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.