Cannabis for IBS

Cannabis has long been used to remedy nausea and gastrointestinal disorders. Indeed, many IBS sufferers have anecdotally attested to the efficacy of cannabis and cannabis products in treating their debilitating symptoms. In this article, we will explore a bit of the science behind this relief. Afterward, we’ll make some recommendations based on this science.

What Is IBS?

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder. Unfortunately, its direct causes aren’t fully understood. It is characterized by abdominal pain or discomfort, and altered bowel habits. And these symptoms, chronic or recurrent diarrhea, constipation, or both – either mixed or in alternation, can range from mild inconvenience to severely debilitating. Indeed, it adversely affects many sufferers for decades.

IBS Affects 10% of the World’s Population

As many as 25 – 45 million people in the United States and 10-15% of the world’s population are affected by IBS. And of these sufferers, almost 2 in 3 are female. Although IBS predominantly affects people 50 and under, including children, it affects older individuals also.

So how does cannabis come into all this and how can it help alleviate IBS? As usual, the answer lies in our newly discovered, ancient Endocannabinoid System (ECS). If you’re unfamiliar with the ECS, we’ve written a primer ‘What is the Endocannabinoid System?’

IBS and the Endocannabinoid System (ECS)

Studies have shown that the ECS is significantly represented throughout the gut. And its balancing actions are seen throughout. Thus, the ECS “is involved in the regulation of food intake, nausea and emesis, gastric secretion and gastroprotection, GI motility, ion transport, visceral sensation, intestinal inflammation and cell proliferation in the gut.” (Izzo and Sharkey, 2010).

To illustrate, studies have confirmed that “Clinical Endocannabinoid Deficiency (CED) has been confirmed as a plausible feature in a series of difficult-to-characterize psychosomatic pathologies, which display hyperalgesia, anxiety, and depression (Russo, 2004, 2016); Migraine, fibromyalgia and IBS fall in this category…” (Brugnatelli et al, 2020).

Consequently, while it is still unclear why and how IBS develops, this research is promising. Namely, positive results have been achieved by therapeutically targeting the ECS using phytocannabinoids and their isolates. In combination with an “IBS-diet” (Brugnatelli et al, 2020) and stress relieving exercises such as mindfulness and yoga, cannabis can provide serious relief for IBS sufferers.

Indica or Sativa Cannabis Strains for IBS?

Does it matter which you choose? Not really. By now the differences between indica and sativa cannabis strains have become common knowledge. Refresher: an indica has a more sedative, wind-down effect, and sativas are notorious for feeling alert and creative. And a hybrid will provide a cross of both phenotypes, or characteristics.

Cannabis Phenotypes That Matter for IBS

As you become more familiar with all types of cannabis strains, recreationally or therapeutically, especially through vaporization and dabbing, these hard differences begin to blur. And this is especially true when assessing a strain’s efficacy for treating IBS. Why is that?

1) THC: CBD Ratio

First, because a well-rounded THC and CBD profile are indicative of a well-rounded cannabinoid profile. Research has shown that non-psychoactive cannabinoids like CBD, CBG, and CBN soften and manage the psychoactive effects of THC. Of course, these cannabinoids are far more than THC-minders and possess many potent benefits themselves.

2) Other Cannabinoids Matter, Too!

Well established as a pain relief medication, CBD or Cannabidiol has become very mainstream. Lesser-known CBG or Cannabigerol is an anxiolytic, meaning it reduces anxiety and depression. Finally, CBN or Cannabinol helps to ease muscle stiffness and has been strongly associated with the seizure relief cannabis is quickly becoming renowned for. Both indica and sativa cannabis strains will have varying levels of these beneficial cannabinoids. And so their distinctions become less important.

Another factor that affects the way certain strains will affect different individuals has to do with ECS ‘tone’.

ECS Tone and Individual Lifestyle

Cannabis contains phytocannabinoids like THC and CBD that interact directly with our individual Endocannabinoid Systems. Like other body systems, such as the circulatory system or nervous system, the ECS also contains subtle differences from individual to individual. These differences can be described in terms of ECS tone, in the same way, you would describe muscle tone.

