Inflammatory bowel disease (IBD) is an umbrella term used to describe disorders that cause chronic inflammation of your gastrointestinal (GI) tract. How IBD differs from irritable bowel syndrome (IBS), is that IBD can cause destructive inflammation and permanent harm to the intestines, can be seen during diagnostic imaging, and may increase the risk for colon cancer. The two most common forms of IBD are Crohn’s disease and ulcerative colitis.
Cannabis has been often used as a form of self-medication by individuals with IBD for symptomatic relief and its cannabinoid derivatives have grown increasingly popular as a potential therapy for IBD. A 2007 study by Garcia-Planella and colleagues in Spain surveyed 214 patients with IBD. They found that nearly 10% of patients were active users of cannabis or its derivatives. In 2011, 291 patients with IBD were surveyed at a tertiary care center in Ontario, Canada by Lal and colleagues. Results showed that 33% of ulcerative colitis patients and 50% of Crohn’s patients who were lifetime users of medicinal cannabis were specifically using for IBD symptomatic relief.
It is estimated that today, about 15-40% of individuals living with IBD rely on cannabinoids to reduce the needs for other medications, as well as increase appetite and reduce pain. Studies have shown that not only may symptomatic relief be realized, but that by modulating the endocannabinoid system (ECS), which regulates various functions to include the pathogenesis of IBD, there may be a therapeutic effect on the GI tract.
The Role of the ECS in IBD
The ability of the ECS to modulate inflammatory responses demonstrates its role in preserving gastrointestinal function. A 2011 study by Di Sabatino and colleagues used biopsy specimens from participants with Crohn’s disease and ulcerative colitis to analyze endocannabinoid levels, expression of cannabinoid receptors, and activity of enzymes. Levels of the endocannabinoid, anandamide, were significantly decreased in inflamed IBD mucosa. The different levels of elements of the ECS in IBD models showed that cannabinoids appear to have a clear role in gut pathology, offering a potential target for drug intervention in the treatment of IBD.
Pharmacological Effects of Cannabidiol (CBD)
CBD is one of the main pharmacologically active cannabinoids of the Cannabis sativa L. plant. It is non-psychoactive and exerts a number of beneficial effects to include anti-inflammatory and antioxidant properties. Several studies have contributed to the understanding of the therapeutic potential of CBD for many diseases, including those associated with oxidative stress. Oxidative stress is a significant pathophysiological factor that plays a role in the initiation and progression of IBD. The use of antioxidants for individuals with GI disorders has been proposed as an alternative therapy to the use of anti-inflammatory or immunomodulatory drugs to both mitigate the adverse effects of traditional treatments and enhance the individual’s quality of life.
Markers of Improved Quality of Life
Irving and colleagues evaluated ulcerative colitis patients receiving a CBD-rich botanical dose for 8 weeks in 2018. While there was no statistical relevance regarding clinical improvement, the treated group reported an improvement in quality of life compared to placebo. Another study by Mbachi and colleagues in 2019 showed that the use of CBD for ulcerative colitis patients was associated with reduced prevalence of severe constipation and hospital length-of-stay when compared with nonusers.
Symptomatic Control with CBD and Delta-9-Tetrahydrocannabinol (THC)
A significant population of individuals suffering with IBD use cannabis to relieve symptoms of pain, nausea, and appetite, as well as to improve their overall mood. THC has been shown through anecdotal evidence to improve abdominal spasms, cramps, and visceral pain; whereas CBD may contribute to the relief of intestinal inflammation, modulating cortisol and metabolism, improve the immune response of the gut, and alleviate the anxiety and stress associated with gastrointestinal discomfort. In a 2021 review of 682 studies of cannabinoid use for IBD patients, clinical symptoms (abdominal pain, general well-being, nausea, diarrhea, and poor appetite) were all improved with cannabinoid therapy.
Choosing a product: Benefits of the full cannabis plant
When looking for a product, it is first advised to understand that the quality of your product matters. We have developed a guide to help you ensure the product you purchase is of quality and have vetted specific products to help you on your journey. Our care team is also on standby with free one-on-one support to help you get started with product choice and dosing guidance.
When looking for a product for IBD symptoms, it may be worthwhile to consider a full-spectrum product that includes cannabinoids, terpenes, and flavonoids to further enhance benefits.
As more research becomes available for additional cannabinoids, we further our understanding of the benefits this plant may provide. For example, CBG may reduce effects of IBD and the development and growth of colon cancer. CBDA shows promise by inhibiting vomiting induced by toxins and possibly reducing involuntary vomiting.
Terpenes are compounds produced by plant species, Cannabis sativa included, that are responsible for determining their distinct scents. They also play a protective role in plants and are known through comprehensive research to have multiple health-promoting properties in humans. Several terpenes have been evaluated in models of IBD and have shown to benefit intestinal anti-inflammatory activity by preventing oxidative stress, combating dysbiosis, restoring intestinal permeability, and improving the inflammation process in different signaling pathways.
Reported data for cannabinoids and terpenes is promising and suggests therapeutic potential. However, there is still a lot of research to be done especially when considering how much to take. Before beginning any alternative therapies, consulting with a medical professional is always recommended.
There is a lot to consider when starting cannabinoid therapy and a Realm of Caring care specialist is here to help with your questions. Contact us today by calling (719) 347-5400 or by emailing firstname.lastname@example.org.