Updated on August 31, 2021.
Medical content reviewed by Dr. Joseph Rosado, MD, M.B.A, Chief Medical Officer
It is one of the most asked questions about cannabis on the internet. Cannabis diarrhea. On that basis alone, we know that some people who take cannabis get an unexpected side effect; extra time in the bathroom. But researchers aren’t 100% sure why it happens to some people, and not others.
There are some legit reasons why cannabis could cause diarrhea. But it may not be marijuana itself that creates the “unleash the hounds” bathroom moments that no one likes (ever).
Pot can make you poop. But the extent to which cannabis can cause diarrhea is not well-known by the medical community. And there are some rare conditions where cannabis-induced nausea and diarrhea can be serious enough to require urgent medical care.
Cannabis Diarrhea: What’s Going On In Your Digestive Tract?
The human body loves cannabis. In fact, humans were genetically engineered to benefit from cannabis in many healthy ways. Inside many parts of our bodies are endocannabinoid receptors. And these little communication centers trigger a lot of our physical activities.
Cannabinoid receptors are responsible for processing sensations like appetite, our general mood, memory functioning, and how and when we detect pain. The endocannabinoid system (ECS) is actually a network of signals and communication within the body. And they are controlled by CB1 receptors. Harvard Health calls the CB1 receptors “traffic cops” that monitor the signals and make adjustments that impact what we feel.
There is also the CB2 receptor. This cannabinoid receptor is responsible for some of the tough jobs. It helps control our immune systems, and specific to the concern about diarrhea? The CB2 receptors control the contraction and inflammation levels of the bowels, and entire digestive and intestinal tract.
Throughout the body are molecules called endocannabinoids. And when THC or CBD are consumed, the molecules are hijacked in a way. Both THC and CBD impact the CB1 and CB2 receptors. In some clinical studies, both CBD and THC have been beneficial for patients with G.I. problems, like IBS or Crohn’s disease.
Who is to Blame for Bathroom Problems? THC or CBD?
If you are finding you run to the bathroom about an hour after packing your first bowl, THC may not be to blame. It could actually be the CBD content in the cannabis you just took that caused the problem. When a pharmaceutical company was testing a new CBD-derived drug called Epidiolex, they discovered some interesting things.
In the patient trials for Epidiolex, the most frequent side effect reported was diarrhea. Not every participant that took the drug got diarrhea, however, but a significant number of them did, compared to the placebo group. The cases were reported to be mild to moderate. No patients were reported to have severe cases of diarrhea requiring medical attention.
Taking a full-spectrum (clinical grade) CBD has helped many patients who have gastrointestinal issues. People with irritable bowel syndrome (IBS) and Crohn’s disease may use cannabis to reduce inflammation and pain. But a high dose of concentrated CBD (500 milligrams or more) may result in more trips to the bathroom for some people. Particularly those not used to taking CBD on a daily basis.
Cannabidiol (CBD) helps regulate gut motility. What that means is that it stimulates the gastrointestinal system and helps push things out. There are natural antioxidants in CBD that help relax nerves through the digestive system. And that can help things flow better, which can be a benefit if you have a problem with constipation. But also a detriment if you are far from a bathroom.
What is Cannabinoid Hyperemesis Syndrome?
There is a difference between having an unexpected experience with diarrhea and a serious health condition that requires medical care. But if you are someone who gets diarrhea sometimes after taking cannabis, there is one health condition you should be aware of.
Cannabinoid hyperemesis syndrome (CHS) has become more common today. And it is caused by consuming high potency cannabis over a long period of time. The body develops toxicity to cannabis, and there are some strong reactions.
People who smoke cannabis on a regular basis, and choose higher potency cannabis products like concentrates, are more at risk of developing CHS. The symptoms include vomiting, nausea, and abdominal pain that may stay for several days and disappear, returning weeks or months later.
This rare condition causes persistent vomiting. And the intensity of the vomiting can be painful for the individual. There is a slang term for it called “Scromiting.” And it is as pleasant as it sounds, requiring in some cases a visit to the hospital before symptoms subside.
Are We “Holding It In” Because of Stress?
Another theory is even more plausible. And it has to do with stress and ‘holding it in’ even if we are not aware we are doing it. While CBD and THC can have a positive anti-inflammatory impact on our body, the answer to the question may be simple.
Pot makes us relaxed. Then, we can poop.
But a 2019 study confirmed that consuming cannabis could result in a 30% decrease in constipation. When was the last time you heard someone who used weed regularly complain about being constipated? It’s an interesting consideration the next time you have a ‘traffic jam,’ and you are looking for a natural way to get things moving again.
On the molecular side, the 2-AG endocannabinoid receptor is responsible for controlling the surge and urge to go. It triggers your body to poop, essentially. And this 2-AG endocannabinoid acts a lot like THC; it has a parasympathetic influence on our digestive tract. That means it acts like a counterbalance to the nervous system, from the brain to every organ, including your glands and bowel.
How to Avoid Getting Cannabis Diarrhea
People who develop gastrointestinal reactions to cannabis can make a few changes if they feel like pot is making them poop too much. One of the best steps is to reduce the potency of the medical cannabis products that you are using. That may mean gearing down from concentrates to a lower potency THC product.
Another suggestion may be to try strains of cannabis that have low cannabidiol content. Since CBD has been proven to increase motility (make you poop), then steer clear of cannabis strains that have a high CBD content.
That being said, a new study discovered that naturally occurring cannabinoids in the gut could help prevent peristalsis. That is the involuntary flexing (constriction and relaxation) of the intestine muscles. And that can also help reduce the severity of diarrhea.
Cannabis can help cure diarrhea symptoms, or it could cause it, making it a ‘crapshoot.’