Digestive health through nervous system regulation
The vagus nerve plays a crucial role in the connection between the brain and the digestive system influencing gut motility, inflammation and overall gastrointestinal (GI) function. Emerging research suggests CBD (cannabidiol) positively impacts vagal tone and, in turn, improves gut health.1 For DCs seeking natural approaches to enhancing nervous system regulation and digestive wellness, understanding the role of the vagus nerve and its interaction with cannabinoids is essential.
The vagus nerve and digestive health
The longest cranial nerve in the body, the vagus nerve is a key component of the autonomic nervous system (ANS). It regulates parasympathetic (rest-and-digest) functions, which include:
- Stimulating digestive enzyme secretion
- Modulating gut motility and peristalsis
- Reducing inflammation in the gut
- Communicating with gut microbiota via the gut-brain axis
- A well-functioning vagus nerve is essential for maintaining a balanced autonomic nervous system. When vagal tone is low, it can contribute to conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), gastroparesis and chronic constipation.2
Many DCs are aware of how nervous system dysregulation can contribute to systemic dysfunction, including gut-related disorders. Spinal adjustments and vagus nerve stimulation techniques are commonly used to improve vagal function, and cannabinoids like CBD may offer an additional tool to support vagus nerve activation.
How CBD interacts with the vagus nerve
CBD primarily interacts with the endocannabinoid system (ECS), a complex cell-signaling system that plays a key role in regulating homeostasis, including nervous system function. The ECS consists of cannabinoid receptors CB1 and CB2, endogenous cannabinoids and metabolic enzymes. The gastrointestinal tract has a high density of both CB1 and CB2 receptors, particularly in the lining of the stomach and intestines.3
Modulating inflammation through the vagus nerve
CBD has been shown to influence the vagus nerve’s anti-inflammatory effects, particularly through the cholinergic anti-inflammatory pathway (CAIP). The CAIP is a mechanism by which the vagus nerve signals to immune cells to reduce excessive inflammation in the gut and other organs.
A 2018 study published in Frontiers in Neurology found vagus nerve stimulation can significantly reduce inflammation, which is a key factor in digestive disorders like Crohn’s disease and ulcerative colitis.4
Additional research that appeared in the International Journal of Molecular Sciences suggests CBD enhances vagal tone, indirectly supporting the CAIP and helping to regulate excessive gut inflammation.5
By improving vagus nerve function and reducing gut inflammation, CBD may help manage symptoms of inflammatory bowel conditions and other gut-related issues.
Reduce gut-related stress and anxiety
The gut-brain axis is a bidirectional communication network linking the enteric nervous system (ENS) and the central nervous system (CNS). Stress and anxiety often manifest as gut symptoms, including bloating, nausea and IBS.
A 2020 review in Neurotherapeutics highlighted how CBD has anxiolytic (anti-anxiety) effects due to its interaction with serotonin receptors (5-HT1A) and modulation of vagus nerve activity.6
Since the vagus nerve plays a crucial role in regulating the parasympathetic nervous system, enhancing vagal tone through CBD may help relieve stress-induced digestive issues.
For patients experiencing functional gut disorders triggered by stress, CBD may offer a natural way to support nervous system balance and gut function.
Support digestive motility and peristalsis
The vagus nerve is responsible for regulating peristalsis, the wave-like contractions of the digestive tract that move food through the intestines. Low vagal tone has been linked to sluggish digestion, constipation and gastroparesis.
A 2018 study found vagus nerve stimulation improves gastric motility, which can help conditions, such as delayed gastric emptying.7
While research on CBD’s direct effects on peristalsis is still developing, its ability to enhance vagal tone suggests it may aid in improving gut motility.
For DCs working with patients experiencing slow digestion or functional GI disorders, combining chiropractic adjustments with CBD supplementation could support optimal gut motility.