What Affects ECS Tone?

These differences are influenced by the environment, genetics, diet and other lifestyle factors. Consequently, each individual’s experience of cannabis and any given strain, be it sativa or indica, will differ.

This also explains why some individuals are hypersensitive to the effects of THC, the psychoactive cannabinoid, while others only experience positive effects like euphoria and relaxation.

How Does This Relate to IBS?

The Doctors Knox, a family of doctors who specialize in the ECS explain: “ECS tone is reflected in how well these processes function and adapt in order to maintain balance and ensure survival. Failure to maintain proper ECS tone, resulting in either an underactive or overactive ECS, has been linked to significant human health issues such as chronic pain, diabetes, multiple sclerosis, PTSD, migraines, cancer, and obesity.” (Doctors Knox, 2021) And IBS falls into this broad base of health problems.

Cannabis Terpenes and IBS

Herbs such as oregano, basil, lavender, and mint have long been studied for their medicinal properties. These types of plants contain the same types of terpenes produced by cannabis, namely: menthol, menthone, menthofuran, isomenthone, (E)-caryophyllene, 1,8-cineole, linalool, limonene, carvone, pulegone, and α-terpineol. One recent study concluded that these terpenes were found to be powerful cognitive and mood enhancers.

The Entourage Effect: Terpenes and Cannabinoids Work Better Together

The Entourage Effects predominantly proposes that terpenes and cannabinoids have meaningful effects on one another and upon the ECS. Since there is comorbidity between anxiety, depression, and IBS (Brugnatelli et al, 2020), there is hope that the synergistic effects of certain terpenes and cannabinoids at CB1 and CB2 receptors could take a serious bite out of IBS suffering.

Since many cannabis strains are high in these terpenes, the theoretical entourage effect could have immense benefits for IBS. (Kennedy et al, 2018) Read our article ‘What Is the Entourage Effect?’ for a detailed look at the fascinating science behind it.

Severe IBS and Cannabis Concentrates

The pain associated with the symptoms of IBS can be immense and debilitating. And this can cause major disruptions to overall well-being and sleep patterns. Since disturbed sleep patterns are a leading cause of stress, and stress is a leading cause of IBS, this cycle is bad news and extremely harmful.

Therefore, it might even be advisable to explore dabbing. Since concentrates are exceptionally high in terpenes and cannabinoids, these higher concentrations could be potentially meaningful in treating IBS symptoms by addressing ECS tone over the long term.

Please note that this is not medical advice, but rather speculation based on these studies (Kennedy et al, 2018). Concentrates are for seasoned cannabis users and medical patients. First-timers should approach with caution. For more about concentrates, we have compiled a series: ‘What Are Dabs?’ and ‘The Benefits of Dabbing’.

Cannabis Strains For IBS Symptoms

Generally, we’re recommending you look for a hybrid with either a balanced THC: CBD ratio or one that tends towards higher THC levels. On top of that, look out for the following terpene profiles and their corresponding aromas (in brackets): menthol (mint), caryophyllene (cinnamon/black pepper), cineole (fresh, mint-like), linalool (lavender/citrus), and limonene (orange/lemon).

We recommend the following strains for their combination of two or more of the above phenotypes:

Girl Scout Cookies and its crosses like Animal Cookies and Lemon Cookies.

Citrique, Citrus Skunk, Lemon Sour Diesel, and other distinctly citrus-smelling hybrids.

OG Kush, Pink Bubba Kush, and other Kush crosses are well-known pain killers and medical user favorites.

Cannabis Concentrates for IBS

High-quality, laboratory-produced, and tested concentrates are mostly made from specific strains. Therefore, it is easy to find concentrated versions of cannabis strains with the phenotypes outlined in the last section. A few examples:

Blueberry Cookies HTFSE Sauce by High Voltage

Ghost Train Haze Black Label Shatter by Sweet Leaf

OG Kush Rosin by YTFC

Final Thoughts

If you’re suffering from IBS or a similar affliction of the GI, cannabis has a lot to offer in its various forms. Again, for sufferers new to the medical use of cannabis, a simple rule of thumb is to start low and go slow. To start, we recommend vaping small amounts of cannabis buds to start. At the same time, mindfully observe your IBS symptoms, your mind and body’s reaction, and go from there.

