Crohn’s disease is a debilitating autoimmune disease with no cure. However, patients with Crohn’s disease are turning to cannabidiol (CBD) as more studies confirm that it is effective and safer to use than traditional medication. CBD has been shown to reduce inflammation, relieve pain, and prevent diarrhea, suggesting CBD is a viable therapy for Crohn’s disease and other inflammatory bowel diseases.
Crohn’s disease and ulcerative colitis are the two major categories of irritable bowel disease (IBD) with an estimated 1.6 million people suffering from IBD in America. Crohn’s disease is thought to be responsible for nearly half of those cases.
Crohn’s is an inflammatory disease that can affect the entire gastrointestinal system, yet it is most often found in the small intestine.
Inflammation is the major cause of symptoms, which includes diarrhea, abdominal pain, bloating, constipation which can lead to bowel obstruction, weight loss, and fatigue.
Children with Crohn’s may experience stunted growth and development due to a lack of nutrients. Many people require surgery to remove the infected part of the gastrointestinal tract.
Since Crohn’s is chronic, patients will often experience symptoms for a period of time and later may not feel any symptoms at all. This will be a continuous cycle during the patient’s lifetime.
Anyone can develop Crohn’s disease, but some factors such as age, ethnicity, and genetics can increase an individual’s risk. Those with an increased risk include men and women between the ages of 15 and 35, living in an urban area, and who have close relatives diagnosed with Crohn’s disease.
Gender is not a factor as men and women are equally likely to develop the disease.
The most likely culprit seems to be genetic abnormalities, but environmental factors can also have an impact. For instance, more cases of Crohn’s disease are observed in developed, urban areas in northern climates.
However, none of these factors alone are believed to cause Crohn’s.
Crohn’s disease begins when the immune system mistakenly attacks harmless bacteria somewhere in the digestive tract. As the immune system attacks, it causes damaging inflammation.
Typically, inflammation caused by the immune system will subside in a healthy digestive system, but inflammation persists with Crohn’s disease. As a result of the chronic inflammation, tissue damage occurs and Crohn’s patients begin to experience symptoms.
Crohn’s and ulcerative colitis are often confused since they are both inflammatory diseases and cause similar symptoms. Crohn’s is a more pervasive disease as it can can affect any part of the entire gastrointestinal system from the mouth to the anus and every layer of the bowel wall, while ulcerative colitis is limited to the colon and its inner lining.
It is also important to note Crohn’s disease and ulcerative colitis are inflammatory bowel diseases; they are not associated with irritable bowel syndrome (IBS). IBS is characterized by muscle contractions of the colon, not inflammation. However, abnormal muscle contractions can also be a symptom of Crohn’s disease.
Unfortunately, there is no cure for Crohn’s disease, and patients often need several medications to manage their symptoms.
Current treatments include antibiotics, anti-inflammatory steroids, immunosuppressants, and biologics.
|MEDICATION||PURPOSE||SIDE EFFECTS||COMMON BRANDS|
|ANTIBIOTICS||Reduce bacteria and suppress the immune system||Nausea, diarrhea, dizziness, and headaches||Ciprofloxacin (Cipro) and Metronidazole (Flagyl)|
|STEROIDS||Reduce inflammation||Diabetes, glaucoma, high blood pressure, and weak bones||Budesonide (Entocort) and Prednisone (Prednisone Intensol, Rayos)|
|IMMUNO-SUPPRESSANTS||Suppress the immune system||Nausea, diarrhea, vomiting, and scarring of the liver||Azathioprine (Azasan, Imuran), Mercaptopurine (Purinethol, Purixan), and Methotrexate (Trexall)|
|BIOLOGICS||Suppress proinflammatory proteins||Headache, low blood pressure, stomach or back pain, and heightened risk of infection or cancer||Adalimumab (Humira) and Infliximab (Remicade)|
Antibiotics are used to manage Crohn’s symptoms by reducing bacteria in the intestine and suppressing the immune system.
Some of the most common antibiotics for Crohn’s are Ciprofloxacin (Cipro) and Metronidazole (Flagyl).
Side effects of antibiotics include nausea, diarrhea, dizziness, and headaches.
Steroids are strong medications used as anti-inflammatory drugs. They are quick acting and used for severe symptoms.
The two most popular steroids for Crohn’s are Budesonide (Entocort) and Prednisone (Prednisone Intensol, Rayos).
Steroids can have serious side effects such as diabetes, glaucoma, high blood pressure, and weak bones.
