CBD for GERD and Acid Reflux: Can Cannabis Oil Help?

Experiencing heartburn after eating a hearty meal — especially a spicy one — isn’t uncommon. In fact, 1 in 10 Americans experiences Gastroesophageal Reflux Disease (GERD), which is closely related to acid reflux. Most people use over-the-counter medications for short-term relief from GERD, but these medications fail to provide long-term benefits. They also have side effects upon prolonged use, including headache, nausea, vomiting, nausea, and vitamin deficiencies.

CBD oil can be an effective alternative for GERD, but most importantly, it also seems safer than conventional treatments. In this article, we explain the mechanism behind CBD’s benefits for GERD and acid reflux on top of providing a buyer’s guide for beginners in this booming and unregulated market.

CBD for GERD and Acid Reflux: Highlights

• GERD is the abbreviation for gastroesophageal reflux disorder. It is caused by esophageal dysfunction and dysregulation of gastric acid secretion.
• In a study published by Current Neuropharmacology, cannabinoid receptor activities in the endocannabinoid system were mentioned to provide modulatory effects on gastric acid secretion, gastrointestinal inflammation, and esophageal function (1).
• A 2016 review posted in the Asian Pacific Journal of Medicine highlighted CBD and THC as potential inhibitors of gastric acid secretions through their interaction with cannabinoid receptors (2).
• According to the British Pharmacological Society, cannabinoid receptors are engaged in modulating esophageal function (3).
• Studies confirmed that the gastric protective and anti-inflammatory effects of CBD might be useful in treating GERD.

What is GERD and Acid Reflux?

Acid reflux occurs when stomach acid flows back into the esophagus due to the movements of transient lower esophageal sphincter (LES) muscle. The sphincter muscle opens when you swallow food. Dysfunctional LES muscles cause the sphincter to open even when a person is not swallowing. The continuous flow of gastric acid in the esophagus may trigger inflammation known as esophagitis. This, in turn, causes heartburn, which is a burning sensation causing discomfort in sufferers.

GERD is a more severe form of acid reflux. On top of heartburn, it can cause coughing, wheezing, sore throat, and voice hoarseness; untreated GERD may also lead to esophageal mucosal damage and hiatal hernia resulting from prolonged exposure to gastric acid on the lining of the esophagus. Individuals with GERD are also more prone to developing esophageal cancer.

Risk Factors for GERD

Acid reflux and GERD may be caused by some lifestyle factors that cause irritation to the esophagus. The risk factors and causes of GERD include:

• Not swallowing food properly
• Eating large meals
• Consuming spicy foods
• Smoking
• Drinking alcohol
• Drinking coffee
• Taking aspirin
• Pregnancy
• Obesity
• Hereditary factors
• Hiatal hernia (bulging of the stomach)

Can CBD Oil Help with GERD and Acid Reflux?

CBD oil isn’t the first-choice treatment for GERD. Doctors usually recommend over-the-counter antacids (stomach neutralizers) and proton pump inhibitors (PPI) such as nizatidine and cimetidine. The PPI medications reduce the number of stomach acids.

However, the said medications might have adverse effects, such as constipation, stomach pain, nausea, vomiting, and neurotoxicity. These side effects, as well as the low cost-efficacy of such treatments, tend to occur in elderly patients, which is why some individuals are seeking natural alternatives.

Although there’s a lack of direct studies on CBD’s efficacy for GERD, existing research indicates that CBD’s activity on the endocannabinoid system (ECS) — specifically on its receptors — might produce several modulatory effects that can regulate gastric acid production, reduce pain, and inflammation in the gut, and promote healthy esophageal function.

The ECS is a widespread regulatory network that helps the body maintain a balance between all biological processes between its systems and organs. It is found in all vertebrates and mammals.

According to a 2016 review published in the Asian Pacific Journal of Medicine, cannabinoid receptor activities prompted by CBD and THC might reduce stomach acid production. The authors of the review cited studies pointing to cannabis extracts as a means to protect animal subjects from mucosal damage and gastric lesions.

Cannabis contains both CBD and THC; depending on the species, they occur in different ratios. Hemp plants contain higher levels of CBD and only trace amounts of THC (no more than 0.3%), while marijuana comes with significant concentrations of THC and low-to-moderate CBD content.

The research team concluded that the gastric protective and anti-inflammatory effects of cannabinoids on the gut may be useful in treating GERD and its symptoms.

An animal study published by the British Pharmacological Society mentioned that cannabinoids could improve gastrointestinal motility by reducing LES relaxation. Some researchers believe that disruptions in gastric motility may also be involved in the faster onset of GERD.

