CBD benefits are widely discussed, but whether CBD for IBS is a viable treatment option is still being studied. However, here’s what early research says. Research suggests CBD oil can alleviate symptoms of IBS-C & IBS-D. View the best CBD oils for IBS & how to find a safe & effective dose.
What You Need to Know About Using CBD for IBS
The Curious Role of the Endocannabinoid System in Gut Health
With the increasing legalization of cannabis and its by-products in the United States, CBD oil — otherwise known as cannabidiol — is everywhere. You can find it in gas stations, grocery stores, as well as in specialty boutiques and cannabis dispensaries, and it’s recommended for a wide range of health concerns.
One of the things CBD is recommended for is Irritable Bowel Syndrome (IBS). Some early research suggests that CBD may be able to influence your gut inflammation, motility, and even your gut microbiome. Is CBD for IBS a valid treatment option?
Currently, there is almost no direct research suggesting that CBD can improve IBS symptoms.
Let’s explore what CBD is, what we know about the effects of CBD for IBS and the digestive system, and what we know and don’t know about how it may treat Irritable Bowel Syndrome (IBS) or other digestive conditions.
What Is CBD?
Cannabidiol (CBD) is one of many cannabinoids, which are cannabis plant compounds produced by Cannabis sativa and hemp plants. CBD is non-intoxicating and non-psychoactive. CBD’s more famous cousin, THC (tetrahydrocannabinol), is the cannabinoid responsible for the well-known psychoactive effects of smoking or consuming cannabis.
Companies that sell CBD products promote it to help remedy a wide range of health concerns, such as chronic pain [ 1
Trusted Source PubMed Go to source ], headaches, joint pain, appetite, sleep, and digestive complaints like IBS.
CBD appears to be able to act as a pain reliever and has anti-inflammatory properties several hundred times stronger than aspirin . However, there is a tendency to generalize claims about full-spectrum cannabis — extracts of whole cannabis — and CBD alone. To more fully explain, we need to dive into the specifics of the endocannabinoid system.
Endocannabinoid System 101
It may surprise you to learn that the human body creates its own cannabinoids and has a vast network of cannabinoid receptors.
This means your body is wired to benefit from cannabinoids. This endocannabinoid system (ECS) plays an important role in the development, balancing, and resilience of your central nervous system and immune system [3, 4
There are two main types of cannabinoid receptors: CB1, and CB2. CB1 receptors are concentrated primarily in your brain and peripheral nervous system, while CB2 receptors are located not only in your brain and nervous system but also in your digestive and immune systems [ 5
Trusted Source PubMed Go to source ]. CBD can bind to either type of cannabinoid receptor.
Some researchers have proposed that endocannabinoid deficiency may influence gut conditions like IBS, pain conditions, such as fibromyalgia and migraines [ 6
Trusted Source PubMed Go to source ], as well as autoimmune diseases [ 7
Trusted Source PubMed Go to source ]. Endogenous cannabinoids (meaning those produced by your body), like anandamide, are thought to influence pain perception and gut motility (the movement of waste through your digestive tract) [ 8
Trusted Source PubMed Go to source ]. For this reason, many people are excited about the potential of cannabinoids like CBD to help chronic pain, opioid addiction, and IBS symptoms like bloating, constipation, and hypersensitivity [ 9
CBD for IBS (Irritable Bowel Syndrome)
Irritable bowel syndrome (IBS) is a common digestive tract disorder. Frequent digestive systemsymptoms of IBS include [ 10
- Abdominal pain or cramping
- Diarrhea or loose stool (IBS-D), or constipation (IBS-C)
- Food sensitivities
The root causes of IBS vary widely, from bacterial overgrowth to nervous system imbalances that affect gut motility. Because of this, treating IBS requires a multi-faceted approach.
Many people with other digestive conditions — such as Inflammatory Bowel Diseases like Crohn’s disease and ulcerative colitis — also have IBS symptoms.
Does CBD Help IBS?
There is not yet clear evidence that CBD can help IBS symptoms, despite some interesting preliminary results and hopeful theories.
In the end, dietary changes such as a low FODMAP diet [ 11
Trusted Source PubMed Go to source ] have proven and documented benefits for IBS where you don’t have to wait for further research. So, while we explore the research so far about CBD and IBS, please don’t ignore more proven approaches.
Multiple literature reviews suggest that targeting the endocannabinoid system with CBD or other cannabinoids may provide some benefit for IBS patients and their symptom flare-ups, as well as patients with other gastrointestinal disorders such as inflammatory bowel disease (IBD) [ 16
However, there is little direct clinical evidence to suggest you are likely to benefit from CBD if you have IBS symptoms..
