The use of Medical Cannabis with inflammatory bowel diseases

This article has been medically reviewed by Kalapa Clinic

reviewed by Kalapa Clinic

One of the most fascinating organs of the human body is the intestine. It is almost 7 meters of length, it fulfils digestive and other relevant functions immune defense-related, for instance. In fact, 70% of all immune cells lie in the small and large intestine, and 80% of all defense reactions also happen there.

At the same time, the gut has a relevant impact or influence on people’s psyche, which is why it is known as the “stomach of the brain.” Why does this happen? The deterioration in our health and mood when this organ is affected, mainly by Inflammatory Bowel Diseases.

What are inflammatory bowel diseases (IBD)?

Inflammatory bowel diseases are a group of chronic inflammatory disorders of the intestine or digestive tract comprising mainly two diseases: Crohn’s disease and Ulcerative Colitis, as well as other types of colitis such as indeterminate, collagenous, or lymphocytic colitis.

These diseases cause chronic inflammation along this duct, and symptoms may occur in the form of flares throughout the patient’s life. The time between outbreaks varies depending on the severity of the disease and the therapy used to treat it. It affects both men and women of any age, although it is true that the diagnosis is more common in patients between 20 and 40 years of age.

It is also a chronic condition, meaning it lasts a long time or even a lifetime, and constantly comes and goes.

The main inflammatory bowel diseases

Both are long-term conditions that cause chronic inflammation in the intestine, which can result in critical damage for internal organs.

In Spain, ulcerative colitis is more common than Crohn’s disease, 58% versus 42%, and this difference will increase slightly in the coming years. Both are known for being essentially immune-mediated, inflammatory, and chronic diseases of the intestine, which evolve in outbreaks (active phases) and periods of remission (inactive phases). Both alter the body’s ability to digest food and absorb nutrients, and also share clinical and pathological features.

Common symptoms include:

  • Diarrhea
  • Blood in the stool
  • Tiredness
  • Abdominal pain
  • Loss of appetite
  • Weight loss
  • Fever

While they have much in common, they also have significant differences. For example, you can only have one or the other, never both.

Crohn’s disease

This type of inflammatory bowel disease features irregular inflammation of the lining of the digestive tract, usually its deeper layers.

It can affect any part of the gastrointestinal tract, from the mouth to the end of the rectum (anus), although it mostly affects the lower end of the small intestine and the beginning of the large intestine.

Thus, the inflammation inherent to this disease damages the entire intestinal wall. Although the causes of the condition are unknown, it is thought to be caused by a combination of bacterial, environmental, and immunological factors (autoimmune disorder).

Ulcerative colitis

Ulcerative colitis is a disease that presents with inflammation and sores (ulcers) in the superficial lining of the large intestine (colon) and rectum.

The disease features a diffuse mucosal inflammation confined to the colon, including the rectum and anus, damaging the inner lining of the intestinal tissue. It often occurs continuously, starting in the anus and spreading towards the rest of the colon, depending on the individual patient.

Both diseases are associated with a correspondingly increased risk of colon carcinoma.

What causes inflammatory bowel disease?

At present, the exact cause of inflammatory bowel disease is unknown.

Research suggests that it could be a combination of genetic, immune, and environmental factors that trigger inflammation in the gastrointestinal tract.

On the other hand, diet and stress can worsen the symptoms, but do not necessarily cause inflammatory bowel disease. At the same time, IBD often runs in families, although not all people with inflammatory bowel disease have a family history.

Inflammatory bowel disease can occur at any age, but it is mostly diagnosed in adolescents and young adults.

Treatment for inflammatory bowel disease

In inflammatory bowel disease, treatment is never definitive. These are two chronic pathologies for which there is still no treatment to cure them.

However, we must bear in mind that the evolution of these pathologies varies according to the treatments administered.

Thus, pharmacological, and surgical therapies cannot cure Crohn’s disease, but can improve the quality of life. The aim of therapy is to maintain the resting phases (remission), and to avoid complications that would imply hospital stays or operations.

As there is no known cure for IBD, pharmaceutical intervention focuses mainly on reducing inflammation and diarrhea, and controlling pain. Regarding this, the effects of cannabinoids at the intestinal level may be optimal for this type of condition, since they:

  • Improve and regulate intestinal motility
  • Have analgesic, anti-inflammatory, and anti-diarrheal effect

Studies on the properties of medical cannabis for IBDs

Decades of research suggest that the use of medical cannabis to control Crohn’s disease (CD) and ulcerative colitis (UC) may help relieve the inflammation that causes many of the symptoms of these diseases.

Although there is not enough definitive evidence to date to show that medical cannabis can control inflammation, its use in various forms is associated with improvements in nausea, abdominal pain, and appetite in most patients. Let’s look at why.

For starters, current research suggests that marijuana can help:

  • Reducing abdominal pain
  • Increasing appetite
  • Reducing diarrhea
  • Controlling nausea

For one thing, cannabinoids have an anti-inflammatory effect. Cannabidiol (CBD) activates CB2 receptors, mainly found on immune cells and in the gastrointestinal tract, therefore reduces inflammatory activity.

In addition, cannabinoids also influence appetite. And it is precisely this reduced appetite that is a crucial factor for people with IBD, as food intake often leads to pain, cramping and discomfort.

In this matter, many patients with Crohn’s disease already consume cannabis products. In Crohn’s disease, cannabinoids have not shown to help relieve stressful symptoms such as nausea and abdominal pain, but THC and CBD have.

For example, one study found that CBD oil can help relieve symptoms of Crohn’s disease when taken in pill form. Other research implies that CBD may help reduce inflammation resulting from colitis.

Other clinical trials have shown that the gut contains high levels of cannabinoid receptors (CB1, CB2), and therefore both THC and CBD are used to treat the disease.

They have proven to decrease symptoms, improve metabolic processes, and cause patients to greatly reduce their traditional medication.

In conclusion, anti-inflammatory CBD can potentially influence disease activity and may be a crucial agent for treating IBD in the future.

Sources Article