References

About IBS (2021) “Facts About IBS,” About IBS, [online] Available from: https://aboutibs.org/what-is-ibs/facts-about-ibs/ (Accessed 31 May 2021).

Baker, D. (2020) “5 Best Marijuana Strains for Irritable Bowel Syndrome,” WayofLeaf, WayofLeaf, [online] Available from: https://wayofleaf.com/cannabis/ailments/best-marijuana-strains-for-irritable-bowel-syndrome (Accessed 30 May 2021).

Brugnatelli, V., Turco, F., Freo, U. and Zanette, G. (2020) “Irritable Bowel Syndrome: Manipulating the Endocannabinoid System as First-Line Treatment,” Frontiers in Neuroscience, Frontiers Media S.A., [online] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186328/#B23 (Accessed 30 May 2021).

Doctors Knox (2021) “Get to Know the Endocannabinoid System,” Doctors Knox, [online] Available from: https://doctorsknox.com/blog/f/get-to-know-the-endocannabinoid-system (Accessed 31 May 2021).

Izzo, A. and Sharkey, K. (2010) “Cannabinoids and the Gut: New Developments and Emerging Concepts,” Pharmacology & Therapeutics, U.S. National Library of Medicine, [online] Available from: https://pubmed.ncbi.nlm.nih.gov/20117132/ (Accessed 30 May 2021).

Kennedy, D., Okello, E., Chazot, P., Howes, M.-J., Ohiomokhare, S., Jackson, P., Haskell-Ramsay, C., Khan, J., Forster, J. and Wightman, E. (2018) “Volatile Terpenes and Brain Function: Investigation of the Cognitive and Mood Effects of Mentha × Piperita L. Essential Oil with In Vitro Properties Relevant to Central Nervous System Function,” Nutrients, MDPI, [online] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116079/ (Accessed 31 May 2021).

Martínez, V., Iriondo De-Hond, A., Borrelli, F., Capasso, R., Del Castillo, M. D. and Abalo, R. (2020) “Cannabidiol and Other Non-Psychoactive Cannabinoids for Prevention and Treatment of Gastrointestinal Disorders: Useful Nutraceuticals?,” International Journal of Molecular Sciences, MDPI, [online] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246936/ (Accessed 30 May 2021).

O’Donnell, B. (2021) “Dronabinol,” StatPearls [Internet], U.S. National Library of Medicine, [online] Available from: https://www.ncbi.nlm.nih.gov/books/NBK557531/ (Accessed 30 May 2021).

Taschler, U., Hasenoehrl, C., Storr, M. and Schicho, R. (2017) “Cannabinoid Receptors in Regulating the GI Tract: Experimental Evidence and Therapeutic Relevance,” Handbook of Experimental Pharmacology, U.S. National Library of Medicine, [online] Available from: https://pubmed.ncbi.nlm.nih.gov/28161834/ (Accessed 30 May 2021).

Thompson, A., Meah, D., Ahmed, N., Conniff-Jenkins, R., Chileshe, E., Phillips, C. O., Claypole, T. C., Forman, D. W. and Row, P. E. (2013) “Comparison of the antibacterial activity of essential oils and extracts of medicinal and culinary herbs to investigate potential new treatments for irritable bowel syndrome,” BMC Complementary and Alternative Medicine, BioMed Central, [online] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4220539/ (Accessed 31 May 2021).

Toczek, M. and Malinowska, B. (2018) “Enhanced endocannabinoid tone as a potential target of pharmacotherapy,” Life Sciences, Pergamon, [online] Available from: https://www.sciencedirect.com/science/article/abs/pii/S0024320518302352 (Accessed 30 May 2021).