytocannabinoids, this study found that a change in microbiota within the gut and lungs is what leads to the halting of cytokine storms.
- While certainly more research is needed, we now have more insight than ever before on how gut health impacts the body and the inter-relationship between bacteria, the endocannabinoid system and almost all organs including the brain.
- Not only does CBD reduce inflammation and reduce the symptoms of IBS, but it also stimulates the endocannabinoid system, which has been shown in mouse models to reshape the microbiome makeup.
- The ECS serves as a bridge between bacteria and the body itself, including the brain, relaying signals back and forth in a symbiotic and mutually beneficial relationship.
- CBD and THC can act as a probiotic and increase the natural count of lactobacillus bacterial strain, commonly found in over the counter probiotics.
WHAT IS CBG? CAN IT HELP WITH IBS?
Cannabigerol (CBG) is another important cannabinoid that shows promise in relieving IBS symptoms and potentially addressing the root cause of endocannabinoid deficiency. Surprisingly, CBG has shown to be an effective broad-spectrum antibiotic with an ability to fight antibiotic-resistant superbugs like MRSA. This may be particularly helpful if you suffer from GI conditions caused by bacterial infections like SIBO.
CBG RESEARCH FOR IBS
Study #1 Beneficial effect of the non-psychotropic plant cannabinoid cannabigerol on experimental inflammatory bowel disease
In this study, researchers at the University of Naples Federico II found that CBG showed an ability to regulate GI motility in animal studies of mice afflicted with chemically induced hypermotility. Additionally, CBG showed a curative and protective mechanism for Colitis within the GI tract.
“We have found that CBG reduced colon weight/colon length ratio of the inflamed colonic tissue, which is considered a reliable and sensitive indicator of the severity and extent of the inflammatory response . CBG was effective when given both before and after the inflammatory insult, suggesting a preventive and a curative (therapeutic) beneficial effect. Significant protective effects were achieved starting from the 1 mg/kg dose (preventive protocol) and 5 mg/kg (curative protocol). Maximal efficacy was achieved with the 1 mg/kg dose and the 30 mg/kg dose in the preventive and in the curative protocol, respectively.”
Study #2 Antibacterial Cannabinoids from Cannabis sativa: A Structure−Activity Study
The study showed an antibacterial effect from CBG and CBC. In the study both CBG and CBC were highly effective at fighting MRSA (Methicillin-resistant Staphylococcus aureus), which is highly damaging to the body.
“All five major cannabinoids (cannabidiol (1b), cannabichromene (2), cannabigerol (3b), Δ9-tetrahydrocannabinol (4b), and cannabinol (5)) showed potent activity against a variety of methicillin-resistant Staphylococcus aureus (MRSA) strains of current clinical relevance.”
CBD FOR IBS: WHAT’S THE RIGHT DOSE?
We recommend starting out your CBD intake with a low dose to see how it works. Depending on the type of CBD you are using, you may experience varied effects and a different uptake time. Have a look at the chart below to see what might work best for you:
**Consult a physician regarding if CBD is right for you and guidance regarding dosage. The above recommendation is not meant to diagnose or cure a disease. CBD affects everyone differently and we recommend staring low and going slow.
NOT ALL CBD IS EQUAL: TYPES OF CBD
The three main types of Cannabidiol (CBD) are Full Spectrum, Broad Spectrum and CBD Isolate. At Potter, we go a step further to select specific terpene combinations that provide benefits such as relaxation, pain and inflammation relief, and promotion of sleep. Here is a short overview of the different types of CBD:
Full Spectrum CBD:
The full spectrum variety of CBD is derived from the whole plant. It contains a balance of helpful cannabinoids, terpenes and a micro dose of THC (<0.3%). A number of studies have proven that full spectrum CBD products are more effective per mg. compared to CBD isolate. This is due to something known as the Entourage Effect .
Broad Spectrum CBD:
Broad Spectrum CBD products are similar to full spectrum products with one exception. They contain 0% THC. Broad spectrum products still contain helpful terpenes that contribute to the entourage effect, although the removal of THC may reduce the percentage of terpenes that remain in the end consumer products. Studies have also shown that having even a small amount THC (<0.3%) available with cannabinoids such as CBD should create a more potent effect than without THC.
This is the purest form of CBD with all other cannabinoids, terpenes, flavonoids and residual plant matter removed completely. The isolate is often derived directly from the hemp plant and contains no detectable THC.
While full spectrum products have been shown great benefits compared to broad spectrum and isolate based products, there is one drawback.The terpenes and additional cannabinoids that are present with CBD are not consistent with every product or every batch. The naturally occurring terpenes found in hemp dictate the flavour and effects of all CBD products. Depending on their type and concentration, terpenes can: easily cross the blood brain barrier (making it easier for cannabinoids to enter the bloodstream to be more effective), increase energy and focus, cause sedation, decrease anxiety and depression symptoms, etc.
