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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.

  • Overview
  • Symptoms
  • Causes
  • Diagnosis
  • Treatment
  • Coping
  • Nutrition

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.

Medical Marijuana

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
  • Seizures

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.

Contraindications

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

Complicated Legalities

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.

Can Marijuana Help Irritable Bowel Syndrome (IBS)?

Stomach cramps, bloating, gas, constipation, diarrhea… People suffering from irritable bowel syndrome or IBS experience all these discomforts. To ease the suffering, some afflicted with this condition are turning to medical marijuana for symptom relief and pain management. But does science and experience back up the belief that marijuana can help irritable bowel syndrome?

Let’s take a closer look.

IBS NOT IBD

If there is any good news for persons suffering from IBS, it is that they are not afflicted with IBD, which stands for inflammatory bowel disease. (As a side note, there is evidence that suggests that marijuana may be an effective treatment for IBD.)

To a person in the throes of severe abdominal cramps, pain, constipation or diarrhea — symptoms common to both conditions — this distinction may not bring much comfort. But from a medical perspective, IBS is not considered to be as severe a disorder as IBD, and is often labeled as a “functional disorder.”

IBD is a term that applies to two degenerative conditions — Crohn’s disease and ulcerative colitis — which cause chronic inflammation of the gastrointestinal tract and can create long-term physical damage. By contrast, IBS can cause significant discomfort, and may interfere with the normal digestive process, but typically does not result in physically-damaging inflammation or lasting harm to the intestines.

THE SEARCH FOR RELIEF

The exact causes of IBS are not fully known, and often vary from person to person. In some cases, it’s simply a matter of having an overly sensitive small intestine or colon. Certain foods and medications may trigger a bout of IBS, and the condition has been linked to elevated levels of stress. As of yet, there is no single pill or potion that cures of all the problems and pains of IBS. Instead, treatment is aimed at addressing the various causes and symptoms individually, which has led many sufferers to seek out a range of alternative treatments, including marijuana.

Lifestyle changes such as limiting caffeine consumption and increasing fiber intake will sometimes relieve the symptoms of IBS, but there is no one dietary change that works for all sufferers. Various medications may also provide relief for one or more symptoms. There are both over-the-counter and prescription laxatives to help with constipation, and a number of anti-diarrheal agents for the opposite problem. Pain relievers may mitigate the discomfort of cramping, probiotics may lessen gas and bloating, and antidepressants are sometimes recommended, not to alter mood, but to reduce the intensity of pain signals going from gut to brain.

Each of these remedies addresses a specific symptom or group of symptoms, but none alone provide total symptom relief.

THE ENDOCANNABINOID CONNECTION

Endocannabinoid research was a key factor in marijuana’s transition from a traditional medicinal remedy to an increasingly accepted component of modern medicine. First identified in the 1990’s, the endocannabinoid system extends throughout the human body, including brain, organs, connective tissues, glands, and immune cells. Within these various tissues, cannabinoids stimulate cannabinoid receptors, which are involved in regulating a wide range of functions involving pain suppression, memory, mood, appetite and immune responses. The endocannabinoid system has also been shown to play a role in controlling visceral pain, which is pain that emanates from internal bodily organs.

The realization that there were significant numbers of cannabinoid receptors within the digestive system led some researchers to investigate the potential use of cannabis and its derivatives for conditions like Crohn’s disease, ulcerative colitis, and peptic ulcer disease. One of the pioneers in this research was scientist, Ethan Russo.

In 2003, Russo first suggested that there might be a link between IBS and cannabinoid deficiencies. In the years since, he and others have gathered supporting research that points to the role such deficiencies might play in conditions such as migraines, fibromyalgia, and IBS.

A 2011 study involving persons with IBS showed that dronabinol, which is a synthetic form of the marijuana cannabinoid THC, “decreased fasting proximal left colonic MI [motility index], decreased fasting distal left colonic MI and increased colonic compliance.” In other words, it helped with diarrhea by regulating the speed and severity of colon contractions.

Gastric motility is a medical term for the natural contractions which move food through the digestive system. When this process gets out of whack, it can result in conditions such as IBS. Colon contractions are too fast in people with diarrhea-predominant IBS and too slow in people with constipation-predominant IBS. Because the endocannabinoid system has been shown to play a role in regulating the speed of these contractions, bringing this system into balance may help mitigate or alleviate some of the most painful and debilitating effects of IBS.

Marijuana for Symptom Relief

In addition to regulating colonic contractions, cannabis and its derivatives may provide relief from a number symptoms associated with IBS. Marijuana’s role in pain management is well documented, and its use may help sufferers deal with the cramping, bloating, pain, and pressure associated with IBS.

A lesser-known benefit that medical marijuana may play in balancing the body’s endocannabinoid system is its role in improving the permeability of intestinal cells, which improves the body’s ability to absorb important nutrients.

IBS AND STRESS

There are well-documented links between IBS and stress, and reducing stress may be one of the keys to controlling IBS. This is why marijuana’s stress-relieving properties may be one of its most important benefits for IBS sufferers.

One of the more interesting lines of research in this area looks at the link between IBS and PTSD. One study found there was a 36% correlation between the two disorders, and another noted improvements in IBS symptoms after treatment for PTSD.

As CannaMD has reported, medical marijuana may help with PTSD. Given the link between PTSD and IBS, this provides one more clue to the potential benefits of medical marijuana for the treatment of this painful and sometimes debilitating gastrointestinal disorder.

Getting Started with Medical Marijuana

If you are currently suffering from IBS, CannaMD is here to help! Find out if you qualify for medical marijuana treatment today by completing a quick application or calling 1 (855) 420-9170.

Wondering how the whole process works from start to finish? Download our free e-book: Medical Marijuana Basics!

Studies show marijuana helps IBS by regulating the speed and severity of colon contractions, decreasing stress, and reducing pain. Get your medical marijuana card today!