Here is a summary of the evidence that suggests CBD may be beneficial for IBS symptoms:
In a large observational study, CBD was associated with reduced gut and non-specified pain [ 19
Trusted Source PubMed Go to source ], normalize both slow and fast gut motility , and positively affect nerve channels that regulate gut motility and secretion [ 25
Out of all these studies, only two are placebo-controlled clinical trials. The rest are lower quality observational, or animal studies, which may or may not have relevance for humans, and none of them specifically studied IBS. So even though these are positive findings, they are not a clear endorsement of CBD.
Add to that the following study results, which don’t support using CBD for IBS symptoms:
A 2021 SR/MA of 15 nonrandomized studies and 5 RCTs concluded that cannabinoids do not induce clinical remission or affect inflammation in IBD patients (although there may be some improvement in symptoms) [ 27
Using CBD for IBS
CBD oil is allowed to be sold throughout the United States as long as the THC content is below 0.3%. People typically consume CBD products orally as an oil, but they can also be consumed as a tincture (a preparation of CBD in alcohol or glycerin) or edible product (like a gummy or baked good).
In states where cannabis is legal, either for medicinal or recreational use, some CBD products may contain varying levels of THC. Some evidence suggests that therapeutic results are better when CBD is given together with other cannabinoids, including THC [ 30
Trusted Source PubMed Go to source ]. This is known as the “entourage effect.” However, not everyone wants the psychoactive side effects of THC. Read your labels carefully, or request help interpreting the information on product labels.
Your ideal dosage will vary widely depending on your body’s needs, the potency of the product, and your tolerance. For best results, consult with a health care provider or medical professional who is knowledgeable about CBD dosing and your medical condition.
CBD Oil Side Effects and Safety
If you want to try CBD for IBS, keep the following considerations in mind.
CBD Side Effects
CBD is often promoted as a safer alternative to medications, but some people do experience side effects.
CBD and other cannabinoids are metabolized in the liver and intestines.
Too much CBD can damage the liver, especially if mixed with other medications, such as leflunomide, lomitapide, mipomersen, pexidartinib, teriflunomide, and valproate . If you are taking these medications or have an existing liver condition, consult a physician before using CBD.
CBD oil consumption can cause possible side effects [ 32
Trusted Source PubMed Go to source ]. These include:
- Nausea or vomiting
- Diarrhea 
- Decreased appetite
- A minority of people may have an intolerance to cannabis oil or its carrier oils such as sesame oil.
A systematic review and meta-analysis found that adverse gastrointestinal tract events may be more common when CBD and other cannabis-based medicines are ingested rather than inhaled [ 36
Non-FDA-approved CBD products on the market vary greatly in quality and consistency. This raises two potential issues:
Without independent laboratory verification, one cannot know whether the dosage of such products is accurate, if the THC content is less than 0.3%, and whether they are unadulterated and uncontaminated [ 37
Always buy CBD products from manufacturers who are transparent about their production methods, quality-control measures, and potency. Look for independent laboratory verification of product contents.
Probiotics and the Endocannabinoid System
Some very early evidence suggests that the gut microbiome may influence the endocannabinoid system [ 38
One clinical study showed that Lactobacillus probiotic supplementation increased the function of cannabinoid and opioid receptors and reduced pain [ 39
Trusted Source PubMed Go to source ]. Dogs with motility problems who were given probiotics showed an increase in cannabinoid receptor action and improved motility [ 40
Trusted Source PubMed Go to source ]. Another study, albeit in mice, suggested that CBD increased the abundance of beneficial gut bacteria but also increased the expression of inflammatory cytokines [ 41
We know that probiotics are a clinically effective treatment option for a wide range of digestive complaints [ 42
Trusted Source PubMed Go to source ]. We don’t need to know whether their interaction with the endocannabinoid system is one more reason for their benefits, but it’s an interesting line of research for the future.
The Truth About CBD for IBS
CBD may be popular, but there isn’t yet proof that it helps IBS symptoms. While early data suggest it may play a helpful role in regulating gut motility, reducing gut pain, and supporting the nervous system, much more research is needed.
There are many proven and effective treatments for IBS, and it makes sense to keep your focus on these approaches. However, If you’re CBD curious, try CBD as a short-term trial and don’t expect miracles.
