On Cannabis & IBS

On the laundry list of medical conditions that cannabis helps manage, chronic gastrointestinal diseases are perhaps some of the most common, but least discussed.

I have IBS, a chronic gastrointestinal condition, and it’s something I’ve dealt with for close to my entire life. I started getting flare-ups at the tender age of 8 years old, and it’s been an ongoing struggle since then to manage the condition while living my best life.

Enter, cannabis.

What is IBS?

IBS is short for irritable bowel syndrome and is a part of the irritable bowel disease (IBD) family of conditions, along with ulcerative colitis and Crohns. IBS is a chronic inflammatory condition characterized by relapsing and remitting episodes of inflammation primarily involving the gastrointestinal tract.

Why people get IBS has not been determined, but it appears to be caused by an “inappropriate inflammatory response with a dysregulated immune system in the appropriate environmental and genetic background.” This is a long-term disease and symptoms include change in appetite, cramping, abdominal pain, bloating, gas, vomiting, and diarrhea or constipation, or both.

Over 3 million Americans suffer from IBS and a further 1.6 million suffer from Crohns and ulcerative Colitis.

IBS is not a disease frequently discussed. For one thing, who wants to cop to having a condition with “irritable bowel” right in the name? Flare-ups involve frequent and elongated trips to the bathroom, and the entire ordeal is loaded with shame and embarrassment. But the second reason is that people who suffer from IBS are heavily female, with a ratio of 2.5:1.

My Experience with Cannabis & IBS

I’ve been dealing with flare-ups for the better part of 18 years, and these can be triggered by diet choices or stress. But saying something is triggered by “stress” is a vague and unhelpful umbrella term for a variety of outside factors. If I’m having a bad week at work, have been feeling poorly, or I’m traveling, a flare up is inevitable.

For me, there is no bigger trigger than traveling. I could be going 3 hours down the interstate, but the change in routine is all it takes to set off a flare up. This involves lack of appetite, nausea, lightheadedness, and instance of vomiting. This, of course, is a less than ideal way to feel while traveling, whether it be to my in-laws or across country boarders.

That’s where cannabis comes in. Smoking weed soothes my overactive digestive system, my anxious mind, and returns my appetite to me. Cannabis is an integral part of managing my IBS flare-ups, and shit gets real when I’m not able to bring it with me or access it.

The Science Behind How Cannabis Helps with IBS

Using cannabis to deal with IBS is not new. A case report from the 1990s describes how IBD patients used cannabis to manage symptoms in the remission period between hospital stays

Cannabis acts in your gastrointestinal system, relaxing the esophageal sphincter, reducing pain and decreasing gastric and bowl secretions and motility (ability of the muscles of the digestive tract to undergo contraction). Essentially, cannabis can relax an overactive digestive system.

A study conducted in Israel surveyed 30 patients with Crohns and found 70% of them experienced a decrease in symptom severity while using cannabis. All patients reported an increase in quality of life and a decrease in daily bowel movements. 9 patients were even able to stop taking all symptom-managing medications. This study was done retrospectively, which means it’s less reliable than a double-blind study, since the primary information source was the memory of participants.

Another study gave 50 g of cannabis to 13 patients to smoke as needed over the course of 3 months. At the end of the study, participants reported how much they smoked and the noticeable effects. All the participants smoked the entirety of the 50 g and all reported improvements in their health. The Harvey-Bradshaw index scores (an index that rates Crohn’s disease symptoms) dropped an average of 9 points, from an average of 11.36 to 2.68. Participants also reported improvements in general wellbeing, a reduction in general pain, abdominal pain, depression, and liquid bowl movements as well as an improvement in social functioning and their ability to work. While this study is too small for generalizations, it does point to a correlation between cannabis and gut health.

These studies support the idea that the benefits were the result of cannabinoids having anti-inflammatory, anti-motility, and analgesic effects.

IBS & The ECS

New research suggests that our endocannabinoid system (ECS) plays a direct role in regulating gut health. Since cannabis is a known anti-inflammatory, research suggests that IBS, Crohns, and ulcerative colitis symptoms can be influenced by cannabis consumption.

The ECS is found throughout the human body distributed among organs and tissues as are the two most studied cannabinoid receptors, CB1 and CB2. CB1 is mainly found in neurons in the center, peripheral, and enteric nervous systems. CB2 is found mostly in immune cells. Both CB1 and CB2 are found in the gastrointestinal system. Extensive studies on mice have found a relationship between the ECS, the gastrointestinal tract, and regulation of gut inflammation. When cannabis reacts with CB1 and CB2 in the gut, they decrease intestinal hypermotility, hypersecretion and inflammatory factors.

Early research shows the those who suffer from IBS have lower levels of anandamide, an endocannabinoid, in the inflamed sections of the gut mucosa. A 2011 study of biopsies of 74 patients with Crohns and ulcerative colitis found that in areas of inflamed gut mucosa, anandamide levels were lower and levels of the fatty acid hydrolase were increased. The study found that cannabinoids have a clear role in gut health and do offer a potential avenue of treatment.

Now I’m not suggesting that cannabis can treat IBS, Colitis, or Crohns. There is no scientific evidence of this, and more studies are needed. But I am saying that, with scientific and anecdotal evidence, that cannabis consumption can moderate and reduce IBS symptoms.

Talking about IBS is not great. There’s a large stigma around gastrointestinal conditions, in the same way that there’s still a large stigma around the cannabis industry.

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