Treating Crohn’s Disease with Cannabis
Do you or a loved one suffer from the symptoms of inflammatory bowel disease (IBD) or Crohn’s disease? Or maybe you are curious to see what modern scientific research says about treating Crohn’s disease with cannabis. Read below to find out how medical marijuana can help with Crohn’s disease.
What are IBD and Crohn’s Disease?
Inflammatory bowel disease is a common condition that affects about 600,000 Americans each year. The most common types of IBD are Crohn’s disease and ulcerative colitis. Typical symptoms associated with IBD are abdominal cramps, bloody diarrhea, fever, and weight loss. Sometimes these conditions also lead to too few red blood cells, which is known as anemia.
Crohn’s disease is thought to be due to genetics, immune system problems, and environmental factors. People who suffer from this condition typically have to deal with the symptoms for their whole life, as there is no known cure. However, with treatment options, some can successfully manage the condition such that it remains in remission for extended periods of time. Others will struggle with success from typical treatment options, and therefore will go through their whole lives being in great pain.
The exact cause of Crohn’s disease remains unknown, which is what makes it so difficult to treat. The immune system typically creates a protein called tumor necrosis factor (TNF), which helps fight off infections. For patients with Crohn’s disease, the immune system mistakes healthy bacteria as something harmful, which causes an excess of TNF to be created. The excess amounts of TNF cause inflammation and swelling throughout the abdominal region.
Can Cannabis Treat Crohn’s Disease?
It is well known that cannabis has anti-inflammatory properties, but does cannabis actually help with treating Crohn’s disease? As you could guess, this topic still remains controversial, as many doctors would never recommend cannabis as a treatment option for any condition due to its negative stigma in society. However, there has been significant research that does suggest that cannabis can help manage Crohn’s disease effectively.
In 2003, a review stated that cannabinoids had potential therapeutic applications for many gastrointestinal conditions, including gastric ulcers, irritable bowel syndrome, Crohn’s disease, secretory diarrhea, paralytic ileus, and gastroesophageal reflux disease. (Ref. 1) While the study seems promising, most of the clinical studies that it references are for using THC as an antiemetic, which helps with nausea and vomiting.
It is well known that cannabis has anti-inflammatory properties. Not surprisingly, research has found that cannabinoids curb excessive inflammation and could be a good treatment option for inflammatory bowel diseases. (Refs. 2-3)
A Netherlands study in 2005 got survey results from 12 patients who would rate various symptoms on a 0-10 scale on and off of cannabis. The symptoms under study included appetite, pain, nausea, vomiting, fatigue, activity, and depression. After collecting the data and performing a statistical analysis, the study found that all of these symptoms were significantly reduced with cannabis. (Ref. 4) Furthermore, flare up frequency and severity was significantly decreased.
Cannabis can significantly reduce many of the symptoms associated with Crohn’s disease and inflammatory bowel disease.
The Netherlands study also found that when cannabis was used, the amount of conventional immunosuppressive medications needed also decreased. Mesalamine is a common anti-inflammatory medication which has side effects that include rashes, itching, and photosensitivity.
Steroids are also used, which often causes anxiety, depression, irritability, nausea, vomiting, and abdominal pain. While this study also seems promising, more studies should be performed that properly use placebo-controlled trials.
While the CB1 receptors are predominantly contained within the brain, they are also scattered throughout the whole body, including in the intestinal regions. A study found that CB1 deficient mice had more intestinal inflammation when they were given a chemical that induced inflammation. (Ref. 5) In other words, the study found that CB1 receptors counteract proinflammatory responses. Other cannabinoids have been found to have therapeutic effects in rodent models of IBD. (Ref. 6)
Many medical patients are weary of CB1 activation through THC, as it has psychoactive properties. However, CBD is non-psychoactive, which makes it a great candidate for purely medicinal purposes. A review found that CB2 receptors help regulate abnormal motility, modulate intestinal inflammation, and limits sensitivity and pain. (Ref. 7) Another study points out that CBD may interact in beneficial ways outside the CB2 receptor as well. (Ref. 8)
The ultimate test of cannabis-based medicine for treatment of Crohn’s disease must involve studies in humans, not just rats. In 2011, an observational study was performed with 30 patients with Crohn’s disease. (Ref. 9) 21 of the 30 patients significantly improved after treatment with cannabis.
The study found that the need for other medication decreased and the number of surgeries needed after cannabis treatment also decreased. Another study points out that treating Crohn’s disease with cannabis leads to a higher risk of surgery, which implies that more clinical trials should be performed. (Ref. 10)
Finally, a placebo-controlled study was performed to see if cannabis can induce remission in patients with Crohn’s disease. (Refs. 11-12) Overall, 5 out of 11 subjects in the cannabis group had a complete remission, compared to 1 out of 10 in the placebo group.