CBD for IBS: Everything You Need to Know
IBS is frustrating. There are few effective treatments for the condition, which can make it hard to live your life to the fullest.
Here’s how CBD might be able to help.
Irritable bowel syndrome (IBS) is not life-threatening, but it can severely disrupt the quality of life for those affected.
Roughly 1 out of 10 people in the developed world have symptoms consistent with IBS .
Despite how common the condition is, IBS is not well understood. As a result, there are few effective treatment options available aside from managing symptoms.
Here we’ll go over how CBD may be used to support an IBS diagnosis, how to use it, what its limitations are, and how to get the most out of it with other diet and lifestyld modifications.
MEDICALLY REVIEWED BY
Updated on November 14, 2021
Table of Contents
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The Benefits of CBD Oil For IBS
There are many potential causes for IBS, but much of what triggers the condition remains unknown. Most of the causes point to a loss of equilibrium in the digestive tract. So the carefully orchestrated balance involved with digestion, absorption, immune defense, and excretion is compromised.
Cannabidiol (CBD) helps with this problem because it serves as a way to “calibrate” different parts of the body. It does this by improving the communication between cells through the endocannabinoid system.
The benefits of CBD oil for IBS Include:
- Addresses anandamide deficiencies 
- Reduces inflammation [7, 8]
- Inhibits digestive muscle hyperactivity and cramping [5, 6]
- Decreases appetite 
CBD will affect the condition differently depending on the form of IBS.
People who have IBS with diarrhea (IBS-D) are likely to experience the most benefit from CBD because cannabis slows muscle contraction in the digestive tract.
But people who have IBS with constipation (IBS-C) can still find benefit from CBD due to the anti-inflammatory, appetite-suppressant, and immune-stimulating properties of the compound.
We’ll get into the different forms of IBS and how CBD is used to support them later on.
What Form of CBD Should I Use?
CBD comes in all different forms. You can buy oils, capsules and concentrates.
When it comes to IBS, the most popular options are oils, capsules, and suppositories.
CBD oils and capsules are easy to take, to store for long periods of time, and can be accurately dosed.
Suppositories have the benefit of delivering the CBD directly to the affected area. This is best for severe IBS-D (more on this below) but can benefit other forms of IBS as well.
What’s The Dose of CBD Oil For IBS?
Dosing CBD can be a challenge because it affects everybody differently.
Some people take 50 mg of CBD per day, while others need more or less.
The dose also depends on the form of CBD you’re taking. As we mentioned, CBD oil and suppositories are the most popular for people with IBS, but the dose for each form varies significantly.
If using oils or capsules, the best way to find a good starting dose it to read through our CBD oil dosing guide.
CBD Dosage Calculator
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For IBS, we recommend starting at the low strength and working your way up slowly to see how you react to CBD.
It will likely take about two or three weeks of regular CBD use before you start noticing any real benefits for your IBS symptoms.
If using CBD suppositories, it’s best to follow the specific instructions listed by the supplier on the packaging. Concentrations can vary from one CBD suppository to the next.
How to Get the Most Out of CBD Oil for IBS
CBD shouldn’t be used alone to treat IBS. This condition is highly complex and involves multiple organ systems.
Other forms of treatment, including dietary changes and physical activity, are essential. If these lifestyle changes aren’t addressed, CBD is not likely to have any effect at all.
You can think of CBD as a bus driver — it will drive the occupants towards a destination, but they can’t arrive without a well-maintained bus filled with gas.
CBD is a tool to help alleviate uncomfortable symptoms of IBS and is used to bring the body back to balance.
What is CBD Oil?
CBD stands for cannabidiol. It’s one of the primary cannabinoids in the cannabis plant.
Most CBD oils on the market today come from the hemp plant (Cannabis sativa), which is a strain of cannabis naturally low on THC — the primary psychoactive cannabinoid.
This means that most CBD products on the market have no psychoactive effects.
CBD is used as a health supplement for a wide range of medical conditions. It owes much of its ability to support health to its involvement with the endocannabinoid system.
The endocannabinoid system regulates balance in the body, otherwise known as homeostasis. This includes the immune, digestive, neurological, musculoskeletal, and integumentary (skin) systems.
What is Irritable Bowel Syndrome?
Irritable bowel syndrome (or IBS) is classified as a syndrome, rather than a disease because it’s a set of symptoms that can’t be linked to a particular cause.
IBS can be summarized as a “widespread dysfunction of the digestive tract.”
Symptoms involve bloating, abdominal pain, indigestion, and changes in bowel movements (constipation or diarrhea, which can be severe).
