There has been talk recently in some circles about the potential usefulness of rectal cannabis. Many people who tried everything for their hemorrhoids, but to no avail, claiming that CBD was the miracle they needed. Does CBD oil help with hemorrhoids? If yes, how do you take it to draw the most out of its health benefits?
RECTAL ABSORPTION OF CANNABINOIDS
**UPDATED INFORMATION AND MULTIPLE BLOGS I HAVE SINCE WRITTEN SHOW THAT WHOLE PLANT CANNABIS IS NOT RECTALLY ABSORBED. THC CAN BE RECTALLY ABSORBED BUT ONLY IF BONDED TO A SEPARATE MOLECULE, SUCH AS HEMI-SUCCINATE.
MANY PATIENTS USE HIGH DOSES OF THC BY THE RECTAL ROUTE TO AVOID PSYCHOACTIVITY. THE REASON THERE IS NO PSYCHOACTIVITY IS BECAUSE IT IS NOT ABSORBED.
There has been talk recently in some circles about the potential usefulness of rectal cannabis. For the first portion of this blog, I will deal with the substantial anecdotal information I am aware of and I will include a reference that truly settles the issue. In my experience with patients, there are a number of patients that use hash rectally. They clearly get VERY stoned, so it is being absorbed. I have many patients with Inflammatory Bowel Disease. If the disease is in the lower bowel, rectal administration often works better than oral absorption. There are a number of reasons why this might be the case for many patients as the cannabinoids are absorbed from two areas of the rectum.
It makes no sense at all to me that the overall cannabinoid effect is less than sublingual when placed in ANY area of the rectum. However, if portal circulation is what is desired, a soft tip syringe placed in 1.5 inches will be drained by the Superior Rectal Vein and mostly go through the liver.
The potential REASONS for using rectal absorption means are:
1. No other method practical.
2. The physician wants to help the cannabinoid medicine travel through the local rectal and pelvic veins and lymphatics. When a patient has a rectal or pelvic disease, it makes sense that this might be more effective….i.e. follow the Cancer. We have NO proof of this, but we are often making decisions with less than adequate information…..and not just in the field of Cannabis Medicine
3. Inflammatory Bowel Disease when oral is not working well
4. Some seizure kids during emergency rectal CBD administration. BTW, this seems to work clinically.
The rectum has two venous drainage sources. As you can see in the above diagram of the rectum, there are three veins that drain the rectum. They are the Inferior Rectal Vein, The Middle Rectal Vein and the Superior Rectal vein.
The inferior and middle rectal veins drain primarily into the Inferior Vena Cava and are absorbed into the blood stream avoiding the first pass effect through the liver.
The Superior Rectal Vein drains into the Portal system, goes through the liver and is first pass metabolized.
So, it depends WHERE in the rectum the suppository or “syringe” is placed. The “suppository” image represents the 3 cm of the Rectum. So, if a typical suppository is inserted fully, it will be absorbed by all the veins and there will always be a portion, probably significant, that goes through the Portal Vein System into the liver.
Oral absorption is a bit more erratic in large part due to stomach acid interfering with absorption, but still very effective especially if delivered with fat and little other food. In my experience with oral CBD capsules, it is extremely important to take it on an empty stomach.
I find that many patients with bowel disease do just fine with oral absorption, but it is not surprising that some with large bowel and or rectal/sigmoid disease, that regional absorption with regional venous and lymphatic drainage is very helpful.
So, now for the data. There are a number of studies showing both oral and rectal absorption of similar doses of cannabinoids. It seems pretty clear that the bioavailability through rectal absorption is about twice that of oral absorption. There are many variables and we have much to learn, but rectal delivery of cannabis is not new and it will become more common as better and more reliable preparations are made available.
