Can CBD oil cause constipation?

by Apoorva Shivankar, M.D

Can CBD oil cause constipation?

CBD and Constipation

Visiting the washroom is a daily essential for a human body, but occasionally you may get an off for some days. Your gut gets lazy and the food you eat just refuses to leave your body creating a back log in there. But what if this gut vacation extends beyond 2-3 days? Imagine!! Trust me the results can give you goosebumps.

I hope you got it right,

Yes, we are talking about constipation, the most unwelcomed guest of our digestive system even worse than diarrhoea, Millions of Americans are bothered by this bowel blockage disorder on a regular basis tormenting their work, physical-mental health as well as financial balance grossly. Yes, these clogged pipes have a much stronger potential to ruin your day or even days than what they appear to have. Don’t believe me, ask someone who is experiencing it.

What’s going on inside?

Constipation is a digestive system disorder wherein the stools become hard and difficult to expel. In a normal person, the motion frequency is usually somewhere between three times a day to three times a week but the passage of tiny amounts of dry, hard stool less than three times a week indicate constipation. This happens because the colon/large intestine siphons off a large amount of water from the food inside it.  More sluggish the flow of food in the intestine, more is the time spent in the colon, more water reabsorption and consequently more dry and harder stools difficult to be pushed out of the body. When this happens emptying the bowels becomes a painful task.

Characterizing symptoms of Constipation:

  • You keep on waiting but nothing comes out.
  • Your toilet time of splendid isolation and relaxation is suddenly transformed into a troubling time.
  • A continuously feel of bloatedness.
  • Bowel movements become painful.
  • Stools are lumpy or hard and difficult to pass.

What makes it worse?

Chronic constipation (recurrent episodes) may lead to serious complications such as

  • Anal fissures.
  • Leaky gut.
  • Haemorrhoids.
  • Faecal impaction.
  • Rectal bulge or prolapse.
  • Autonomic neuropathy
  • Parkinson’s disease

This makes timely management of constipation a must which includes

5 main strategies:

  1. Life-style and diet modification (high fibre diet, hydration, regular exercise).
  2. Over-the-counter (OTC) laxatives act by loosening the stools and increasing bowel movements.
  3. Prescription medications like lactose, lactulose act as stool softeners by drawing water back into the intestine.
  4. Biofeedback: Retraining the muscles that control digestive tract motility.
  5. Treat the cause.

Knowing the cause can be of great help to target the problems right at the grass-root level.

This takes us to the topic of what causes constipation?

The list of potential constipation triggers is vast, and unending but some of the most prominent ones include

  • Faulty eating habits and diet lacking in fibres, vitamins.
  • Lack of exercise
  • Stress
  • Dehydration
  • Medications - strong painkillers, antidepressants, iron pills, antacid containing calcium or aluminium.
  • Travel constipation- the most famous ‘not my loo’ syndrome.
  • Pregnancy
  • Hypothyroidism
  • IBS (irritable bowel syndrome)
  • Resisting the urge to defecate.
  • Overuse of laxatives.
  • Nerve or muscle damage.

Latest and most surprising addition to this list is the current heartthrob of the medicine world- ‘Cannabidiol’. Yes, one of the forthcoming string circulating in the constipation territory states that the increasing use of CBD products for different causes is associated with an increased occurrence of constipation in the users. Surprising, isn’t it?

Can CBD oil make you constipated? Really?

How can a gut health-promoting CBD product known for its efficacy in treating bowel disorders such as IBS, IBD can itself cause constipation?

Confused? We were confused too.

Hence to clarify this, we tried to look around for the shreds of evidences or researches verifying the claims but all went in vain. We could not find any study suggesting or explaining the link between CBD and the cause of constipation. On the contrary, studies confirmed that CBD may cause diarrhoea in long term use. Also, a large number of publications demonstrated the positive effects of CBD on gut health including constipation.

Does this mean that the claims of those users are baseless?

No, not at all. These claims were based on experience and can be explained as a result of sheer CONFUSION. Let us explain.

So, the question was:

Can CBD Oil cause bowel problems?

Ans: Yes and No

Yes, because using CBD oil can cause constipation.

No, because the exact cause for constipation is not using CBD but the other ingredients present in the same oils such as

  • Carrier oils

CBD in CBD oils is usually clubbed with a carrier oil to improve its absorption. These oils can be coconut oil, palm oil, lavender oil, essential oil, olive oil, etc. which might play a role in constipation. Thus, if you have experienced constipation, try shifting to a CBD oil with a carrier of hemp origin only (hemp seed oil only)

  • THC content

Tetrahydrocannabinol is known to slow down bowel movements leading to more water absorption and faecal hardening. This THC is a cousin cannabinoid of CBD present in all products (except CBD isolates) in a limited quantity not enough to exhibit its effect in the presence of CBD. But due to the lack of strict regulations in CBD product formulation and manufacturing, certain poor quality CBD oil may contain higher THC explaining the constipation effect.

  • Additives

Presence of additives such as guar gum, inulin, potassium benzoate and modified food starch can be the cause of CBD oil-induced stomach and digestive problems.

  • Impurities

Poor quality oil may contain impurities capable to cause constipation.