Medical marijuana also can cause a complete remission of Crohn’s disease.
Also, a Crohn’s Disease Activity Index was measured in the study. 10 out of 11 of the cannabis group had a significant decrease in this index, compared to 4 out of 10 in the placebo group. Furthermore, no significant side effects were noted for the cannabis users.
Another placebo-controlled study found that cannabis has significant benefits in patients with Crohn’s disease. (Ref. 13) Another study found that cannabis is effective for improving the quality of life, disease activity, and weight gain for IBD patients. (Ref. 14)
A survey of 292 patients found that many people suffering from IBD use marijuana and find it helpful for symptom control. (Ref. 15) While doctors rarely suggest cannabis-based medicine, patients are aware of their benefits.
Continuing on the trend of finding non-psychotropic cannabinoids, a study found that CBG could also be a good alternative for patients with inflammatory bowel disease. (Ref. 16) Natural cannabis does have some CBG, but only trace amounts. THC and CBD are the two most prominent cannabinoids in the naturally grown plant.
Conclusions
As many studies have found, cannabis is quite useful for helping with the symptoms of Crohn’s disease and other inflammatory bowel diseases. Furthermore, there have been many surveys that have stated that cannabis has helped with complete remission of outbreaks. Since traditional treatment options are not always effective, cannabis-based medicine may be a great option for patients who have struggled with the drugs that are typically prescribed by doctors.
At WoahStork, we believe that it is important for medical marijuana patients to properly understand what cannabis can and cannot do for them. While cannabis is a federally regulated Schedule 1 drug with “no medical value”, many studies support the effectiveness of cannabis treatment for a wide variety of medical ailments.
Check out our other articles that review the scientific literature on many other diseases, such as ADD/ADHD, Alzheimer’s, arthritis, cancer, and epilepsy.
References
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(2) G. Kunos and P. Pacher, Cannabinoids cool the intestine, Nat Med. 2004 Jul; 10(7): 678–679.
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(4) J. Hergenrather, Cananbis Alleviates Symptoms of Crohn’s Disease, O’Shaughnessy’s, Autumn 2005.
(5) F. Massa, et al., The endogenous cannabinoid system protects against colonic inflammation, J Clin Invest. 2004 Apr 15; 113(8): 1202–1209.
(6) M. Alhouayek and G. Muccioli, The endocannabinoid system in inflammatory bowel diseases: from pathophysiology to therapeutic opportunity, Volume 18, Issue 10, Oct 2012, 615–625.
(7) K. Wright, M. Duncan, and K. Sharkey, Cannabinoid CB2 receptors in the gastrointestinal tract: a regulatory system in states of inflammation, British Journal of Pharmacology, Volume 153, Issue 2, Jan 2008, 263–270.
(8) G. Esposito, et al., Cannabidiol in Inflammatory Bowel Diseases: A Brief Overview, Phytotherapy Research, Volume 27, Issue 5, May 2013, 633–636.
(9) T. Naftali, et al., Treatment of Crohn’s Disease with Cannabis: An Observational Study, IMAJ 2011: 13: August: 455-458.
(10) M. Storr, et al., Cannabis Use Provides Symptom Relief in Patients with Inflammatory Bowel Disease but Is Associated with Worse Disease Prognosis in Patients with Crohn’s Disease, Inflammatory Bowel Diseases, March 2014, Volume 20, Issue 3, 472–480.
(11) T. Naftali, et al., Cannabis Induces a Clinical Response in Patients With Crohn’s Disease: A Prospective Placebo-Controlled Study, Clinical Gastroenterology and Hepatology, Volume 11, Issue 10, Oct 2013, 1276–1280.
(12) T. Naftali, R. Mechulam, and F. Konikoff, Cannabis for Inflammatory Bowel Disease, Digestive Diseases, Vol. 32, No. 4, Jun 2014.
(13) R. Schicho and M. Storr, Cannabis Finds Its Way into Treatment of Crohn’s Disease, Pharmacology 2014;93:1-3.
(14) A. Lahat, A. Lang, and S. Ben-Horin, Impact of Cannabis Treatment on the Quality of Life, Weight and Clinical Disease Activity in Inflammatory Bowel Disease Patients: A Pilot Prospective Study, Digestion 2012;85:1–8.
(15) J. Allegretti, Marijuana Use Patterns Among Patients with Inflammatory Bowel Disease, Inflamm Bowel Dis. 2013 Dec; 19(13): 2809–2814.
(16) F. Borrrelli, et al., Beneficial effect of the non-psychotropic plant cannabinoid cannabigerol on experimental inflammatory bowel disease, Biochemical Pharmacology, Volume 85, Issue 9, 1 May 2013, Pages 1306–1316.