Allan Frankel, MD Dr Allan Frankel is one of the few physicians in the US who truly understands Cannabis as a medicine. All treatments suggested have been well studied. Every patient seen by Dr Frankel is given a personally created Treatment Plan created with the patient’s specific issues defined. Plant medicine requires “tuning” of the dosing. Dr Frankel works with his patients thru a messaging portal. The use of this portal, allows quick and simple follow up contact with Dr Frankel. Patients are not charged for these messages, as this is how Dr Frankel has learned what he has learned. Follow up appointments in person or by phone/video are also available when needed
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CBD for Hemorrhoids: Can Cannabis Oil Help?
According to a recent survey, 41% of respondents use CBD to alleviate the symptoms of a wide range of illnesses and ailments (1). These conditions include everything from anxiety and minor aches to chronic pain, neurological disorders, and diseases that stem from inflammation. The last group contains one illness that is particularly difficult for people who have it — we’re talking about hemorrhoids.
The condition is caused by inflamed blood vessels in the lower rectum and anus, which may cause pain, itching, bleeding, and swelling. The pesky symptoms are also burdened with social stigma, as people with hemorrhoids often find it embarrassing to admit they struggle with this problem.
Numerous studies have mentioned CBD as a potent anti-inflammatory and analgesic (painkiller), but what is the current state of research when it comes to taking CBD specifically for hemorrhoid relief?
In this article, we’ll explain everything you need to know about hemorrhoids; from what they are to how CBD can help and what type of products are recommended to maximize the efficacy of one’s treatment.
What You Need to Know About Hemorrhoids
Hemorrhoids, also known as piles, are swollen veins in the lower region of the anal tract in the rectum area. When the walls of these vessels stretch excessively, they become irritated and inflamed, causing the aforementioned pain and itching. Despite being an unpleasant and painful condition, hemorrhoids are generally easy to treat and prevent.
Causes of Hemorrhoids
The underlying cause of hemorrhoids is increased pressure in the lower rectum. This can result from straining during bowel movements, a sitting lifestyle, chronic diarrhea, viral constipation, or poor diet. Other risk factors include obesity, anal intercourse, and bad hygiene (2).
People who eat processed food instead of the one that provides dense nutritional content find themselves constipated on a regular basis, which can speed up the development of hemorrhoids.
Clean eating habits, an active lifestyle, and supplementation with CBD go hand-in-hand for successful prevention and treatment of this ailment.
Interestingly, one of the most common causes of hemorrhoids is that people just push too hard during the heavier duty on the toilet. Sometimes it’s not their fault, as the said constipation may force them to do so in order to push the stool out.
What Are the Symptoms of Hemorrhoids?
Symptoms of hemorrhoids may vary depending on their type. If you suffer from external hemorrhoids, you may experience itching in the anus and notice a hard little tender lump near its area.
You may also experience anal pain, especially when sitting for too long. Although you might be tempted to strain, rub, or clean the area around these lumps, this can make the symptom worse. Fortunately, the majority of external hemorrhoid cases typically go away in up to 5 days.
If you have internal hemorrhoids, it may lead to bleeding from your rectum. It may manifest as bright red blood on the stool, on the toilet paper, or inside the toilet. Hemorrhoids that fall through the anal opening are known as prolapse and may require medical attention.
Can CBD Oil Help with Hemorrhoids?
Common hemorrhoid treatments include non-steroidal anti-inflammatory drugs (NSAIDs) and painkillers such as acetaminophen. However, some individuals have adverse reactions to these compounds; others are afraid of the dangerous side effects, hence the recent interest in natural remedies, such as CBD oil.
Here’s how CBD may help with hemorrhoids.
Several studies mention how CBD might reduce inflammation and pain, which are the telltale signs of hemorrhoids.
CBD Oil for Inflammation and Pain
Several studies mention how CBD might reduce inflammation and pain, the two signs of hemorrhoids.
According to a study published in Therapeutics and Clinical Risk Management, CBD produces beneficial effects for the human body through its analgesic, antioxidant, and anti-inflammatory activities (3).
