Irritable Bowel Syndrome – Cannabis Research

Irritable Bowel Syndrome Research Dashboard

24

Primary Studies

78

Related Studies

102

Total Studies

Clinical Studies

0

Clinical Meta-analyses

7

Double-blind Clinical Trials

2

Clinical Trials

Pre-Clinical Studies

13

Meta-analyses/Reviews

2

Animal Studies

0

Laboratory Studies

What am I missing as a non-subscriber?

To see a full dashboard with study details and filtering, go to our DEMO page.

As a subscriber, you will be able to access dashboard insights including chemotype overviews and dosing summaries for medical conditions and organ system and receptor breakdowns for cannabinoid and terpene searches. Study lists present important guidance including dosing and chemotype information with the ability to drill down to the published material. And all outputs are fully filterable, to help find just the information you need. Stay up-to-date with the science of cannabis and the endocannabinoid system with CannaKeys.

CannaKeys has 102 studies associated with Irritable Bowel Syndrome.

Here is a small sampling of Irritable Bowel Syndrome studies by title:


Components of the Irritable Bowel Syndrome Research Dashboard

  • Dosing information available for Irritable Bowel Syndrome
  • Chemotype guidance for treating Irritable Bowel Syndrome with cannabis
  • Synopsis of cannabis research for Irritable Bowel Syndrome
  • Individual study details for Irritable Bowel Syndrome

Ready to become a subscriber? Go to our PRICING page.

Irritable Bowel Syndrome Research Dashboard

24

Primary Studies

78

Related Studies

102

Total Studies

Clinical Studies

0

Clinical Meta-analyses

7

Double-blind Clinical Trials

2

Clinical Trials

Pre-Clinical Studies

13

Meta-analyses/Reviews

2

Animal Studies

0

Laboratory Studies

What am I missing as a non-subscriber?

To see a full dashboard with study details and filtering, go to our DEMO page.

As a subscriber, you will be able to access dashboard insights including chemotype overviews and dosing summaries for medical conditions and organ system and receptor breakdowns for cannabinoid and terpene searches. Study lists present important guidance including dosing and chemotype information with the ability to drill down to the published material. And all outputs are fully filterable, to help find just the information you need. Stay up-to-date with the science of cannabis and the endocannabinoid system with CannaKeys.

CannaKeys has 102 studies associated with Irritable Bowel Syndrome.

Here is a small sampling of Irritable Bowel Syndrome studies by title:


Components of the Irritable Bowel Syndrome Research Dashboard

  • Dosing information available for Irritable Bowel Syndrome
  • Chemotype guidance for treating Irritable Bowel Syndrome with cannabis
  • Synopsis of cannabis research for Irritable Bowel Syndrome
  • Individual study details for Irritable Bowel Syndrome

Ready to become a subscriber? Go to our PRICING page.

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Overview - Irritable Bowel Syndrome

Description of Irritable Bowel Syndrome

Originally termed mucous colitis by Sir William Osler in 1892, a digestive disease characterized by mucous diarrhea and abdominal colic, is known today as irritable bowel syndrome (Surawicz et al., 2007, p. 458).


Abbreviated as IBS, Irritable Bowel Syndrome is the most common condition within the family of functional bowel disorders characterized by recurrent abdominal pain, bloating, discomfort, and alteration in bowel habits (W. Chey et al., 2015Alammar & Mullin, 2019). Depending on the nature of the bowel function, IBS is further categorized into four disease subtypes:



  • Diarrhea predominant (IBS-D)

  • Constipation predominant (IBS-C)

  • Mixed (IBS-M)

  • Unsubtyped (IBS-U).


Irritable Bowel Syndrome (IBS) is a chronic, functional gastrointestinal disorder of the large intestine, characterized by recurring symptoms without clear structural or biochemical abnormalities. Because IBS is considered non-inflammatory and largely idiopathic (of unknown cause), it is defined as a syndrome rather than a distinct disease.


Diagnostic Criteria: At present, irritable bowel syndrome has no pathognomonic blood tests, markers, or imaging studies. The diagnosis is based on characteristic symptoms using established criteria (Rome IV, 2016), exclusion of concerning features called “red flags”, and use of selected tests to exclude conditions that can mimic IBS (Alammar & Mullin, 2019, p. 440). Typical features (symptoms) of IBS include (W. Chey et al., 2015):



  • Loose/frequent stools

  • Constipation

  • Bloating

  • Abdominal cramping, discomfort, or pain

  • Symptoms brought on by food intake or specific food sensitivities

  • Symptoms are dynamic over time (change in pain location, change in stool pattern)

  • The most common clinical method used for the diagnosis of IBS is the Rome IV Criteria for Irritable Bowel Syndrome (C1) in conjunction with stool characterization using the Bristol Stool Form Scale (BSFS).


