Can CBD Cause Constipation?
Ah, the digestive system, everyone’s favorite body system to discuss. It can be awkward, for sure, but digestive health is hugely important, and bowel movements are a big part of that.
Paying attention to how your body is processing food can help you stay healthy, catch problems early, and have a more fulfilling life. So don’t be embarrassed to ask some “poop” questions.
The short answer is, yes, in some cases CBD can cause constipation, but this is quite rare. Usually, it has the opposite effect and most people find that using CBD oil or other CBD products can improve their digestive health.
How Cannabis Affects the Digestive System
One of the least-well-understood mechanisms in the human body is the digestive system and how it interfaces with the nervous system, the endocrine system, and many other important body systems. In short, what you eat, how you want it, and how your body digests it matters a lot.
So one of the interesting and inspiring things about CBD and the development of new CBD products is the potential for better bowel health. This is especially important for those suffering from conditions like Crohn’s disease, irritable bowel disease, and other gastrointestinal issues.
But even the casual cannabis consumer can find wellness benefits in the use of CBD products. One thing that’s important to note is that the Food and Drug Administration (FDA) has only approved CBD as a treatment for epilepsy, and only some forms of epilepsy at that. So health claims about cannabis products are not currently legal. Still, the initial research is promising.
The Endocannabinoid System
So what’s going on under the hood? Why is CBD so impactful on bowel health? This is all thanks to the endocannabinoid system (or ECS), a system of receptors and transmitter molecules made in the human body. The transmitter molecules, called cannabinoids, include anandamide and 2-arachidonoylglycerol.
These may be all of the naturally occurring (or endogenous) cannabinoids, but there may be more. These are produced by the human body and act on cannabinoid receptors, which mainly occur in the nervous system, but are also present in the bowels! This is part of how THC (the most psychoactive chemical in cannabis plants) creates a “high” effect.
It binds with cannabinoid receptors in the brain and central nervous system. Cannabidiol (or CBD) on the other hand, interacts with the endocannabinoid system differently. Scientists aren’t quite sure how exactly, although they do know that CBD does not bind to the two identified endocannabinoid receptors (CB1 receptors and CB2 receptors) in the same way as THC does.
It’s clear that CBD can have some therapeutic benefits as well, however, so more research is certainly warranted.
CBD and Constipation
So what does all this have to do with constipation? It’s important to note that not only do cannabinoids act on the digestive system, but they also act on the brain. In fact, the ECS works as a sort of a gut/brain communication system.
So, depending on the cause of constipation and other factors at work, some people may find that CBD helps relieve constipation, while others won’t. The gut is a complicated place and constipation can be caused by a variety of different issues. To start, there are three basic kinds of constipation:
- Atonic: This type of constipation is caused by a failure of the intestinal muscles to work correctly, either due to atrophy or other issues.
- Obstructive: With obstructive constipation, there is something in the bowels blocking or obstructing bowel function.
- Spastic: Most people who experience chronic constipation have some sort of spastic constipation, which means constipation caused by spasms and inflammation in the intestines. Rather than worsening constipation, most people with these conditions find that CBD can reduce their symptoms.
How CBD Can Help
For spastic constipation, in particular, CBD can be an effective anti-inflammatory treatment. We’ll cover the specific diseases that are often the cause of spastic constipation in a minute, but at the basic level, we can say these are inflammatory diseases.
People with chronic constipation from Crohn’s or irritable bowel syndrome experience symptoms because their immune system is overactive, or improperly reactive, causing inflammation and irritation along the digestive tract. Since this immune response involves both the nervous system and the gut, the endocannabinoid system plays a major role.
So, CBD, and other cannabinoids can provide a lot of relief by acting on this system. For some people, over-the-counter laxatives provide enough relief from constipation itself. Inflammatory bowel diseases come with many other symptoms though, and many report that CBD and other cannabinoids help to relieve stomach pain, diarrhea, and other discomforts as well.
All of this should be taken with a grain of salt as research is still underway and the Food and Drug Administration has not approved CBD for the treatment of such diseases on the national level.
Constipation and CBD Oils
That said, for people without inflammatory bowel conditions, CBD (and cannabis-derived products in general) can be somewhat dehydrating. This means that some people do experience constipation after using CBD products, and especially after consuming edible CBD products. Simply staying properly hydrated will prevent this.
The only other way CBD oil can cause constipation is when people who are using it for relief from an inflammatory bowel condition use it for a very long time. Some people with these conditions experience an eventual return of symptoms, sometimes suddenly, once the body becomes too adjusted to a particular therapy.
So some people who use CBD oil to treat Crohn’s and similar symptoms do have constipation come on suddenly with the return of symptoms.
Other Side Effects of CBD Oil
The more likely GI side effect to experience after using CBD oil is diarrhea. While CBD can help people with bowel conditions manage this symptom as well, others find that too much CBD will trigger diarrhea. Other possible side effects include:
- Dry mouth
- Appetite changes
As you can see, these are all pretty mild. They’re also more likely to occur with full-spectrum CBD products rather than CBD isolate products. Full-spectrum hemp products use all parts of the plant and so may have more THC present than CBD isolate products do. THC can exacerbate some of these side effects.
CBD Products for GI Diseases
It would be impossible to write about CBD and digestive health without mentioning that many of the state medical marijuana programs do include Crohn's disease, IBS, and other gastrointestinal diseases as approved conditions.
While the FDA has not approved CBD as a treatment on the national level yet, many in the field think this will happen soon, especially as more research is concluded on these diseases. As noted above, one advantage of CBD is that it can work in “both directions” for people who experience constipation as well as diarrhea thanks to conditions like Crohn's disease. Let’s look at some of these conditions a little more closely.