Another review supporting CBD’s anti-inflammatory properties has examined the efficacy of the cannabinoid on different conditions, including irritable bowel syndrome (IBS) (4).
IBS triggers inflammation in the lining of the colon, causing severe pain and discomfort. It can also cause hemorrhoids as a result of repeated bowel movements and straining. Treating IBS can translate into successful hemorrhoids prevention.
On top of that, CBD has been highlighted as a potential solution for pain that is difficult to treat. Researchers have been touting CBD for its ability to mitigate pain signals and modulate inflammatory responses in the body.
CBD Oil for Healthy Bowel Movement
Regular, healthy bowel movements are ensured by proper gastrointestinal motility. Dysfunctional motility can trigger constipation and diarrhea.
In a study published in the Frontiers in Neuroscience, the authors mention how CBD is able to modulate gastrointestinal motility in rodent models (6). Another study from the Gastrointestinal Motility Society showed that cannabinoids such as CBD play an important role in relieving certain forms of constipation and controlling intestinal secretion (7).
CBD Oil for Anxiety
A review conducted by Elsevier demonstrated that people with pain conditions might also suffer from anxiety. The authors of the review associated conditions like arthritis, stomach problems, migraine, and hemorrhoids with elevated anxiety levels (8).
CBD has been recently shown by a clinical study to exert anxiolytic (anti-anxiety) actions on the brain. The study examined patients who took CBD for anxiety. The authors concluded that 79.2% of patients noted improvements in their anxiety scores after CBD treatment (9).
The study also stressed the importance of conducting more clinical trials to verify CBD’s efficacy in anxiety-related disorders, although the research team acknowledged that CBD holds therapeutic potential in treating the condition.
How to Use CBD for Hemorrhoids
Taking CBD for hemorrhoids is straightforward; what makes people confused is the abundance of different formats available on the market. These products use different routes of administration, each providing different potency, bioavailability, onset of effects, and duration.
In the next section, we’ll cover the most common CBD options for hemorrhoids.
The Oral Way
We’ve decided to use the “oral” term here because all product types we mention below are meant for dealing with symptoms deriving from deficiencies in the endocannabinoid system. However, the section covers both sublingual, oral, and inhaled forms of CBD.
- CBD oil – also known as CBD drops, the oil comes in dark glass bottles with a dropper for precise dosing. The user needs to pull the desired amount of CBD using the dropper, transfer it under the tongue, and wait for up to one minute until the CBD absorbs through the tiny blood vessels located in the mouth. This route of administration ensures relatively fast effects — within 15–30 minutes after consumption — and a duration time of up to 6 hours. The bioavailability of CBD oil (the amount of CBD that makes it to the bloodstream) has been measured at around 35%.
- CBD capsules — every health supplement out there has a capsule form, and so does CBD. Capsules are more convenient than oil because they carry a predetermined amount of CBD per serving and are super easy to take — you just take as many capsules as you need and swallow them down with water. Since CBD capsules need to be digested in the gut before reaching the bloodstream, they lose some of their potency and the effects take hold with a little delay — up to 2 hours from ingestion — but ensure a longer duration, up to 10 hours. The bioavailability of CBD capsules has been measured at 20%.
- CBD edibles – this category covers food infused with CBD, including gummies, honey sticks, protein bars, lollipops, and more. Similar to capsules, edibles contain a fixed dosage per serving, so there’s no guesswork involved when it comes to dosing. They’re also the most enjoyable form of CBD out there, as you can choose from many different shapes, sizes, and flavors to suit your preferences. Alas, they share one downside with capsules, which is the delayed onset of effects.
