Pain, constant trips to the bathroom, and an inability to thoroughly enjoy food can make an irritable bowel disease almost unbearable. Many IBD patients find themselves in and out of hospitals with a bag full of new pharmaceuticals. Is there another option? If recent research means anything, it looks like there is an alternative. Here’s how cannabis can treat irritable bowel diseases.
What is inflammatory bowel disease?
In severe cases, inflammatory bowel disease (IBD) can be relentless.
For some unknown reason, renegade inflammation takes over all or some
part of the digestive tract. This causes a whole host of problems, many
of which send patients running to the bathroom multiple times a day.
The
most common forms of IBD affect the small intestine and the colon.
There are a few conditions that fit under the IBD umbrella. The two most
common are ulcerative colitis and Crohn’s disease. The severity of
these conditions ranges greatly from patient to patient.
According to the Mayo Clinic, some major symptoms of both include:
- Diarrhea
- Fever
- Fatigue
- Abdominal pain and cramping
- Blood in stool
- Reduced appetite
- Unintended weight loss
Two additional disorders categorized as inflammatory bowel
diseases are collagenous colitis and lymphocytic colitis. However, these
two disorders are often distinguished from the more common and classic
forms of IBD.
Cannabis and inflammatory bowel disease (IBD)
Over
the past decade, cannabis has shown therapeutic promise in a wide
variety of conditions. Some areas of research are more promising than
others.
Fortunately for those who have an IBD, cannabis medicines seem to be living up to expectations. But, how what gives the herb so much potential? How does it affect the digestive tract?
Both
cannabis and gastrointestinal medicine are hot topics in the science
world. The research on cannabis and gastrointestinal health is emerging,
but what has been discovered is fascinating and opens doors to new
treatment approaches for those with insufferable bowel diseases.
Cannabis in the gut
Some
may find this surprising, but the gut holds 80% of the human immune
cells. The gut is also connected directly to the brain through the vagal
nerve, an information highway that can tell you when you’re hungry,
inform you that you are sick, and even trigger the fight or flight
response.
So, where does cannabis fit in? Compounds in the herb
(cannabinoids) directly engage with regional immune cells and the vagal
nerve. Cannabis has immunomodulatory properties and also can impact
messages sent between the gut and the brain.
Cannabis has these
effects because cannabinoids tap into the endocannabinoid system (ECS)
throughout the gastrointestinal tract. The ECS is a large network of
signaling cell receptors that maintain optimum balance in the body. The
majority of
The majority of cannabinoid receptors
are located in the central nervous system. But, the gastrointestinal
tract and immune system contain cannabinoid receptors as well.
The ECS can get quite complicated.
How does cannabis help IBD?
Compounds
in cannabis cause biochemical changes in the gut. In the case of IBD,
these changes seem beneficial. If you are feeling nauseated, vaping a
little cannabis blocks messages from the gut that tell the brain that
you need to vomit.
This is one reason cannabis has such potent anti-nausea properties. Studies have shown that THC
binds to a specific cell receptor (the CB1 receptor) on the vagal
nerve, altering gut-brain communication. This is thought to reduce
nausea and vomiting, as well as cause changes in pain perception.
In terms of the immune system, cannabis compounds like CBD and THC engage immune cells.
Specifically, they have potent anti-inflammatory properties. They halt
pro-inflammatory proteins and encourage anti-inflammatory proteins.
But, there’s a lot more to it than that. Here are three ways cannabis may treat IBD:
1. An inflammation-fighting herb
One 2008 review articulates
that one type of cannabinoid receptor, the CB2 receptor, was not very
common in a healthy intestinal tract. However, when the intestines
became inflamed, more CB2 receptors popped up. The CB2 receptor is most
abundant on immune cells. These receptors were calling out for
endocannabinoids, the body’s natural THC.
The CB2 receptor is most
abundant on immune cells. These receptors were calling out for
endocannabinoids, the body’s natural THC.
In the case of IBD, the
potent inflammation-fighting compounds in cannabis can drastically
reduce symptoms caused by an excessive amount of intestinal
inflammation. Both CBD and THC engage cannabinoid receptors, albeit in
different ways.
In 2010, British researchers tested
both THC and CBD in rodent models of colitis. They found both compounds
not only reduced inflammation but they also “lowered the occurrence of
functional disturbances”. That’s a nice way of saying that cannabis
extracts reduced diarrhea.