Inflammatory Bowel Diseases (IBD)
The term “inflammatory bowel disease” refers to a few different conditions, including ulcerative colitis and Crohn's disease. We discussed some of the common symptoms and how these diseases work above, but let’s look at some of the ways in which people are using CBD and other cannabinoids to combat the symptoms of ulcerative colitis and Crohn’s disease.
It all goes back to the endocannabinoid system, which regulates the connection between the gut and the central nervous system. ECS receptors are found in immune cells as well and some research suggests that the ECS may be the regulatory system at work behind the maintenance of homeostasis in the gut (normal gut function) and gut motility in particular (the ability to move food through the digestive tract).
So, the little-understood inflammatory bowel diseases may be rooted in ECS malfunction. There is currently more research underway to study this possibility. In the meantime, many who suffer from Crohn’s or ulcerative colitis have found great relief from CBD products and hemp seed oil in particular.
Since these body systems are still poorly understood, it’s not known which cannabinoids (CBD, THC, or others) work best for GI issues, but early research suggests that pairing multiple cannabinoids may be the most effective.
Irritable Bowel Syndrome
Irritable bowel syndrome affects the same part of the body as the diseases above, the digestive tract. It can be more difficult to diagnose, however, as the inflammation isn’t as clear and consistent as with IBDs. Stil, IBS can be very uncomfortable and is characterized by stomach pain, gas, bloating, and diarrhea.
People with IBS often have additional health issues like fibromyalgia, migraines, joint disorders, anxiety, and other problems. Like IBDs, IBS is still somewhat poorly understood, as are its links with these other disorders. Again, the ECS has provided scientists with a potential path forward.
This research is also in its early stages, but cannabinoids including CBD have helped many people with IBS reduce and manage symptoms.
Gastroesophageal Reflux Disease (GERD)
Gastroesophageal reflux disease or GERD is easy to understand for anyone who’s had heartburn. Experiencing heartburn every once in a while can be uncomfortable, but people with GERD experience it chronically, sometimes every time they eat. They may also experience chest pain and trouble swallowing.
People who have used CBD oil as a therapy for GERD report mixed results. Some find that it helps to relieve pain and reduce symptoms, while others see no effect. Again, it’s still unclear which cannabinoids work best for GERD, and more research needs to be done on CBD treatments in general.
Managing Chronic Pain
One reason that cannabis is so often used to relieve the symptoms of these conditions is that it also works generally to reduce pain. A lot of these syndromes are characterized by chronic pain in the gut or elsewhere. While it’s still an understudied area how CBD and other cannabinoids might work with the ECS to regulate the gut and immune system, we can say that CBD is helpful in at least managing the associated pain that comes with Crohn’s or GERD.
For digestive issues, most people use edible CBD, such as CBD oil, but other kinds of chronic pain can be helped with topical CBD as well. Muscle soreness, whether due to exertion or an issue like fibromyalgia, is a common reason for taking CBD. Some even note positive effects on gut pain and the like simply by using topical CBD too.
Full-Spectrum CBD and the Entourage Effect
It’s not just about CBD though. One thing that’s important to note is that some think that there is an “entourage effect” when using these products to treat digestive issues. What this means is that many people report more success when using a combination of multiple cannabinoids, such as both CBD and THC (or tetrahydrocannabinol).
Even if you live in a state with a limit on the THC content of cannabis products, you may still be able to get full-spectrum CBD, however, which will include other cannabinoids besides CBD. Full-spectrum CBD is made from the entire hemp plant, rather than isolates, and so may contain other cannabinoids that are still less understood, including:
- Cannabichromene (CBC)
- Cannabigerol (CBG)
- Cannabinol (CBN)
- Cannabidiolic acid (CBDA)
- Cannabidivarin (CBDV)
The Legality of CBD Treatments
Another thing to look out for when choosing between different CBD products is that some types of CBD are not legal on the federal level yet. The 2018 Farm Bill legalized the production of hemp and hemp derivatives with up to 0.3% THC content. So, CBD isolates and some full-spectrum products are legal nationwide. In many states, additional products are also available and legal on the state level, but this is not true everywhere.
So, if you’re going to purchase CBD products for GI relief, know the relevant laws in your state and keep in mind that CBD is not approved by the FDA to treat these conditions. Any reputable CBD retailer will have disclaimers making this clear. While many people do find great relief from these products, it is illegal to make health claims about them outside of their use in treating epilepsy.
Finding High-Quality CBD for Digestive Issues
There are a few other things you should look out for in locating a reputable CBD retailer as well. Especially if you’re looking for full-spectrum CBD to relieve stomach pain or constipation, finding the right retailer is going to be important. So how can you find the best CBD products for your needs? Keep these shopping tips in mind, and remember to always do your research beforehand.
- Look for third-party lab testing: Third-party testing ensures the products are pure and don’t contain dangerous additives. It also lets you know just how much CBD is in each product and can help you avoid scams and fakes.
- Read reviews and ratings: Reading actual customer reviews and asking around about retailers will give you more accurate information than just looking at their website or walking in. Make sure to compare retailers before you buy.
- Know what you want: Part of the comparison should be comparing the products available. Some people prefer products like CBD tinctures, which are relatively easy to find but don’t always taste great. But if you're looking for tastier options like gummies or cookies, you might be in for a longer search.
While CBD can contribute to constipation in some specific circumstances, it usually has the opposite effect! In fact, CBD can be very helpful for people suffering from chronic constipation or other gastrointestinal issues, in addition to the every day benefits of CBD for relaxation and stress relief.
Keep in mind that these body systems are not fully understood yet and that the FDA has yet to approve CBD for inflammatory bowel diseases but, hopefully, the research underway right now will provide some answers soon!