Potter CBD combines organic full spectrum CBD with a selected and research-based terpene formula to provide a consistent and effective and dose of CBD, based on the effect you need: Calm, Sleep, Relief and Uplift.
Potter Select Spectrum oils:
Our Select Spectrum line utilizes full spectrum CBD and consistent terpene profiles along with beneficial cannabinoids like CBG (cannabigerol) at a consistent ratio of CBD to CBG. The high concentration of additional cannabinoids like CBG, CBC, or CBN contribute to a powerful entourage effect, designed for specific wellness needs.
The combination of multiple cannabinoids and terpenes which have shown in studies to fight inflammation should be more effective than traditional full spectrum CBD oil for certain ailments such as Irritable Bowel Syndrome.
NEW Leaky Gut Repair!
Potter has combined all the knowledge acquired from the research studies included in this write up as well as working with local naturopaths to develop our NEW Targeted Effects Leaky Gut Repair product. It combines water soluble CBD with other ingredients that heal the gut lining, reduce inflammation, and improve the epithelial barrier.
SIDE EFFECTS AND CONTRAINDICATIONS OF CBD
Most people are able to use CBD without any difficulties. However, some of the common side effects that are reported are dry mouth, lower appetite, minor fatigue and diarrhea at higher doses. If you are taking any medications, check with your doctor before using CBD. It may interact with blood thinners, potentially enhance the side effects of NSAIDs, and reduce the effects of other medications.
Are CBD and CBG Safe?
Due to the growing number of CBD, hemp and other cannabis products, it is important to buy CBD oil from a trusted supplier. Always look for high quality, third-party lab tested CBD products for your maximum benefit and safety. This ensures that they are independently tested for quality purity and strength.
At Potter, we test all our products at ProVerde Labs, an accredited third-party cannabis testing facilitly in Millford, Massachusetts. You can easily access the the lab report for each Potter product by batch number here , or by simply scanning the QR code located on our product labels. Recent studies have shown that up to 1500mg of CBD is generally well tolerated in humans. Side effects tend to be mild compared to traditional pharmaceuticals and may include appetite suppression, diarrhea, and fatigue.
Many of our users have personally experienced the unique benefits of CBD oil in their own lives ranging from mild indigestion to severe stomach pains and cramping due to food allergies, SIBO or IBS. There are many online users that have also reported significant benefits after using CBD oil for their IBS pain, such as this reddit user: Years of severe IBS curbed with CBD hemp oil! :
You can even find some Quora discussions related to Cannabis and IBS. Here is a response from Kellie G: Has cannabis helped alleviate SIBO or IBS issues at all?
Research suggests that both scientists and patients have found benefits for IBS with CBD due to its anti-inflammatory action, pain relief, stimulation of the ECS, and its impact on gut microbiota. It is specifically helpful for people suffering from Gastrointestinal Disorders like IBS, SIBO, CD and IBD. While the science and feedback is promising, everyone’s body reacts differently and you may not experience the same effects as other users. However, if IBS symptoms are impacting your quality of life, then it is worth trying a natural treatment that is backed by science, such as CBD, CBG or Beta Caryophyllene.
***Disclosure: Please consult your physician and/or dietician before taking any supplements or making drastic changes to your diet..
- Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes
- Cannabidiol Reduces Intestinal Inflammation through the Control of Neuroimmune Axis
- Therapeutic Use of Cannabis in Inflammatory Bowel Disease
- The endocannabinoid system links gut microbiota to adipogenesis.
- Prevention of Diet-Induced Obesity Effects on Body Weight and Gut Microbiota in Mice Treated Chronically with Δ9-Tetrahydrocannabinol
- Endocannabinoids — at the crossroads between the gut microbiota and host metabolism
- Administration of Δ9‐Tetrahydrocannabinol (THC) Post‐Staphylococcal Enterotoxin B Exposure Protects Mice From Acute Respiratory Distress Syndrome and Toxicity
- Beneficial effect of the non-psychotropic plant cannabinoid cannabigerol on experimental inflammatory bowel disease
- Antibacterial Cannabinoids from Cannabis sativa: A Structure−Activity Study
- The endocannabinoid system links gut microbiota to adipogenesis
- Crosstalk between the gut microbiota and the endocannabinoid system: impact on the gut barrier function and the adipose tissue
- Beyond Cannabis: Plants and the Endocannabinoid System
- Colonization with the commensal fungus Candida albicans perturbs the gut-brain axis through dysregulation of endocannabinoid signaling
- Cannabinoids and the Microbiota–Gut–Brain Axis: Emerging Effects of Cannabidiol and Potential Applications to Alcohol Use Disorders
- Obesity Affects the Microbiota–Gut–Brain Axis and the Regulation Thereof by Endocannabinoids and Related Mediators
- Gut Microbiota & The Endocannabinoid System