- CBD vape oil — CBD vapes are consumed through inhalation. The CBD oil is mixed with thinners like vegetable glycerin or propylene glycol to make the extract compatible with vape pens (the devices you use to consume CBD vape oil). CBD vapes have a major advantage over other consumption methods. Namely, their bioavailability reaches 56% and the effects are noticeable within 5 minutes after inhalation since CBD absorbs into your system through the lung tissue, avoiding the liver and the first-pass metabolism. However, the effects of CBD vapes are short-lived, usually going away after 3 hours.
The Rectal Way
Another way you may target inflammation and pain caused by hemorrhoids is to use a CBD topical such as CBD cream or suppositories.
- CBD cream – topical CBD products are good for treating hemorrhoids because none of the applied CBD has to go through the gastrointestinal system. Instead, the cannabinoid interacts with the CB2 receptors in the skin’s endocannabinoid system, producing its anti-inflammatory and analgesic effects. Individuals seeking relief from hemorrhoids may apply CBD topicals to the affected area in order to target localized inflammation.
- CBD suppositories – this fairly new invention is one of the best ways to apply CBD for hemorrhoids. The rectal walls are chock-full of the blood vessels that absorb and carry CBD to your endocannabinoid system, ensuring remarkably fast absorption and high bioavailability. You may use CBD suppositories for fast relief from inflammation and pain.
CBD Dosage for Hemorrhoids
There are no dosage standards established for CBD products. Those taking CBD for hemorrhoids for the first time are advised to start with a low dose and gradually increase it until you achieve a satisfying level of relief from your symptoms. A study analyzing different dosages recommended starting with 1–50 milligrams a day.
However, studies have yet to determine the right topical CBD dosing for pain relief in affected areas.
Is CBD Safe for Hemorrhoids?
CBD is generally considered a safe substance, with doses of 1,500 mg daily reported as well-tolerated by humans. The biggest advantage of CBD over conventional treatment is the lack of dangerous side effects, such as addiction, tolerance buildup, and lethal overdose.
That being said, CBD has a few mild side effects when taken at high doses:
- Dry mouth
- Changes in appetite
There’s also a risk of CBD-drug interactions, as CBD is known to inhibit the system of enzymes that metabolizes active ingredients in medications. For this reason, you should consult a doctor before incorporating CBD oil into your supplementation plan.
What People Are Saying About Using CBD Oil for Hemorrhoids
Although studies on the use of CBD for hemorrhoids are in their infancy, people are using cannabis-derived products to relieve a wide range of ailments — something they couldn’t achieve using conventional measures.
For example, one mum shared on Reddit that CBD had ‘saved her butt’ after she gave birth and suffered from severe hemorrhoids. According to her comment, she suffered from plies following the birth of her baby until discovering CBD. She explains that CBD has helped her go to the bathroom without crying just within 2 days. While the mum admits she was in pain, it was nothing like the pain-coaster she had been on. The CBD absorbed and reached internal hemorrhoid, decreasing inflammation, and pain.
Another person from the same thread described their experience of using the oil for hemorrhoids, saying:
“It was absolutely incredible. I applied it, noticed the inflamed area hurt less within 10 minutes, then went to take a shower about 45 minutes later, and when I went to wash (ahem…) back there, all the swelling had gone and I was completely back to normal.”
Although researchers are still trying to understand the mechanism of action behind CBD’s health benefits for hemorrhoids, experts are saying it probably derives from the remarkable anti-inflammatory effects of CBD.
According to David Barcly, MD, “There have been reports of CBD being a very responsive anti-inflammatory. So one can understand why people would consider using it in this manner. It would be beneficial to have some official research into this.”
Other Remedies for Hemorrhoids
Wondering how you may complement your hemorrhoids treatment with other natural remedies? Here are some common solutions:
- Witch hazel – found in anti-itch wipes and soaps, this ingredient is a natural anti-inflammatory that can reduce both itching and pain. It can also be purchased on its own as a liquid and applied directly to the hemorrhoids.