GERD is often associated with inflammation and oxidative stress caused by inflammatory cytokines. These compounds are known to cause early inflammation in individuals with GERD. In a study using animal and human biopsies, the researchers have found that CBD produces remarkable anti-inflammatory and antioxidant effects. The authors of the study added that these benefits hold promise for treating inflammation conditions.

According to researchers, GERD could be a significant cause of anxiety and depression. A study published by Cureus concluded that 41% of GERD patients suffered from depression, 34% suffered from anxiety, and 27% had both (4).

A study from Frontiers in Immunology acknowledged that CBD may be an effective treatment for mental health problems due to its anxiolytic and antidepressant effects.

How Does CBD Work for GERD?

The endocannabinoid system (ECS) plays an important role in the regulation of biological processes in the body, including gastrointestinal function. As mentioned, cannabinoid receptor activities have been linked to modulatory effects on gastroesophageal activity and the production of stomach acids.

Cannabinoid receptors are found in the immune system, central nervous system, and gastrointestinal system. The immunomodulatory effects of CBD derived from its interaction with CB2 receptors. CBD also reduces the production of pro-inflammatory cytokines, curbing inflammation and allowing the body to regenerate faster (5).

The presence of cannabinoid receptors in the gastrointestinal system is another possible explanation for the benefits of CBD for GERD.

Long story short, CBD’s interaction with the ECS and its receptors may regulate GI tract motility, reduce gastric acid secretion, and lower inflammation in the gut.

Is CBD Oil the Same as Medical Marijuana?

CBD oil can be extracted from two types of cannabis plants: hemp and marijuana. It is made using CO2, steam, or solvents — resulting in a concentrated oil chock-full of cannabinoids and terpenes. This oil can be further added to carrier oils, edibles, capsules, topicals, and vape liquids.

If a CBD oil is derived from hemp, it will contain only 0.3% of THC per volume. These are insufficient concentrations to produce a high. Instead, the user will experience the benefits of CBD enhanced by the presence of other cannabinoids and terpenes.

On the other hand, CBD oil sourced from medical marijuana strains will provide higher concentrations of THC, ranging between 5–35% depending on the strain. Selectively bred marijuana plants also come with higher ratios of CBD. They may come in a 1:1, 2:1, 5:1, 10:1, or even 20:1 ratio. Depending on the THC content in such CBD oils, the intoxicating effects may range from nearly nonexistent to mild euphoria on the verge of high. However, these effects are nowhere near the signature intoxication from high-THC strains.

If you’re looking for a product that is legal in all 50 states and won’t get you high, hemp-derived CBD oil is a more available option for GERD. This may change, though, as more states are on the way to legalizing the entire spectrum of cannabis.

How to Choose CBD Products for Acid Reflux?

Here are a few tips to consider before buying CBD for GERD and acid reflux:

• Do your research about any company selling CBD. The market is unregulated, so there’s a risk of buying a mislabeled or dangerous product. You can find more information about the CBD product and the company behind it by checking customer reviews, testimonials, and by reading expert blogs.
• People with GERD should first consult with a gastroenterologist and discuss different treatment options. Holistic physicians should be knowledgeable about CBD and its benefits for inflammation and gastrointestinal problems.
• Be sure to check for Certificates of Analysis (CoA) from an independent laboratory to confirm that the potency on the label reflects the actual chemical profile of your CBD oil. Outside laboratories also look for common contaminants, such as pesticides, solvents, heavy metals, and residual solvents.

Another important thing to consider when buying CBD oil for GERD is the cannabinoid spectrum it offers.

Full Spectrum or Isolate: Which Is Better for GERD?

CBD is available in three basic formats: full-spectrum CBD, broad-spectrum CBD, and CBD isolate.

Full-spectrum CBD contains all the cannabinoids in hemp, including CBD, CBC, CBG, CBN, and traces of THC (up to 0.3%). Together, these compounds enter a synergy known as the entourage effect. According to a review published in Frontiers in Plant Science, the entourage effect increases the primary activity of the endocannabinoid system. The author of the study noted that the whole-plant synergy would explain why botanical extracts are more efficient compared to isolated compounds (6).

The entourage effect was demonstrated by a controlled trial on patients with chronic pain. In the study, opioid treatment supported with isolated THC failed to provide significant relief compared to placebo. However, a whole-plant extract containing both THC and CBD produced much better results (7).

The second type — broad-spectrum CBD — includes CBD, CBG, CBC, CBN, all the minor cannabinoids, and terpenes — but without any THC. The intoxicating cannabinoid is removed after initial extraction. Although not as potent as full-spectrum CBD, broad-spectrum extracts still evoke some of the entourage effects.

