IBS

What Is IBS? 

Irritable bowel syndrome (IBS) is one of the most common diseases of the large intestine, affecting 15-20% of North-Americans. Signs and symptoms include cramping, abdominal pain, gas, bloating, mucus in the stool and changes in bowel movements. Most of these symptoms improve or even completely relieved after passing a bowel movement. Some individuals develop IBS-D (IBS predominant diarrhea), some IBS-C (IBS predominant constipation), while some will experience IBS mixed (when diarrhea alternates with constipation). It is believed that IBS is a chronic condition that you will have to manage long term.

What causes IBS? 

While the exact cause of IBS is not known, doctors found some factors that play a role in the development of IBS. These factors can include, but are not limited to: 1) imbalance in gut flora, 2) abnormal muscle contractions in the intestines, 3) impairment in the nervous system related to the gut/brain pathway, 4) gut inflammation, 5) or infections. 

Could endocannabinoid deficiency be a major cause of IBS?

Researchers believe that the underlying cause for many complex ailments with multiple symptoms, such as IBS, could are due to an imbalance in the endocannabinoid system (i.e. clinical endocannabinoid deficiency [CED]).

As you may be aware, our body has a built-in system called the endocannabinoid system. It is made of two main cannabinoid receptors: CB1 receptors, which are mainly found in the central nervous system, and CB2 receptors that are found in peripheral nerves. In addition, the body has evolved to make it’s own endocannabinoids and metabolic enzymes to activate those molecules.

The endocannabinoid system regulates many important processes in the body, and also helps maintain digestive health. This system is involved in muscle contractions of the intestine, the regulation of gut flora and the immune system that resides in the gut. Endocannabinoid system also decreases the inflammation in the gut. As you can see above, all these gut processes are impaired in IBS.

Researchers found that diseases like IBS are strongly connected with a deficiency of the endocannabinoid system- for example, the body does not produce enough endocannabinoids or is deficient in cannabinoid receptors. A leading researcher in this field of study, Dr.Ethan Russo, was the first to propose the concept of clinical endocannabinoid deficiency over a decade ago. IBS, fibromyalgia, and migraines are mostly correlated with endocannabinoid deficiency.

If the endocannabinoid system is deficient and causing diseases like IBS, then one would assume that medical marijuana could help manage this condition, right?

Medical Marijuana for IBS- Clinical Trials

There is supporting evidence that medical marijuana could help manage IBS-D by correcting endocannabinoid deficiency. However, very few studies actually evaluated how this herb works for this condition. 

We know that cannabis was one of the first effective therapies in the 19th century for diarrhea associated with cholera, which shares similar problems with diarrhea associated with IBS.

Many patient surveys support the benefits of marijuana treatment of IBS symptoms and there is also a lot of anecdotal support on the internet, too- according to a study that gathered the relevant data.

However, there are only 3 clinical trials to date. One randomized controlled study suggests that dronabiol (synthetic THC) may be helpful for IBS-D, as the treatment improved some markers of gut function. Another two clinical trials on synthetic THC did not show benefits. Keep in mind that no clinical trials evaluated the whole herb (medical marijuana) for IBS. 

Bottom line: scientists believe that “cannabinoids have the potential for therapeutic effect in patients with IBS”, although more research is needed. Medical marijuana should be considered in cases of IBS-D and IBS-mixed. It should not be used in IBS-C, as it may aggravate constipation. 

Until we have more research available, consider visiting a medical marijuana clinic and consult a cannabis specialist.