Bloating, cramping, and constipation: Can medical cannabis help?

What causes gastrointestinal symptoms?

Gastrointestinal (GI) symptoms cover a wide range of symptoms that affect the gastrointestinal tract. These can include indigestion and heartburn, as well as bloating, cramping, and constipation. Many of these symptoms can be normal bodily reactions; however, they may also be linked to more serious problems, such as irritable bowel syndrome (IBS) - which includes ulcerative colitis and Crohn’s disease - and inflammatory bowel disease (IBD). 

Existing health conditions

The significance of gastrointestinal symptoms is often overlooked by both patients and healthcare providers. For example, while it is estimated that 10-15% of the adult population may suffer from IBS symptoms, only 5-7% have been diagnosed with the condition. Abdominal cramp/pain, bloating, and constipation are among the most common symptoms of gastroenterological conditions like IBS; however, they can also be associated with a number of non-gastroenterological conditions and factors. 

Bloating and cramping are extremely common symptoms of endometriosis, a condition in which tissue similar to the lining of the uterus grows outside of the uterus. It is estimated that endometriosis affects around 1 in 10 women; however, diagnosis can be difficult and is often extremely delayed. 

Prescribed medications

Bloating, cramps, and constipation can also be side effects of many prescribed and non-prescribed medications, including opioid painkillers and nonsteroidal anti-inflammatory drugs (NSAIDs). It is estimated that more than one million people in the UK are currently prescribed opioid medications, 50,000 of whom have been taking them for six months or more.

With such a high number of patients currently prescribed these products, gastroenterological symptoms and side effects are extremely common. In some cases, patients may benefit from alternative treatments to manage their condition.

Medical cannabis and gastrointestinal side effects

Patients in the UK are becoming increasingly interested in the potential of alternative therapies, including medical cannabis for IBS and other conditions associated with gastrointestinal and abdominal symptoms. Does cannabis aggravate IBS symptoms? Or is cannabis good for gastrointestinal symptoms? 

More importantly, can medical cannabis provide relief from bloating, cramps, and constipation? Let’s find out. 

Medical cannabis and bloating

If you have a condition such as endometriosis, IBS, or IBD, you may wonder how to get relief from bloating. For patients with gastroenterological conditions, bloating may be linked with other symptoms of the condition, such as slowed transit time, bacterial overgrowth, and gut sensitivity. 

The endocannabinoid system (ECS) has been found to play a regulatory role in gastrointestinal symptoms. Indeed, cannabis-based medicines are potentially beneficial in slowing intestinal motility, and maintaining a healthy gut microbiome. 

Bloating is also a common symptom of endometriosis. This can occur for several reasons, including endometrial-like tissue building up and causing inflammation in the abdomen, the formation of cysts, bacterial overgrowth in the small intestine, or due to digestion issues. 

Whatever the cause, endometriosis bloating can be associated with severe pain. Some reports - both anecdotal and clinical - suggest that medical cannabis can be beneficial when managing endometriosis bloating and pain.

So as you can see, medical cannabis may carry some significant therapeutic potential in several conditions for which bloating is a primary symptom. However, little research has focused on its effects specifically on bloating. 

But, what about when it comes to cramps and constipation?

Medical cannabis and cramps

Cramps and abdominal pain are common symptoms of gastroenterological and reproductive conditions. They can cause severe discomfort and pain, which can often require pharmaceutical intervention, including the use of opioid painkillers and NSAIDs. Anecdotally, many patients report experiencing relief from cramps with the use of cannabis. 

Cannabinoids may help to reduce inflammation that can affect the intestines and stomach in conditions such as IBS and IBD. Pre-clinical studies show that interactions between cannabinoid receptors and cannabinoids can limit intestinal inflammation and disease severity in colitis, potentially suggesting a role for medical cannabis in relieving cramps; however, more clinical evidence is required.

As we mentioned above, some research indicates that medical cannabis can also be helpful for patients managing cramps and pelvic pain associated with endometriosis. Some evidence suggests that the ECS may be a promising target for therapeutic interventions for endometriosis as the system may modulate pain associated with the condition. 

Medical cannabis and constipation

People can experience constipation for a wide range of reasons, including lifestyle and dietary habits, as a symptom of an underlying condition, or due to certain medications. So could medical cannabis help to provide constipation relief?

Few studies have focused on medical cannabis for constipation; however, one study analysing the effects of recreational cannabis found that the prevalence of constipation was lower among those with recent medical cannabis use compared with those without. 

Medical cannabis as an alternative to conventional therapies

Ongoing concerns around the over-prescription of opioid painkillers have prompted calls for alternative therapeutic options, and medical cannabis has emerged as a potential option for patients living with a wide range of conditions. Exploring alternative therapies such as medical cannabis may also help mitigate the side effects of these conventional medications, which typically include a high risk of addiction and overdose, as well as bloating, cramps, and constipation.

A growing body of evidence indicates that initiation of medical cannabis therapy can help patients reduce their intake of other analgesics, including opioids and NSAIDs.And, a recent review of medical cannabis for endometriosis found that many patients report reducing their use of analgesics following the initiation of medical cannabis treatment. Similar findings have been made for several other conditions, including chronic pain.

Final thoughts

Medical cannabis has been found to demonstrate therapeutic potential in a number of conditions associated with gastrointestinal symptoms such as bloating, cramps, and constipation. Moreover, some studies indicate that cannabis-based medicines may help patients to reduce their use of conventional medications such as opioids and NSAIDs which may also be associated with these symptoms.