The study also concluded that using both CBD and THC together could have additional benefits in the treatment of IBD.
2. Cannabis for abdominal pain
The endocannabinoid system also plays a role in pain sensation in the gut. In fact, activation of CB2 receptors blocks some pain perception and reduces hypersensitivity. One
One author suggests
that the exaggerated presence of CB2 receptors in an inflamed gut calms
down the nervous system. This disrupts signals from the gut to the
brain that would otherwise tell you that you are in pain.
In IBD,
pain can be severe. As mentioned above, compounds in cannabis activate
cannabinoid receptors. This disrupts pain signaling. Combined with the
herb’s potent anti-inflammatory properties, it seems like IBD patients
may experience less pain, improved bowel functioning, and less
excruciating and even life-threatening inflammation.
Clinical trials in humans are sorely needed, but the pre-clinical research is certainly promising.
3. Weight gain and health status
When
you can’t properly digest your food, you run the risk of developing
nutrient deficiencies and losing unnecessary weight. This is something
cannabis may be able to help. The herb has a reputation for inspiring
the munchies. Yet, with IBD, it may promote weight gain and improve
overall health status as well.
This is something cannabis may be
able to help. The herb has a reputation for inspiring the munchies. Yet,
with IBD, it may promote weight gain and improve overall health status
as well.
One 2012 study followed
13 IBD patients for three months of medical cannabis treatment. The
long-standing IBD patients began to gain weight and improved their BMIs.
The
patients also reported an improved quality of life, less disease
activity (flare-ups), less depression, less pain, and improved social
functioning and ability to work.
Not bad for a simple plant.
Conditions helped by medical cannabis
In
theory, there is quite a lot of pre-clinical evidence that cannabis can
drastically improve disease symptoms and improve quality of life in
those with IBD.
Unfortunately, the Schedule 1 status of cannabis
makes the herb difficult to research in humans. But, there are a handful
of small human studies worthy of mention.
Here is some recent research for the two most common irritable bowel diseases:
Crohn’s Disease
In 2013, researchers performed a small placebo-controlled study of 21 Crohn’s patients. None of the patients had responded well to conventional treatments.
The
participants were divided into two groups: a cannabis-receiving group
and a control group. The those receiving cannabis treatment were given
115mg of THC.
The THC was smoked twice daily. The control group
received cannabis with the THC extracted. The treatment lasted 8 weeks.
Follow up was after 2 weeks.
11 of the participants were given
cannabis. Of the 11, 5 achieved complete disease remission. 10 of the 11
showed a positive clinical response to the cannabis treatment.
Though
this is a small study, the results are quite impressive. Almost half of
the patients were able to achieve remission. Yet, the downfall of this
trial is the use of smoked cannabis.
Many Crohn’s patients with medical cannabis authorizations use medical cannabis oil or extracts over smoked herb. Medical cannabis oil is far more powerful.
Ulcerative Colitis
Quality
studies on cannabis for ulcerative colitis are few and far between. The
majority of evidence focuses on Crohn’s or makes generalizations about
irritable bowel disease.
However, a 2011 survey questioned 100 ulcerative colitis and 191 Crohn’s patients about medical cannabis.
Of
the 100 colitis patients, 51% reported lifetime cannabis use. Of those
lifetime consumers, 33% reported that they used the herb to alleviate
disease symptoms. These symptoms included diarrhea, abdominal pain, and
reduced appetite. Patients who had a history of abdominal surgery were
more likely to turn to cannabis for relief.
Though human research is lacking, animal studies and pre-clinical research show
positive signs. Both CBD and THC have effectively slowed motility,
reduced inflammation, and improved symptoms in rodent models of the
disease.
Cannabis therapy may even reduce the risk of colon
cancer. Colon cancer risk increases sharply when the large intestine is
under chronic stress and inflammation.
There
is a lot we still need to learn about cannabis and the gut. As of right
now, there is ample anecdotal evidence and a wealth of pre-clinical
research advocating cannabis as a potential treatment for inflammatory
bowel diseases.
Unfortunately, without serious reform for medical
research, patients are left to make difficult decisions about cannabis
themselves. Luckily, signs are positive thus far.
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