How you can integrate CBD for vagal and gut health
Given the growing body of evidence supporting the role of CBD in vagus nerve regulation and gut health, you can consider several approaches to incorporating it into patient care:
Educate patients on the gut-brain-vagus-CBD connection
DCs already emphasize nervous system health—integrating knowledge about the vagus nerve, gut function and cannabinoids can enhance patient education. Explaining how stress, inflammation and nervous system dysfunction impact digestion can help patients make informed wellness choices.
Combine chiropractic adjustments with CBD
Spinal adjustments, especially to the upper cervical spine, may help stimulate vagus nerve function. DCs can suggest patients complement adjustments with high-quality, third-party-tested CBD products to further support nervous system regulation.
Recommend CBD for stress-related digestive issues
For patients experiencing IBS, functional gut disorders or stress-related digestive issues, CBD may help regulate the nervous system’s response to stress and improve gut function. You can recommend full-spectrum or broad-spectrum CBD oils that contain additional cannabinoids and terpenes for enhanced therapeutic effects.
Support vagus nerve activation through lifestyle changes
Encourage patients to combine CBD with vagus nerve-stimulating activities, such as deep breathing, meditation, cold exposure and gut-friendly nutrition, to maximize benefits. A holistic approach that includes CBD, chiropractic care and lifestyle modifications may yield the best outcomes for digestive wellness.
Final thoughts
The vagus nerve is a key player in digestive health, and its regulation is essential for maintaining gut function and reducing inflammation. Emerging research suggests CBD may enhance vagus nerve function, contributing to better gut motility, reduced stress and improved inflammation control.
For DCs looking to provide a comprehensive, holistic approach to gut health, integrating CBD into patient care on the gut-brain axis provides an opportunity to stay at the forefront of natural healthcare solutions.
Joe Kryszak, MBA, is president of Stirling Professional CBD. Stirling is committed to helping DCs help their patients. Since 2014, Stirling has grown, extracted and produced the purest CBD available. Stirling Professional brings amazing, affordable CBD+ products to patients, with an industry-leading lineup of 2,500-mg CBD lotions, THC and THC-free capsules and gels and four great solutions for better sleep. For more information, visit stirlingprofessional.com.
References
1. Kowalski CW, et al. Cannabidiol activation of vagal afferent neurons requires TRPA1. J Neurophysiol. 2020;124(5):1388-1398. PubMed. https://pubmed.ncbi.nlm.nih.gov/32965166/.
Accessed March 18, 2025.
2. Veldman F, et al. Efficacy of vagus nerve stimulation in gastrointestinal disorders: A systematic review. Gastroenterology Report. 2025;13. https://academic.oup.com/gastro/article/
doi/10.1093/gastro/goaf009/7979382. Accessed March 18, 2025.
3. Sharkey KA, Wiley JW. The role of the endocannabinoid system in the brain-gut axis. Gastroenterology. 2016;151(2):252-266. PubMed. https://pubmed.ncbi.nlm.nih.gov/27133395/.
Accessed March 18, 2025.
4. Bonaz B, et al. The vagus nerve at the interface of the microbiota-gut-brain axis. Front Neurosci. 2018;12:49. PubMed. https://pubmed.ncbi.nlm.nih.gov/29467611/. Accessed March
18, 2025.
5. Zou S, Kumar U. Cannabinoid receptors and the endocannabinoid system: Signaling and function in the central nervous system. Int J Mol Sci. 2018;19(3):833. PubMed. https://pubmed.ncbi.nlm.nih.gov/29533978/. Accessed March 18, 2025.
6. Blessing EM, et al. Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics. 2015;12(4):825-836. PubMed. https://pubmed.ncbi.nlm.nih.gov/26341731/. Accessed March 18, 2025.
7. Lu KH, et al. Vagus nerve stimulation promotes gastric emptying by increasing pyloric opening measured with magnetic resonance imaging. Neurogastroenterol Motil. 2018;30(10):e13380. Wiley. https://onlinelibrary.wiley.com/doi/10.1111/nmo.13380. Accessed March 25, 2025.
