Medical marijuana and Inflammatory Bowel Disease (IBD)

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Marijuana may help treat symptoms of inflammatory bowel disease.

Marijuana has a long history of use in ancient medicine to treat inflammation of the bowels. Today, marijuana use is becoming increasingly common among patients living with inflammatory bowel disease, or IBD.

Studies show marijuana may be an effective treatment for IBD. It has antioxidant, anti-inflammatory, and neuroprotective effects which can all benefit those with the disease.

Additionally, many patients with IBD find relief when using marijuana to help treat their symptoms. Let’s take a look at the link between marijuana and IBD.

What Is Inflammatory Bowel Disease?

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Inflammatory bowel disease is a term used to describe a set of conditions that cause inflammation in the digestive tract, namely the colon and small intestine.

Crohn’s disease and ulcerative colitis are the two main subsets of IBD.

These conditions cause symptoms like diarrhea, abdominal pain, bloody stool, weight loss and a lack of appetite.

While the names may sound similar, IBD is not to be confused with IBS, or irritable bowel syndrome.

IBD causes inflammation and ulcers in the bowels, while IBS mostly affects how the bowels and intestines function.

The major difference between IBD and IBS is that the intestines of those with IBS look healthy, while the intestines of those with IBD show signs of inflammation.

Can Marijuana Help Treat IBD?

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While IBD is not currently considered an approved condition for medical marijuana, scientific evidence suggests that marijuana can help those living with IBD.

Marijuana can help reduce inflammation associated with the disorder, as well as oxidative stress that contributes to symptoms in IBD.

Inflammation

As the name suggests, chronic inflammation of the bowels is a major factor in IBD.

Marijuana has anti-inflammatory effects that appear to help those living with IBD.

While other drugs, like steroids, can reduce inflammation in the bowels, they also have more significant side effects and can cause dependence.

Marijuana is advantageous over these drugs as it does not cause dependence, and carries beneficial side effects such as increased appetite.

Antioxidant

Many patients with IBD use antioxidants to help lower oxidative stress in the gastrointestinal tract. Oxidative stress is a significant factor that contributes to gastrointestinal damage of patients with IBD.

It is one of the causes for IBD symptoms like diarrhea, abdominal pain, and toxic megacolon.

Marijuana contains cannabinoids that have antioxidant effects, such as THC and CBD. These cannabinoids may be beneficial in lowering oxidative stress in the bowels and reducing damage to the gastrointestinal tract.

Neuroprotection

Marijuana is known to have neuroprotective effects.

Many people may associate these effects with protecting the brain, but neurons regulate functions throughout the body, including the digestive tract.

IBD causes an increase in pro-inflammatory chemicals produced by the body, which can damage tissue and kill neurons in the colon and intestines.

This can cause degradation or destruction of anti-inflammatory neurons in the gastrointestinal tract. As a result, inflammation becomes unregulated by the nervous system, causing symptoms of IBD to become further exacerbated.

What Do Studies Say?

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Studies suggest that compounds in marijuana may be able to reduce abdominal inflammation, improve symptoms in Crohn’s disease, as well as reduce inflammation in ulcerative colitis.

Abdominal Inflammation

Endocannabinoids influence many aspects of human health, including digestive health. Dysfunction of this prominent system is also believed to underlie some diseases, including IBD.

In a 2012 paper, researchers reported that endocannabinoids like anandamide and 2-AG are implicated in gut functions like inflammation and gastrointestinal motility.

They suggested that dysfunction of the endocannabinoid system may be a biological cause of IBD, making it a promising target for therapies.

This research was further supported by a 2016 paper which indicated that cannabinoid signalling is significant in regulating disease in the gastrointestinal tract.

This may mean that targeting the endocannabinoid system with cannabinoids from marijuana could be an effective treatment for IBD.

Crohn’s Disease

A 2013 human trial performed at Tel Aviv University found remarkable results in Crohn’s patients using marijuana.

The researchers observed that 5 of the 11 patients experienced complete remission when given marijuana. In contrast, in the placebo group, only 1 patient out of 10 that experienced complete remission.

They also found clinically significant decreases in the Crohn’s Disease Activity Index (CDAI) in 10 of the 11 patients given marijuana. In the placebo group, only 4 of the 10 patients were found to share similar results.

Even more interestingly, over the 8-week course of treatment, three of the patients given marijuana were weaned from their steroid dependency they developed prior to the marijuana treatment.

Ulcerative Colitis

In a 2011 study, researchers investigated how cannabinoids can affect inflammation of the intestines in patients with ulcerative colitis (UC).

The researchers used intestinal cells collected from patients with UC, as well as intestinal segments of mice that modeled UC.

They discovered that administering CBD was effective at reducing markers of UC, suggesting the treatment may improve symptoms of the disease.

In human tissue, CBD reduced levels of similar markers of UC, supporting the results found in mice.

The researchers state that CBD treatment led to a reduction in intestinal damage, and that the cannabinoid may act as a future therapy for patients with UC.

THC vs. CBD

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THC and CBD each have important benefits for IBD, and may work together effectively.

A 2009 study examined how CBD impacts IBD, and found that CBD reduced injury to cells in the models they investigated.

CBD reduced damage by lowering oxidative stress to the cells, as well as reducing endocannabinoid changes caused in the IBD models.

In a 2010 study, researchers compared the effects of CBD to THC, as well as a combination of both, in rat models of IBD.

THC was found to be more effective than CBD when applied individually, but when used in combination CBD could make an ineffective dose of THC more effective.

Both cannabinoids were found to protect cholinergic nerves which regulated contraction and inflammation in the colon.

The researchers concluded that the combination of cannabinoids was effective in reducing inflammation, and could also restore functional disturbances of the colon that occur with IBD.

Marijuana Use in Patients with IBD

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Studies show marijuana use is common among patients with IBD.

A 2011 study assessed almost 300 patients with Crohn’s disease and ulcerative colitis, finding 48-51% of patients reported lifetime use of marijuana.

Patients used marijuana to relieve diarrhea, reduced appetite, and abdominal pain.

Patients were also found to be more likely to use marijuana to manage their symptoms if they had a history of abdominal surgery, abdominal pain, or a low quality of life.

Another 2013 study found that 12.3% of IBD patients were currently using marijuana, and 39% had used it in the past.

Patients reported marijuana to be helpful in reducing nausea, abdominal inflammation, and diarrhea.

Half of the respondents who had not used marijuana indicated an interest in using it to manage symptoms.

Summary

Current evidence suggests that marijuana has a role in reducing inflammation in IBD, and can also help treat other symptoms.

Marijuana has antioxidant, anti-inflammatory, and neuroprotective effects that are beneficial for IBD.

Studies have shown that marijuana may be beneficial for ulcerative colitis and Crohn’s disease.

Many people with IBD use marijuana to help treat their symptoms, indicating that marijuana may be helpful for the disease.

Future research will reveal more about the benefits of marijuana for IBD patients.

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