  • Improper cultivation

Being a bio-accumulator, hemp-plant is known to absorb everything from the soil. So, the soil should be continuously checked for heavy metals, toxins, etc. If not checked properly harmful chemicals may enter the plant from the contaminated soil, which may be responsible for the ultimate side-effects of CBD oil including constipation.

  • Very rarely CBD itself

Based on the universal law stating that ‘extended long-term use of a drug for certain condition can eventually result in a return, and possible worsening, of the original symptoms’, the possibility of long-term use induced constipation by CBD can’t be denied. It is hence advised to take cannabidiol for 3 weeks, give a break of 1 week and start again.

Thus, the statement that CBD oil causes constipation is only partially correct.

Another ringing question is:

If not a cause, can CBD oil help with constipation?

Here CBD wins multiple thumbs up from different studies supporting its gut-health promoting effects. How? Let’s see

CBD oil, derived from flowers, stalks and leaves of hemp variety of cannabis plants is known to cure a multitude of ailments ranging from insomnia to depression. The cannabis plant contains nearly 400 medicinal compounds including >100 cannabinoids (psychoactive THC and non-psychoactive CBD being the most predominating ones), along with a variety of flavonoids and terpenes.  The therapeutic powers of these cannabinoids are known for centuries though the mechanisms were revealed only recently.

Facts supporting CBDs role in constipation:

  • Back in 2300 BC, physicians in India used to treat constipation with hemp leaves taken along with milk, sugar and spices suggesting the age-old authenticity of hemp- derived CBD products.
  • Even now the herbal mixture of hemp seed oil with other herbal extracts is in huge demand as laxative in developed countries like China.

Mechanisms by which CBD can help constipation include:

CBD is known to act through the Endocannabinoid system ECS spread throughout the body to maintain the homeostatic balance. It mainly consists of CB1 and CB2 receptors

CB1 – present in intestinal epithelium and central nervous system-

Regulate bowel movements.

CB2 immune cells (especially those of GIT) and peripheral nervous system-      Check visceral pain and inflammation.

  • In case of any imbalance such as anxiety, stress, pain, inflammation, appetite changes, GI insults or dysfunctions; endogenous cannabinoids like anandamide are synthesized on demand.
  • These endocannabinoids then bind to the endocannabinoid receptors, turn them on and send positive neurotransmitter signals to rectify the imbalances and maintain a relaxed harmonious state in the body.
  • CBD share a similar structure with endogenous cannabinoids and thus, can replace them in case of deficiency. It can also prevent the breakdown of endocannabinoids maintaining anandamide levels to ease homeostasis.
  • This freedom from anxiety, stress, pain response, inflammation and restoration of bowel movement play a vital role in constipation management by CBD products.

Balanced brain-gut axis

CBD relaxes the hypersensitive gut nerves and muscles to restore bowel movement and relieve visceral pains (by interacting with the cannabinoid receptors of the vagus nerve).

CBD beyond Endocannabinoid System

CBD by boosting serotonin levels - Hormone of Happiness - elevates your mood, regulates bowel movements, and frees you from important stimulators of IBS and constipation such as stress and anxiety.

  • The pain-alleviating effect of non-addictive CBD can reduce the dose of opioids needed to treat chronic pain and thus, protect the patient from opioid-induced stomach pain, nausea and secondary constipation often seen with long-term use of opioids.

  • Finally, CBD oil, by effectively treating intestinal disorders such as IBS, inflammatory bowel disease, etc automatically reduces some of the important causes of constipation.

 

Thus, Cannabidiol can do magic with your constipation in a more scientific way by addressing both the triggering agents (stress, inflammation, anxiety, appetite) as well as the symptoms (pain, gastric mobility, nausea, vomiting) simultaneously.

Are there any side-effects of CBD?

Very rare but seen mostly with higher doses.

  • vomiting
  • diarrhoea
  • dizziness
  • dry mouth
  • drowsiness
  • fatigue, etc.

How will you select a correct CBD product for constipation?

We have the guidelines:

  • Select best quality, organically cultivated, branded, hemp-derived CBD products.
  • Check the label for contents and quantity
  • Say no to heavy metals, artificial sweeteners, preservatives, colouring agents, pesticide.
  • Should be third party tested.
  • Prefer full-spectrum CBD products because the ‘entourage effect’ ensures maximum health benefits,
  • Oral forms have better results as compared to topical
  • Use the form which works for you.

 

Takeaway message:

Remove the fear that CBD may land you in troublesome constipation, instead, this magical natural remedy can sail you through constipation and other digestive issues unhurt- you just have to be extra cautious with the labels while purchasing the CBD oil.

FAQs

Q. What is “Cannabinoid Hyperemesis Syndrome”?

Recurrent nauseavomiting and cramping abdominal pain due to cannabis use usually seen in very heavy cannabis smokers. Weekly cannabis use is generally required for this syndrome to develop.

Q. CBD Oil or Hempseed Oil: Which one is Best for Constipation?

Both the oils share similar benefits in constipation but the higher number of side-effects seen with hempseed oil give CBD oil an upper hand. These side-effects of hemp seed oil include:

  • Immune suppression.
  • Aural hallucinations.
  • Explosion risk while cooking. 
  • Risk of exposure to noxious peroxides.

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