Medical cannabis and IBD: what does the research say?

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living with IBD

Those who live with inflammatory bowel disease (IBD) do so with the knowledge that there is no cure for the disease, at least for now. Crohn’s disease and ulcerative colitis, divided into two types of diseases, can cause severe discomfort, diarrhea, tiredness and unintentional weight loss. Both conditions are expected to affect millions of people worldwide, with diagnoses increasing even in developed countries.

The impact of IBD does not only affect the body. Mentally, sufferers feel isolated and alone, as the symptoms prevent many from being able to socialize freely and carry out their daily activities. Unfortunately, one of the hardest hit demographics is teens and children. About a quarter of all IBD diagnoses are under the age of 20.

Given the lack of a cure for the condition, the goal in treating IBD is to reduce the frequency and severity of symptoms. This is accomplished with varying degrees of success. Not all health professionals have the evidence and research to provide holistic treatment advice when traditional medicines fail.

The endocannabinoid system and IBD

One field of study that is showing particular promise is the use of medical cannabis in the treatment of IBD. Currently, treatments are based on drugs designed to slow down or reduce the reaction of the immune system. Although this can work, it is not free of significant side effects. By comparison, the side effects associated with medical cannabis are generally well tolerated and less severe than those of pharmaceutical drugs.

The relationship between Crohn’s disease, ulcerative colitis and medical cannabis is complicated. Anecdotal testimonials have long supported the concept that cannabis alleviates IBD symptoms. However, by the time several case studies came to light, our understanding of the mechanisms at play was insufficient. We had yet to understand the intricacies of the endocannabinoid system.

Since then, several studies have been carried out using rat models to understand the relationship between our endocannabinoid system and IBD. Ulcerative colitis causes intense inflammation in the colon. The Journal of Clinical Investigation determined that our “endogenous cannabinoid system protects against colonic inflammation.” The authors concluded that the endocannabinoid system was intrinsically linked to the biological processes that take place when inflammation occurs in the colon. By modulating a response from the endocannabinoid system, muscle irritation from inflammation was reduced.

CBD and IBD

Another study also supported the idea that our endocannabinoid system plays a role in gastrointestinal functions. The results demonstrated that the endocannabinoid anandamide (AEA) could be used to protect the gut against inflammation. The researchers acknowledged that “although the results were promising, further studies are needed to determine the role of cannabinoid pathways in intestinal inflammation.”

Cannabis for inflammatory bowel disease

Supported by increasing anecdotal evidence and preliminary findings from rat-based studies, researchers had the incentive and theoretical foundation to explore the impact of medical cannabis on IBD in human physiology.

The Institute of Gastroenterology and Hepatology at the Meir Medical Center in Israel completed a review of studies on IBD and medical cannabis to identify any correlation between the results. Israel is at the forefront of medical cannabis research, as some of the world’s leading scientific minds there seek to discover the potential of cannabinoids and our endocannabinoid system.

The review consisted of three separate studies. The first was an observational study with 30 patients who had been diagnosed with Crohn’s disease (CD). Cannabis was found to have “improvements in disease activity” and “a reduction in the use of other medications.”

The second study found that 10 out of 11 patients taking cannabis experienced a decrease in CD activity. In the placebo-controlled group, only 4 out of 10 patients saw a similar reduction. Encouragingly, the results also indicated that 5 of the 11 patients in the cannabis control group went into complete remission.

The final study used as a reference focused explicitly on the efficacy of the cannabinoid CBD. Although the results were not as favorable compared to medical cannabis, the importance of CBD has not been completely lost.

CBD and IBD

CBD and IBD

CBD is considered a therapeutic treatment due to its incredibly low toxicity. It has been proven that up to 500mg does not cause harmful side effects. In 20 participants, all diagnosed with Crohn’s disease, each of them was given either CBD and olive oil or just olive oil. Both groups were asked to take 5mg twice a day for 8 weeks. After the 8-week trial, it was concluded that CBD was safe but ineffective in reducing CD symptoms.

Does that mean we should completely rule out CBD? Not quite. The dose used in this particular trial was extremely low, especially compared to the 500mg limit. What this research suggests is that dose is an important factor when looking at the relationship between cannabinoids and IBD disease. The Meir Medical Center researchers also recognized this important fact. They concluded that further studies were needed to establish the specific cannabinoids and the optimal dosage “to maximize beneficial effects.”

In the same way that we don’t know what causes IBD diseases to develop, we don’t know the full scope of the potential of cannabinoids, our endocannabinoid system, and how it can help treat IBD. The challenge is to reconstruct what has been demonstrated, isolating each variable until reaching a definitive conclusion.

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