Immunosuppressants suppress the immune system to limit inflammation. Doctors generally prescribe these when other medications do not work first.
Some common immunosuppressants include Azathioprine (Azasan, Imuran), Mercaptopurine (Purinethol, Purixan), and Methotrexate (Trexall).
Side effects include nausea, diarrhea, vomiting, and scarring of the liver.
Biologics are drugs made from biological organisms and also target the immune system. Specifically, most biologics target tumor necrosis factor (TNF), a proinflammatory protein released by the immune system that is abundant in Crohn’s patients.
Biologics used in Crohn’s include Adalimumab (Humira) and Infliximab (Remicade).
Possible side effects are headache, low blood pressure, stomach or back pain, and heightened risk of infection or cancer.
Sometimes, patients do not find relief with medication or feel worse as a result of the side effects of their medicine. Additionally, medications can cause long-term side effects which include bone diseases, susceptibility to infection, and pancreas, liver, and kidney problems.
Thankfully, studies show CBD can effectively alleviate symptoms while causing fewer and milder side effects.
Research on CBD for Crohn’s disease shows it may be a reliable and safe treatment for Crohn’s disease.
Cannabis, which contains both THC and CBD, has been shown to significantly help in the relief of Crohn’s symptoms, even causing remission in some patients. Cannabis also improved the colon’s ability to function, helping patients absorb nutrients.
In a study of CBD taken alone, CBD significantly reduced inflammation and inhibited disease activity, making it a viable treatment option for inflammatory bowel diseases.
The following studies demonstrate these effects of CBD treatment for Crohn’s:
Conducted by the Department of Gastroenterology and Hepatology at Tel Aviv University, 21 patients who could not find relief from Crohn’s with steroids and other medications participated in a study for eight weeks to test cannabis’ effectiveness on the disease.
Eleven patients smoked cannabis cigarettes twice daily while the other 10 were placed in a placebo group. Ten of the 11 patients found relief from their Crohn’s symptoms with cannabis, while five experienced complete remission of the disease. Three patients were also weaned off the steroids they had taken previously.
Additionally, none of the patients experienced significant side effects.
Another study by the Department of Gastroenterology at Tel Aviv University tested if cannabis would improve quality of life, weight gain, and disease activity in 13 patients with inflammatory bowel disease during a three-month trial.
Patients experienced an average of 4.3 kg (9.5 lbs) in weight gain and average increase of 1.4 in BMI (body-mass index), meaning cannabis improved the gastrointestinal system’s ability to absorb nutrients.
After answering a quality of life questionnaire, patients reported significant improvement in certain aspects of their life such as social functioning, ability to work, pain, and depression.
The study concluded cannabis was an effective treatment as it improved quality of life, decreased disease activity, and improved patients’ overall health.
Researchers from the Institute of Experimental and Clinical Pharmacology at the Medical University of Graz in Austria and the Department of Medicine at the Ludwig Maximilian University in Germany tested administered CBD to mice induced with colitis.
CBD was administered to the mice orally, intrarectally, or intraperitoneally (i.e., through the abdominal cavity).
The results showed CBD significantly reduced inflammation in the colon and inhibited disease activity intrarectally and intraperitoneally, but not orally.
CBD primarily treats Crohn’s by interacting with receptors in the endocannabinoid system called CB2. The CB2 receptors are found on immune cells and can regulate the release of cytokines, a group of proinflammatory proteins. When CBD activates these receptors, it inhibits the production of cytokines, reducing inflammation and its associated symptoms. By performing the same actions, CBD can also treat ulcerative colitis.
The following are ways CBD treats Crohn’s disease:
The damaging inflammation in Crohn’s disease is caused primarily by cytokines. The immune system releases cytokines in the system’s attempt to remove the bacteria it considers as foreign and harmful.
When the immune system cannot remove the bacteria, it forms clumps of immune cells around the bacteria leading to bowel obstruction, increased inflammation, and the many other symptoms patients experience.
Oxidation is also a prevalent issue in Crohn’s disease. First, it is an additional source of inflammation because it produces free radicals that damage cells. Second, oxidation happens at a faster rate in Crohn’s leading to a shortage of fat in Crohn’s patients.
CBD is well known for its anti-inflammatory and antioxidant benefits.
In addition to binding with CB2 receptors, CBD also binds with other receptors to reduce inflammation. One such set of receptors is called TRPV1, which when activated promote anti-inflammatory effects by slowing down the release of cytokines.
