Will Medical Marijuana Help IBS?

Pharmacist and customer with medical marijuana
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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 IBS. In this overview you will learn about the potential benefits and risks of marijuana and what is known about its usefulness in addressing the symptoms of IBS.

What Is Medical Marijuana?

Marijuana itself is typically a mixture of the dried leaves and flowers (and less typically the seeds and stems) of Cannibis 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.

The term "medical marijuana" was coined to describe the use of the Cannibis plant, either in whole or extract form, to treat symptoms or diseases. Its use for medicinal purposes is controversial and remains a matter of great debate among users, scientists, and governing bodies.

Will Medical Marijuana Help IBS?

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 endocannabinoids 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 a man called Ethan B. Russo who, in 2003, theorized that IBS and other health conditions were the result 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 to 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. They also protect the digestive system from inflammation and stomach acids. This line of inquiry thus seems to lead naturally into the question as to 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. In one 2017 review of the topic, writers pointed out that "additional high-quality method studies are needed before a clinical recommendation is indicated."

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 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.

Do You Feel High From Medical Marijuana?

Yes, 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 (judgement, 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. Therefore, medications or strains of medical marijuana that are high in CBD but low in THC, will not cause you to experience these "high" sensations.

Do You Have to Smoke It?

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 heavier use of the drug.

The potential negative effects of marijuana, whether in 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 judgement, 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 and arrhythmias and tachycardia.

Who Should Not Use Medical Marijuana?

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 an 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 breast-feeding an infant
  • You have heart disease
  • You have any kind of a lung disease

The Complicated Legalities of Medical Marijuana

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:

A Word From Verywell

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.

However, as of now, the use of marijuana as a viable treatment for IBS has not yet been supported by research. And the use 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. And 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.

The good news is that there does appear to be a connection between endocannabinoid system and its receptors and digestive symptoms. This suggests that the potential exists for a pharmeceutical 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 has returned mixed results.

The bottom line is that more research is needed which will clarify cannibis' role 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.

Sources:

Bashashati M & McCallum R. Cannabis in Gastrointestinal DisordersPractical Gastroenterology 2014;12.

Clarke SC & Wagner MS. Clinical endocannabinoid deficiency (CECD) revisited: Can this concept explain the therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions? Neuroendocrinology Letters 2014; 35(3):198–201.

NIH National Institute of Drug Abuse. DrugFacts—Is Marijuana Medicine?

NIH National Institute of Drug Abuse. Drug Facts-Marijuana.

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