Rome IV Criteria:


Recurrent abdominal pain on average at least 1 day/week in the last 3 months*, associated with two or more of the following criteria:



  1. Related to defecation

  2. Associated with a change in the frequency of stool

  3. Associated with a change in the form (appearance) of stool.


*Criteria fulfilled for the last 3 months with symptom onset at least 6 months before diagnosis.


Stool patterns must be present greater than 25% of the time with Types 1 and 2 indicative of IBS-C, Types 6 and 7 for IBS-D, and Types 1 and 7 for IBS-M (Mearin et al., 2016).


Importantly, somatic causes of diseases with similar symptoms must be excluded, which are often the rationale for performing diagnostic studies for a condition that has no identifiable specific or pathognomonic findings.


Warning signs (“red flags”) for somatic causes of IBS-like disease (W. Häuser et al., 2012), (W. Chey et al., 2015):



  • Diarrhea is the main symptom

  • Fever

  • Severe or progressively worsening symptoms

  • Blood in the stool (rectal bleeding or melena)

  • Unexplained iron-deficiency

  • Weight loss of more than 10% despite unchanged food intake

  • Nocturnal symptoms (diarrhea)

  • Family history of colon cancer or other organic gastroenterological disease, including Celiac disease, or inflammatory bowel disease

  • Onset of symptoms after age 50 years

  • Brief history (<6–12 months) and/or progressive symptoms

  • In the basic laboratory profile, anemia or signs of inflammation


Aside from concerning “red flags,” several medications, both over the counter (OTC) and prescription, can imitate or exacerbate IBS symptoms. OTC medications such as antihistamines, calcium, iron, magnesium, nonsteroidals, and wheat bran have potential bowel-related side effects and should be considered in the history obtained from the patient. Likewise, prescription antibiotics, antidepressants, antiparkinsonian drugs, antipsychotics, calcium-channel blockers, diuretics, metformin, opioids, and sympathomimetics can cause IBS-like symptoms. Some of the more notable “organic” conditions that can cause IBS-like symptoms or occur in association with IBS include celiac disease, microscopic colitis, the inflammatory bowel diseases (IBD), Crohn’s disease and ulcerative colitis, bile acid diarrhea, colon cancer, and dyssynergic defecation. One-third of patients with IBD fulfill Rome criteria for IBS (W. Chey et al., 2015).


Because IBS is a diagnosis of exclusion, a thorough clinical evaluation is important to rule out other gastrointestinal diseases such as IBD or celiac disease. Treatment approaches often require multimodal care, targeting both gut physiology and psychological well-being. 


The pathophysiology of irritable bowel syndrome has not been completely elucidated. Numerous causes have been proposed, none of which have been proven to be the sole cause of symptoms. According to Chey, both environmental and host factors contribute to the symptoms of IBS (W. Chey et al., 2015). The list of potential etiologic factors is extensive:


Environmental Contributors to IBS Symptoms



  • Early life stressors (abuse, psychosocial stressors)

  • Food intolerance/sensitivity

  • Antibiotics (and other ingested xenobiotics)

  • Enteric infection


Host Factors Contributing to IBS Symptoms



  • GI dysmotility

  • Altered pain perception

  • Altered brain-gut interaction

    • Autonomic hyperactivity

    • Dysfunction of the hypothalamic-pituitary-adrenal axis



  • Altered enteric neurotransmitters

  • Dysbiosis (an imbalance between the types of organisms present in a person's natural microflora, especially that of the gut, thought to contribute to a range of conditions of ill health)

  • SIBO (small intestinal bacterial overgrowth)

  • Increased intestinal permeability

  • Microscopic intestinal inflammation

  • Bile acids

  • Increased gut mucosal immune activation

  • Visceral hypersensitivity

  • Genetic predisposition

  • Clinical Endocannabinoid Deficiency Syndrome

  • Alterations in the Endocannabinoidome (eCBome)

Disease Classification

Condition: Irritable Bowel Syndrome
Disease Family: Gastrointestinal Disorder
Organ System: Digestive System
ICD-10 Chapter: Diseases of the Digestive System
ICD-10 Code: K58

Irritable Bowel Syndrome Symptoms:

Abdominal pain (e.g. bloating, cramping), abdominal distention, diarrhea, constipation, or both (alternating), imbalances in microbiome, common comorbidities may include fibromyalgia, depression, anxiety, or chronic fatigue syndrome

Also known as:

IBS, IBS-C, IBS-D, Irritable colon, Spastic colon, irritable bowel syndrome without diarrhea, colon spasm, irritable bowel syndrome not otherwise specified, irritable colon, spastic colon, irritable bowel syndrome with diarrhea, irritable bowel syndrome with constipation, mixed irritable bowel syndrome, other irritable bowel syndrome, irritable bowel syndrome with predominant diarrhea, irritable bowel syndrome with predominant constipation

Drug Interactions

THC Interaction with Pharmaceutical Drugs

  • Tetrahydrocannabinol (THC) can enhance the effects of drugs that cause sedation and depress the central nervous system, such as benzodiazepines, barbiturates, and alcohol. 
  • THC is metabolized by an inhibitor of several enzymatic liver pathways referred to as cytochrome P450 (aka CYP450). There are more than 50 enzymes belonging to this enzyme family, several of which are responsible for the breakdown of common drugs such as antidepressants (e.g., amitriptyline, doxepin, fluvoxamine), antipsychotics (haloperidol, clozapine, Stelazine), beta-blockers (e.g., propranolol), bronchodilators (e.g., theophylline), or blood thinners (e.g., warfarin). Thus, patients taking these medication classes may find that THC increases the concentration and effects of these drugs and the impact duration.
  • Clinical observation (not yet confirmed by clinical trials) suggests no likely interactions with other pharmaceuticals at a total daily dose of up to 20mg THC.

If you are interested in the interaction potential of specific pharmaceuticals with THC, consider visiting these free drug interaction checkers: Drugs.com or DrugBank Online.

CBD Interaction with Pharmaceutical Drugs

  • Cannabidiol (CBD) may alter the action of metabolic enzymes (specific drug-transport mechanisms) and alter interactions with other drugs, some of which may produce therapeutic or adverse effects. For instance, CBD interacts with the enzyme cytochrome P450 3A4 and cytochrome P450 2C19, increasing the bioavailability of anti-epileptic drugs such as clobazam (a benzodiazepine). This makes it possible to achieve the same results at significantly lower dosages, reducing treatment costs and risks of adverse effects. 
  • Groups of drugs affected include anti-epileptics, psychiatric drugs, and drugs affecting metabolic enzymes.
  • Clinical observations (not yet confirmed by clinical trials) suggest no likely interactions with other pharmaceuticals at a total daily dose of up to 100mg CBD.

If you are interested in the interaction potential of specific pharmaceuticals with CBD, consider visiting these free drug interaction checkers: Drugs.com or DrugBank Online.

THC/CBD Interaction with Pharmaceutical Drugs

In general, when using cannabinoid-based therapeutics that contain both THC and CBD consider the ratio between them and weigh the relevant information displayed in the individual THC and CBD Drug Interaction windows accordingly.

If you are interested in the interaction potential of specific pharmaceuticals with both primary cannabinoids and THC/CBD, consider visiting these free drug interaction checkers: Drugs.com or DrugBank Online.

Concerns about Cannabis and Cancer-related Immunotherapies:
Some recent clinical observational studies have suggested that the co-administration of cannabinoid-based therapeutics and immunotherapy or immune checkpoint inhibitors in the treatment of certain types of cancer has been associated with worse overall survival rates (T. Taha et al., 2019; A. Biedny et al., 2020; G. Bar-Sela et al., 2020).

However, other studies have suggested that the co-commitment use of immune checkpoint inhibitors and cannabis-induced no such deleterious effects. More specifically, one trial was conducted on animals resulting in data suggesting that cannabis did not negatively affect the properties of immune checkpoint inhibitors (B. Waissengrin et al., 2023). The same authors compared the previous study results with findings from a cohort of 201 patients with metastatic non-small cell lung cancer who received treatment with monotherapy pembrolizumab as a first-line treatment and adjunct cannabis to treat mainly pain and loss of appetite. Their time to tumor progression was 6.1 versus 5.6 months, and overall survival differed between 54.9 versus 23.6 months in cannabis-naïve patients and cannabis-using patients, respectively. However, while numerically different, the authors write that these differences were not statistically significant, leading them to suggest that “These data provide reassurance regarding the absence of a deleterious effect of cannabis in this clinical setting.”

Dosing Considerations

THC Dosage Considerations

  • THC micro dose:  0.1 mg to 0.4 mg
  • THC low dose:  0.5 mg to 5 mg
  • THC medium dose:  6 mg to 20 mg
  • THC high dose:  21 mg to 50+ mg

CBD Dosage Considerations

  • CBD low dose:  0.4 mg to 19 mg
  • CBD medium dose: 20 mg to 99 mg
  • CBD high dose:  100 mg to 800+ mg (upper limits tested ~1,500mg)
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Information on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own licensed physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disease. If using a product, you should read carefully all product packaging. If you have or suspect that you have a medical problem, promptly contact your health care provider.

Information on this site is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your physician, nutritionally oriented health care practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.