Another set of receptors CBD binds with is called PPARs. When PPARs are hyperactivated, they release cytokines; however, CBD binds to PPARs and inhibits this action. CBD has the same effect on GPR55 receptors which also produce cytokines when overstimulated.
As an antioxidant, CBD eliminates free radicals, preventing inflammation and protecting tissue in the GI tract from further damage.
Patients with Crohn’s disease have compromised gastric motility (motility is the movement of the digestive system and how its contents are transported). Crohn’s creates inflammatory hypermotility, which is why diarrhea is common. To manage the related symptoms, a patient needs treatment to slow down their motility.
CBD has anti-motility effects as indicated by the study above regarding colitis-induced mice.
One way CBD affects motility is by slowing down muscle contractions in the GI tract. CBD accomplishes this by suppressing a neurotransmitter called ACh and by activating opioid receptors. Opioid receptors are known to affect motility and slow down muscle contractions.
CBD also promotes the body’s natural anti-motility ability by increasing the levels of anandamide, an endocannabinoid which can help regulate the digestive tract. Anandamide is broken down quickly by enzymes in the body, so CBD helps by inhibiting such enzymes, allowing anandamide’s effects to last longer.
Pain is a common symptom in the life of Crohn’s patients and those with IBD. It is caused by inflammation, leading to abdominal pain, pain while using the bathroom, and general discomfort. Pain can also be caused by side effects of medications.
Fortunately, as a result of CBD’s anti-inflammatory and anti-motility abilities, pain relief can be found without the risk of serious side effects.
CBD provides pain relief when it binds with the CB2 and TRPV1 receptors. CBD interacts with CB2 receptors to reduce inflammation and desensitizes TRPV1 receptors to the point where they eventually do not send pain signals.
Tetrahydrocannabinol (THC) possesses some of the same benefits as CBD, yet administers them in a slightly different way.
THC can bind to a different receptor that CBD does not called CB1. These receptors influence pain perception and mental aspects such as stress, anxiety, mood, and behavior. When the CB1 receptors are activated by THC, they can cause psychoactive effects. However, CBD negates psychoactivity when combined with THC in an appropriate ratio.
Adding THC to CBD may also add an extra level of potency to therapeutic treatment, often known as the entourage effect.
THC provides similar anti-inflammatory benefits to CBD.
THC binds to CB2 receptors allowing it to reduce inflammation by inducing the deaths of proinflammatory cells, preventing immune cells from clumping and causing further damage to bowel tissue.
THC and CBD can also enhance each other’s anti-inflammation effects and may even have the ability to help close wounds in the colon.
THC binds to CB1 receptors in the nervous system surrounding the gastrointestinal tract. By activating these receptors, THC helps slow down the GI tract to prevent hypermotility and diarrhea.
THC also acts like anandamide, the endocannabinoid that helps regulate the GI tract. Thus, when CBD and THC are combined, not only does THC provide the effects of anandamide but CBD also sustains the level of natural anandamide in the body, effectively reducing inflammatory hypermotility.
CBD prolongs the therapeutic effects of THC. Much in the same way it sustains and promotes levels of anandamide, CBD inhibits the enzymes that would break down THC, allowing THC’s effects to last longer.
CBD can also negate the psychoactive effects of THC. THC’s activation of the CB1 receptors is the cause of such effects, yet CBD modulates the receptor to suppress THC’s ability to bind with CB1 receptors. This prevents the user from experiencing negative side effects while also enjoying the benefits.
With cases of Crohn’s disease on the rise and the risk of medication leading to other chronic issues, it is more important than ever to find an effective, safe alternative treatment.
Thankfully, CBD seems to be a promising answer.
As studies and clinical trials are constantly illustrating, CBD can be so effective that some patients may experience complete remission of their Crohn’s symptoms. While medication may fail or become ineffective over time–and can complicate a patient’s quality of life by adding severe, long-term side effects–CBD seems to be a safe alternative for those who cannot alleviate their pain.
Although patients with Crohn’s disease and irritable bowel diseases are fighting a lifelong battle, it is encouraging to know there may be an opportunity to live a normal life with CBD.
Have you or a loved one used CBD to treat Crohn’s disease? If so, what were the results you achieved? Share your story in the comments below!
Disclaimer: The content on this site is for informational purposes only. We are not medical experts and nothing should be construed as medical advice. Be sure to speak with your physician before taking CBD or any other treatment.