The symptoms of IBS are very similar to those of inflammatory bowel disease (IBD). The difference is that IBD has inflammation present in the gastrointestinal tract, confirmed by Lab tests and special cameras inserted in the digestive system.
If no inflammation is present to confirm a diagnosis of IBD, an IBS diagnosis is given instead.
In this process, there are some diagnostic criteria put in place by various experts, but none of them are conclusive and not all doctors agree on them for a diagnosis of IBS.
The most popular criteria doctors tend to use is something called the Rome III Criteria.
IBS Diagnosis: The Rome III Criteria Checklist
In order to meet a diagnosis of IBS, the patient must have the following symptoms:
- Recurrent abdominal pain or discomfort at least 3 days per month over 3 months
- Symptoms involving at least two of the following characteristics:
- Improvement of symptoms with defecation
- Onset associated with a change in stool frequency
- Onset associated with a change in stool form
If these criteria are met and there is no other explanation for a cause (such as inflammation, traumatic damage, or infectious disease) the patient is diagnosed with IBS.
Symptoms of Irritable Bowel Syndrome:
3 Types of IBS & the Effects of CBD
20-50% of visits to a gastroenterologist end in a diagnosis of IBS , making it the most common functional disorder of the digestive system.
Gastroenterologists further classify IBS according to the most predominant symptoms:
1. Diarrhea-Dominant IBS (IBS-D)
This refers to IBS presented primarily with diarrhea.
IBS-D symptoms indicate that the bowels are filling with water. Common precursors for this include high sodium foods, a poor gut membrane, and hyperactive muscle activity in the digestive tract.
With high sodium foods and poor membrane control, water begins to accumulate in the areas filled with salty foods. This happens because of a principle in biophysics called osmosis: the water goes where the salt is. As the intestines fill up with water, it causes diarrhea.
Additionally, many people with IBS-D experience hyperactive muscle activity in the intestinal tract. When the muscles become spastic, they experience cramping, abdominal pain, and bloating. The digestive tract pushes food through too quickly without properly breaking it down and absorbing it. Instead, unabsorbed foods begin to ferment in the large intestine, causing severe bloating, nausea, and diarrhea.
CBD is useful for this type of IBS because it can reduce spastic muscle activity in the gut, allowing it to properly digest and absorb nutrients. For this type of IBS, it’s best to combine CBD with a low-sodium diet and a good source of soluble fiber.
2. Constipation-Dominant IBS (IBS-C)
IBS-C stands for IBS presented predominantly with constipation.
This type of IBS indicates low activity in the digestive tract. Pancreatic enzymes, bile, and stomach acid are scant. These enzymes help break down our food and stimulate the smooth muscle lining our intestines. This stimulation causes the muscles to expand and contract, moving food along the digestive tract.
If there is a problem with the secretion of digestive enzymes or muscle movement in the intestinal tract, we become constipated.
This can be extremely uncomfortable, causing symptoms such as severe bloating, feelings of fullness, nausea, fatigue, and physical belly distention.
Although nothing will produce the same level of benefit as a change in the diet, CBD does offer some unique benefits to this form of IBS.
CBD increases anandamide — a naturally occurring endocannabinoid responsible for slowing bowel movement, fighting inflammation, and controlling microbiome diversity.
3. Alternating IBS (IBS-A) or Mixed-type IBS (IBS-M)
This form of IBS involves alternating bouts of diarrhea and constipation.
The potential causes of this type of IBS are far more variable and can involve factors of both. For several months, the patient may suffer from constant diarrhea, followed by several months of severe constipation. The sudden changes in bowel activity can be due to dietary, neurological, or immunological factors — making the cause hard to isolate and treat.
CBD is useful for this type of IBS because it doesn’t push the digestive function in any specific direction. Instead, it improves the body’s ability to regulate homeostasis. Along with other therapies to manage symptoms, the body has a better chance of returning to a higher state of health on its own.
What Causes IBS?
The exact cause of IBS is not yet understood — but there are some well-accepted theories in the medical community.
Suspected Causes of IBS Include:
Western countries including Canada, The United States, and Sweden have the highest rates of IBS in the world [11, 12]. In the United States, roughly 1 in 10 people suffer from IBS.
These nations often consume diets high in processed foods. Foods that have been highly processed tend to have poor nutritional content (in terms of vitamins, antioxidants, minerals) and are high in calories (in the form of fat or sugar).
When we eat these foods, they tend to move slowly through our digestive tract due to the lack of fiber and bulk of the food.
