Larry Good, MD, FACG1, James Baumgartner, PhD2 1Larry I. Good, MD PC, Lynbrook, NY; 2Panacea Life Sciences, Golden, CO
Introduction: IBS is a common disorder that affects up to 15% of the population in the U.S. 3/4 of whom are women. The pathogenesis of IBS involves the interplay of multiple factors including disruption of the microbiome, alterations in the tight junctions between intestinal epithelial cells, dietary intolerances, genetic factors and brain-gut interactions. Phytocannabinoids have been reported to improve many symptoms of IBS. 2 candidate phytocannabinoids, cannabidiol (CBD) and cannabigerol (CBG) have particular promise as therapeutic agents because of anxiolytic and anti-inflammatory properties that may improve intraluminal environment in the GI tract and reduce inflammatory changes at the gut-mucosal interface. Neither cannabinoid has yet to be studied in a rigorous clinical trial.
Methods: 6 patients with IBS in a GI practice were administered a CBD/CBG oral tincture containing 16.7 mg CBD and 16.7 mg CBG per dose BID. 5 women and 1 man were enrolled (Age 22-86). 3 women were menstruating regularly, one was taking an oral contraceptive. Patients received an electronic survey for symptom collection at study entry, Day 7 and 14. Abdominal pain at Baseline, relief of abdominal pain with a bowel movement, Bristol Stool Scale description of BM, number BM's/week and bloating, distension and flatulence were collected.
Results: 5 of the 6 patients had a reduction in pain scale from baseline using a Likert Pain Scale of 0-10. Mean pain score 6.6 at baseline and 3.7 at Day 14, a decrease of 33.4%. 1 male patient had a worse pain score Day 14 (5) than Baseline (1). 5 responders reported a reduction of abdominal pain after a bowel movement on Day 7 and 14. There were no changes in Bristol Stool Scale report and there were no changes in the number of bowel movements per week in any patient. All patients reported complaints of bloating, distension and flatulence at study entry. These remained the most prominent symptom on Days 7 and 14 and were unchanged through the study. All patients reported a stable quality of life on a scale of 0-10 in the range of 6-8. All 3 menstruating women were followed for 24 weeks on this regimen reported no dysmenorrhea or worsening of IBS symptoms during their menses.
Discussion: This proof-of-concept study suggest that phytocannabinoids may reduce IBS symptomatology, especially in the reduction of abdominal pain. No adverse reactions were reported. Especially provocative is the absence of menstrual cramping in young women maintained on CBD/CBG orally for 24 weeks.
Figure: Stool Reporting Instrument
Likert Abdominal Pain Score
Responding Patient 0 7 14
1 7 6 6 2 10 5 3 4 3 5 0 5 10 6 6 6 3 2 2
Mean 6.6 3.7 % Reduction 33.43%
Disclosures:
Larry Good indicated no relevant financial relationships.
James Baumgartner indicated no relevant financial relationships.
Larry Good, MD, FACG1, James Baumgartner, PhD2. P1939 - Proof of Concept Open Label Trial of CBD/CBG Oral Tincture in the Management of Symptoms in Adult Patients with Irritable Bowel Syndrome, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.