Finally, individuals who are allergic to other compounds from hemp, or those afraid of failing a drug test for THC, may opt for CBD isolate. This product contains 99% pure CBD and carries the highest dose in a single serving. However, CBD isolate doesn’t produce the entourage effect and is less predictable when it comes to dosing.

Safety: Can CBD Oil Make Acid Reflux Worse?

There is no evidence that CBD oil could make acid reflux or GERD worse. Unlike conventional anti-acid reflux medications, CBD doesn’t have dangerous side effects and is well tolerated in humans in doses of up to 1,500 mg daily. Numerous health agencies, including the World Health Organization (WHO), have concluded that CBD is a safe and effective compound.

Of course, this doesn’t mean CBD oil is free from side effects. They do exist, but they are very mild and typically include the following symptoms:

• Dry mouth
• A temporary drop in blood pressure
• Dizziness
• Fatigue
• Changes in appetite
• Diarrhea

There’s also a chance of CBD-induced drug interactions, so if you take any medications, consult your doctor to avoid them. Doing so may also help you find the right dosage for yourself.

CBD Dosage for Acid Reflux

The FDA has yet to regulate CBD products, so until that happens, there are no officially established dosage guidelines when it comes to using CBD for specific conditions. The best CBD dosage range for GERD and acid reflux depends on several individual factors, such as your age, weight, metabolism, the severity of symptoms, and previous experience with CBD. The potency of your product, its cannabinoid spectrum, and the route of administration also affect the onset, type, and duration of effects.

It’s recommended to start with a low dose to evaluate your body’s response to CBD. The optimal initial dosage is between 2–5 mg of CBD for every 10 pounds of the body weight. After one week, you can reassess the effects and adjust the dose if needed. Once you’ve found your effective dose, you can stick to it; there’s no risk of building tolerance to CBD.

Final Verdict: Does CBD Help with GERD?

Acid reflux is a gastrointestinal condition that can cause discomfort in the stomach, leading to backflow or “reflux” of gastric acid to the esophageal tract. Poor diet and bad lifestyle choices (e.g. high-sugar diet, spicy food, and smoking cigarettes), can cause acute acid reflux to turn into a chronic disease known as GERD.

CBD interacts with the endocannabinoid system, whose receptors are present in the gastrointestinal tract. Through this interaction, CBD modulates the activity of the immune system, reducing inflammation. It also slows down the production of stomach acid and improves gastrointestinal motility, preventing fluid backflow to the esophagus.

CBD is a promising anti-acid reflux agent; however, more direct clinical trials are needed to confirm its efficacy on a relevant sample. If you’re considering taking CBD oil for acid reflux, you should seek advice from a holistic gastroenterologist.

Do you take CBD oil for GERD? Or do you know anyone who has managed to overcome acid reflux using CBD products? Let us know in the comments section!

References:

1. Gyires, Klára, and Zoltán S Zádori. “Role of Cannabinoids in Gastrointestinal Mucosal Defense and Inflammation.” Current neuropharmacology vol. 14,8 (2016): 935-951. doi:10.2174/1570159×14666160303110150
2. Abdel-Salam, Omar. “Gastric acid inhibitory and gastric protective effects of Cannabis and cannabinoids.” Asian Pacific journal of tropical medicine vol. 9,5 (2016): 413-9. doi:10.1016/j.apjtm.2016.04.021
3. Wright, K L et al. “Cannabinoid CB2 receptors in the gastrointestinal tract: a regulatory system in states of inflammation.” British journal of pharmacology vol. 153,2 (2008): 263-70. doi:10.1038/sj.bjp.0707486
4. Mohammad, Saleh et al. “Depression and Anxiety in Patients with Gastroesophageal Reflux Disorder With and Without Chest Pain.” Cureus vol. 11,11 e6103. 8 Nov. 2019, doi:10.7759/cureus.6103
5. Nagarkatti, Prakash et al. “Cannabinoids as novel anti-inflammatory drugs.” Future medicinal chemistry vol. 1,7 (2009): 1333-49. doi:10.4155/fmc.09.93
6. Russo, Ethan B. “The Case for the Entourage Effect and Conventional Breeding of Clinical Cannabis: No “Strain,” No Gain.” Frontiers in plant science vol. 9 1969. 9 Jan. 2019, doi:10.3389/fpls.2018.01969
7. van de Donk, Tine et al. “An experimental randomized study on the analgesic effects of pharmaceutical-grade cannabis in chronic pain patients with fibromyalgia.” Pain vol. 160,4 (2019): 860-869. doi:10.1097/j.pain.0000000000001464