- Aloe vera – this plant has been used historically to treat hemorrhoids and various skin conditions. It has strong anti-inflammatory properties, helping the user to reduce irritation. The gel can be bought in skincare stores; it is also found in other products, but you should only use pure Aloe vera gel on hemorrhoids. Although clinical studies haven’t yet investigated its efficacy, the National Center for Complementary and Integrated Health considers it very safe for topical use.
- Epsom salt – warm baths with Epsom salt can help ease the irritation from hemorrhoids. You can take a full-body bath in your tube, or use a sitz bath, which is a small plastic tube that you place over the seat of your toilet.
- Over-the-counter ointments –ointments and creams, such as Preparation h, can be found in every pharmacy and provide immediate relief. For some people, it can even reduce swelling and speed up the healing of hemorrhoids. However, it’s best to use these creams for up to one week if they contain hydrocortisone.
- Soothing wipes – regular toilet paper can further irritate existing hemorrhoids. Using a soothing wipe can help keep your rectal area clean without causing further irritation. Some wipes also come with anti-hemorrhoid ingredients, such as aloe vera or witch hazel. Make sure that the wipes you’re buying are free of alcohol, perfume, or other irritants, as they could deteriorate symptoms instead of providing relief.
- Cold compresses – Applying cold compresses or ice packs to the anus may help relieve swelling for 15 minutes at a time. This can be an effective treatment for large, painful hemorrhoids. However, keep in mind not to apply anything frozen directly to the skin, as it may provide opposite results.
- Stool softeners – As reported by the National Institute of Diabetes and Digestive and Kidney Diseases, stool softeners or supplements containing fiber, such as psyllium, can help reduce constipation, soften the stool, and make it easy to push it out without painful bowel movements. Many of these products come in the forms of capsules, liquids, and powders that you take orally once and three times a day.
- Loose, natural clothing – changing your tight clothes from synthetic material to ultra-breathable cotton or hemp can help keep the areas prone to hemorrhoids clean and dry. This can also reduce symptoms like redness and irritation. Make sure to steer clear of perfumed detergents or fabric softeners to lower the risk of irritation.
How to Prevent Hemorrhoids
Hemorrhoids can be easily prevented by undertaking certain lifestyle and dietary changes.
First, it’s important that you stay physically active and eat healthy to maintain regular bowel movements. If your diet includes high amounts of carbohydrates and food to which humans are rather adapted than physiologically predisposed, then adding high-fiber foods may come in handy.
Another important step for hemorrhoids prevention is to drink plenty of water. Doing so will help you keep the digestive process working correctly without constipation.
Regular exercise and avoiding long periods of sitting can also help prevent hemorrhoids. The most effective way to prevent constipation is to visit the bathroom when you first feel the urge for the heavy-duty. Delaying bowel movements allows the organ to reabsorb water from the stool, making it harder to excrete.
Final Verdict: Does CBD Help for Hemorrhoids Relief?
Although no study has yet investigated the efficacy of CBD specifically on hemorrhoids, research has acknowledged that CBD oil might help reduce symptoms of this ailment, such as pain and inflammation.
Through influencing the endocannabinoid system to modulate the motility of the gastrointestinal tract, CBD might help maintain healthy bowel movements and prevent hemorrhoids from occurring in the first place.
Maintaining a high-fiber diet that promotes regular bowel movement, as well as staying physically active, can also prevent the condition.
If hemorrhoids do occur, it’s best to consult a physician and discuss your treatment options, including taking CBD oil. A consultation with a qualified doctor will help you not only determine the right dosage for your case of hemorrhoids but also avoid potential interactions with other medications.
Have you used CBD for hemorrhoids? If so, did it help? Share your story in the comments below!
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Livvy is a registered nurse (RN) and board-certified nurse midwife (CNM) in the state of New Jersey. After giving birth to her newborn daughter, Livvy stepped down from her full-time position at the Children’s Hospital of New Jersey. This gave her the opportunity to spend more time writing articles on all topics related to pregnancy and prenatal care.