Can Cannabis Treat Inflammatory Bowel Disease (IBD)?

cannabis for IBD

Evidence is mounting that marijuana may prove vital to ease the suffering of 1.6 million Americans with inflammatory bowel diseases.

Cannabis has already proven effective at reducing symptom severity for a bunch of different digestive issues. The central question about cannabis for inflammatory bowel diseases (IBD) is whether it’s only effective to treat symptoms of IBD, or whether it’s affecting the gut to also reduce inflammation.

An August 2018 study on mice with IBD seems to provide the strongest evidence yet that cannabis does actually reduce gut inflammation rather than just masking the symptoms.

What Is Inflammatory Bowel Disease (IBD)?

IBD includes ulcerative colitis and Crohn’s disease, which are intestinal conditions interfering with digestion, causing abdominal pain, diarrhea, and other symptoms.

IBD is an autoimmune disease, meaning the body is mistaking healthy gut tissue and vital beneficial gut bacteria as invaders, sending out white blood cells called neutrophils to attack them.

The diseases are often chronic and can worsen in flares that last days or weeks before receding.

According to the August 2018 study in the Journal of Clinical Investigation, activating the natural cannabinoid receptors in the interior cells of the intestine blocks the entrance of white blood cells into the inside of the intestine, reducing the severity of the attack on healthy germs and tissue.

The endocannabinoid system is composed of a series of nerve receptors and cannabis-like chemicals that fit into them like keys in locks. These interactions between the cannabinoids the body produces naturally and their receptors govern all sorts of physiological functions, from mood, to sleep, to appetite, to perception, to digestion.

Only recently have researchers discovered that the gut is filled with cannabinoid receptors. In the August study, scientists showed that mice who lacked these receptors or didn’t produce enough natural endocannabinoids were likely to develop ulcerative colitis and Crohn’s. The cannabinoids in marijuana work by hijacking the endocannabinoid system and fitting into the cannabinoid receptors in place of the body’s natural cannabinoids.

CB1 receptors are found all throughout the Large and Small Intestine.
Image from DiPatrizio (2016)

Beth McCormick of the University of Massachusetts, a lead researcher on the subject, told Popular Science that her team had no intention of researching marijuana or even the endocannabinoid system. But the endocannabinoid system revealed itself as one of the causes of IBD.

“They weren’t looking to explain cannabis’s mechanism of action, they just found it,” McCormick said. “‘Sometimes, as they say in the field, the blind squirrel finds the nut.’”

What Do We Know About Cannabis for IBD?

Controlled trials of marijuana and its components are in their infancy because obtaining and using the drug — even in clinical settings — is still illegal federally. But small observational studies show promising results when cannabis is prescribed to patients with IBD.

The doctors at the Canadian Society of Intestinal Research figure cannabis can open new avenues of relief for their patients. On their 2018 position statement on cannabis, they cited a paper from a 2014 Israeli study:

“ They found that 70% of the patients experienced a decrease in Crohn’s disease symptom severity when using cannabis, and that many were able to reduce or eliminate the medications that they were using. For example, before using cannabis, each individual took some sort of prescription medication to treat their disease. When using cannabis, nine individuals were able to cease all prescription medication use. They also reported a drop in daily bowel movements from eight to five per person, as well as a slight decrease in the number of surgeries required.”

Another small study shows that IBD patients who were not marijuana users were given 50 grams to smoke as needed over the course of three months. The study included only 13 patients, but achieved dramatic results. All reported dramatically improved wellbeing and a big reduction in abdominal pain.

More objectively, the subjects gained an average of 9.5 pounds (in this case, a health improvement) over the course of the study, and reduced their number of bowel movements by a third.

Are Clinical Trials to Test Cannabis for IBD?

Still, even proponents of cannabis for IBD call for more research.

“We still don’t know quite how it works,” states the Society position paper. “It might be limited only to pain relief and increased appetite, but it might also help by reducing inflammation. We need more research on the topic before we can know for sure how cannabis affects IBD.”

Luckily, medical institutions are responding to the call. According to the U.S. government’s clearinghouse for clinical trials, medical centers from Minnesota to Canada to the Netherlands are testing cannabis and its various derivatives for effectiveness against IBD and their less severe cousin, irritable bowel syndrome.

Mount Sinai Hospital in Toronto is setting up a clinical trial to study the effect of the cannabis based pharmaceutical Nabilone (Marinol / Dronabinol) for IBD pain, while the University of Illinois at Chicago has a trial planned for cannabidiol (CBD, one of the main cannabinoids in marijuana) as an adjunct therapy for Crohn’s.

As of October, 2018, neither of these studies was yet recruiting patients, according to ClinicalTrials.gov.

Another study in the Netherlands is testing CBD chewing gum for IBD relief, but participants can enter that study by invitation only.

Additional Cannabis For IBD Refernces:

Cannabis For IBD: ClinicalTrials.gov

https://clinicaltrials.gov/ct2/results?cond=IBD&term=cannabis&cntry=&state=&city=&dist=

About Nicco Reggente, PhD 116 Articles
Nicco is the co-founder and CEO of WoahStork and Strain Genie-- two companies dedicated to bringing to life his passion of bringing personalized medicine to the cannabis industry. Nicco received his PhD from UCLA in cognitive neuroscience with a focus on machine learning applied to neuroimaging datasets. He previously received two B.As from NYU in Psychology and Philosophy.

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