The slow movement and high sugar content cause this food to ferment in the digestive tract by bacteria living there. Fermentation in this context is bad for our digestive functioning — it causes bloating, pain, and changes in bowel movements.
One of the main dietary treatments for IBS is called a low FODMAPS diet, which substitutes highly processed foods for high-fiber, low sugar ones.
Frequent fermentation of processed sugars can damage the structural integrity of the digestive lining over time — leading to accumulation of fluid and diarrhea (IBS-D) or lack of movement in the muscles in the small and large intestines causing constipation (IBS-C).
2. Viral Infection
Viral infections can cause a lot of damage to the body. Many people report their IBS symptoms started shortly after getting a stomach bug overseas. After a few days of illness, they seemed to be getting better, but their gut never fully recovered.
Viruses disrupt normal cellular function, hijacking our cells to manufacture more viruses and preventing them from their job. They can wreak havoc on an entire organ in a short amount of time.
The digestive lining is home to a complex ecosystem of bacteria and fungal species called the microbiome. The microbiome is heavily involved with digestion and absorption in the digestive tract. When we fall ill with a virus, this can cause dramatic changes to the microbiome, leaving us with long-lasting side-effects, such as IBS.
3. Neurological Dysfunction
The movement of the intestinal tract (called peristalsis) is a complex orchestra of muscle contractions working together to move food through the intestinal tract. This involves careful innervation both locally and in collaboration with the brain.
Many people find that when they drink coffee, it stimulates a bowel movement. This is a good visualization of how the nervous system affects the digestive tract.
If our nervous system is in a state of constant stimulation, we are likely to develop diarrhea (IBS-D).
If we experience the opposite (insufficient stimulation), we are likely to end up with constipation (IBS-C).
Based on neurological activity, we can compare IBS types with other side-effects that often affect IBS patients at the same time.
Neurological Characteristics of IBS and Related Side-Effects:
|IBS type||Nervous System Activity||Related Side-Effects|
|IBS-D||Too stimulated||Anxiety Panic disorders Insomnia Heart palpitations|
|IBS-C||Not stimulated enough||Fatigue Depression|
|IBS-A||Either too stimulated or not enough||Anxiety Panic disorders Insomnia Heart palpitations Fatigue Depression Immune deficiencies|
Although IBS by definition does not require visible or detectable inflammation, numerous studies have shown that IBS sufferers have low-grade inflammation of the gut wall . This inflammation may be too subtle to be picked up by blood tests or visual inspection with colonoscopies/endoscopies.
Common Medications Used to Treat IBS
Lifestyle and diet changes will have the most impact on treating IBS. Besides the low FODMAP diet, it can help to reduce stress and get more exercise.
In some cases, medications can be prescribed to help reduce the symptoms of IBS. For diarrhea, drugs like loperamide, rifaximin, or eluxadoline may help. Fiber supplements, laxatives, lubiprostone, or linaclotide can be used to treat constipation. Abdominal pain can be relieved with antispasmodics. Sometimes antidepressants are prescribed for those with more extreme cases.
The Endocannabinoid System & IBS
The endocannabinoid system is thought to play a major role in IBS .
The CB1 and CB2 endocannabinoid receptors are used to regulate different processes in the human body — many of which are present in the digestive tract.
CBD for Other Functional Disorders
IBS is considered a functional disorder, suggesting there’s a clear problem with the function of the organ without an apparent cause.
Other conditions that fit this category are fibromyalgia and chronic fatigue syndrome — both of which are also improved with regular CBD use. The mysterious nature of these conditions makes it difficult to pinpoint exactly why CBD is so useful for treating them, but the likely explanation is the role CBD plays in homeostasis.
Homeostasis is the state of balance in the body. It penetrates virtually every aspect of life — from body temperature to digestive enzyme secretion. Any issues with homeostasis can negatively affect our health.
CBD serves as a useful tool for regulating homeostasis, which is why this compound has so many different benefits.
Key Takeaways: Using CBD for IBS
Although IBS isn’t well understood, it likely involves a combined dysfunction of multiple organ systems, lifestyle habits, and diet — CBD offers broad benefits towards different variations of the condition.
It’s best to use CBD in the form of an oil, capsule, or suppository for optimal results. It’s also important to take CBD oil for long periods of time to exert its full effects. CBD can take a while to start providing benefits for this condition because there are many factors involved.
Through persistent CBD supplementation, dietary and lifestyle changes, and patience, IBS symptoms can be forced into remission for long periods of time.