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Introduction

Scientists recently discovered that some compounds in Cannabis can be used as effective anti-inflammatory agents. Ever since, different Cannabis preparations have been considered as pharmacological tools to fight various diseases that are worsened by inflammation. these include irritable bowel diseases and other gut disturbances. Previously, the use of Cannabis was highly limited by the psychotropic effects portrayed by one of its main components, THC. Recently, however, scientists have gained fresh interest in another cannabinoid derived from the same plant called cannabidiol (CBD). This compound has shown many beneficial effects on the gut without any psychoactive effects. This article is a summary of all the studies concerning CBD and irritable bowel syndrome.

Background

CBD manifests beneficial effects in a variety of pathological disorders, including mood disorders, addiction, nausea, neurodegenerative conditionsamong many others. This compound also shows therapeutic effects with regards to gastrointestinal diseases, including emesis, diarrhea, inflammatory bowel disease and intestinal pain.

For years, the activity of CBD has been a mystery to both pharmacologists and gastroenterologists alike. But now, there is more evidence showing how CBD may relate with extra-cannabinoid system receptor sites, including PPARγ, among other strategic interactions. This makes CBD a potential contestant in the race for developing a new class of more efficient anti-IBD drugs.

The Endocannabinoid System and its Role In Inflammatory Bowel Disease

All mammals have an endocannabinoid system (ECs)that consists of naturally occurring ligands, that is, anandamide and 2-AG, their biosynthetic and degradative enzymes, and the cannabinoid (CB) receptors CB1 and CB2.

The ECs system plays a homeostatic role in the body, and scientists are still trying to grasp its full range of effects. CB1 receptors are mainly found on central and peripheral neurons (including the enteric nervous system) where they control neurotransmitter release. On the other hand, CB2 receptors are adapted to immune function, inflammationand pain.

The ECs system operates throughout the body, for instance, it has been shown to be an important physiologic modulator of gastrointestinal motility. Furthermore, some forms of irritable bowel syndrome have been associated with polymorphisms in the gene encoding CB1 (CNR1).

It does not end here, the ECS is involved in the regulation of nausea, vomiting as well as visceral sensations such as moods. The homeostatic role of the ECs spans even to the regulation of intestinal inflammation.

CBD’s Interaction with the Endocannabinoid System

Interestingly, cannabidiol can regulate many physiological functions through the endocannabinoid system. Its most important function in IBS is its activity as an anti-inflammatory agent, which it does by modulating cytokine cascade. It is this efficacy as an anti-inflammatory agent that has led researchers to test CBD’s potential in treating irritable bowel syndrome.

Studies Investigating the Efficacy of CBD and Irritable Bowel Disease

To begin with, writers of a recent literature review noted that cannabinoids can reduce gastrointestinal transit in rodents by activating CB1, but not CB2, receptors. However, both CB1 and CB2 receptors were shown to reduce the upsurge of intestinal motility caused by inflammatory stimuli in randomized clinical trials that were considered in the review. In summary, the authors endorsed the idea that the regulation of the endocannabinoid system in the gut by cannabinoids such as CBD may provide a useful therapeutic target for gastrointestinal diseasessuch as irritable bowel syndrome.

Another literature review affirmed that under pathophysiological conditions, the endocannabinoid system manifests protective effects to the GI tract. This includes protection from inflammation and abnormally high gastric and enteric secretion. According to the authors, the ECs may represent a new therapeutic target against different GI disordersfor such protective functions through cannabinoids such as CBD. These include inflammatory bowel diseases (e.g. Crohn’s disease), functional bowel diseases (e.g. irritable bowel syndrome), as well as secretion and motility-related illnesses.

A different investigation evaluated the effects of cannabigerol (CBG), another non-psychoactive cannabinoid, on mice induced with murine colitis. Inflammation was analyzed by assessing various inflammatory parameters such as myeloperoxidase activity, by histological analysis and immunohistochemistry. The effect of CBG on nitric oxide production and oxidative stress were evaluated using murine macrophages and intestinal epithelial cells.

The results showed that CBG reduced murine colitis, reduced the production of nitric oxide in macrophages through activation of CB2 receptorsand attenuated formation of ROS in intestinal epithelial cells. The authors recommended further clinical experimentation of CBG in patients with IBD to determine whether it can be utilized as a therapeutic option.

How CBD Works to Reduce Intestinal Inflammation

Acute and chronic inflammation in the gut is usually regulated by enteric glial cells (EGC). These cells multiply and release growth factors, neurotrophins and pro-inflammatory cytokines which either amplify or reduce immune responsiveness.

Cannabidiol (CBD) is an interesting compound since it is able to mediate reactive gliosis in the CNS, without any undesirable psychoactive effects. To establish exactly how CBD interacts with the gastrointestinal tract, one study investigated its effects on intestinal biopsies from patients with ulcerative colitis (UC) as well as from intestinal segments of mice with LPS-induced intestinal inflammation.

The researchers found that the function of CBD is, at least partly, facilitated through the selective PPARγ receptor pathway.They observed that CBD targets enteric reactive gliosis, counteracting the inflammatory environment caused by LPS in mice and in human colonic cultures extracted from patients with UC. These mechanisms lead to a reduction of intestinal damage. The results from this study prove that CBD is indeed a novel therapeutic strategy for the treatment of inflammatory bowel diseases.

Conclusion

There is a lot of political and social controversy affiliated with Cannabis. That being said, the medical community has come to the realization that cannabinoids such as CBD have the potential to develop novel therapeutic agents for the treatment of many illnesses, including irritable bowel syndrome.

Therefore, it goes without saying that our understanding of cannabinoids and how they relate to homeostasis and diseases such as irritable bowel diseases must be advanced through well-designed research.

Below is a list of all the studies summarized in this article and more, concerning CBD and irritable bowel syndrome. In case of any new developments with regards to CBD for IBD, come back to this pageand we will be the first to let you know.

Research and Case Studies on the effects of Cannabis to treat Irritable Bowel Syndrome: