Crohn’s Disease / Colitis: Cannabinoids and CBD Research Overview

Crohn’s disease is a type of inflammatory bowel disease that is prevalent among adolescents and young adults. Studies have shown cannabinoids to be effective at decreasing digestive tract inflammation, and in some cases, helping patients achieve long-term remission.

Overview of Crohn’s Disease / Colitis

Crohn’s disease is an inflammatory bowel disease (IBD) that causes the lining of the digestive track to become inflamed. The disease may affect as many as 700,000 Americans, according to the Crohn’s & Colitis Foundation of America, causing abdominal pain, rectal bleeding, severe diarrhea, fever, weight loss, fatigue and malnutrition. The pain can be so intense that it becomes debilitating. In some cases, the disease can prove to be life-threatening.

According to Mayo Clinic, the most common area of the digestive tract affected by Crohn’s disease is at the end of the small bowel (the ileum) and the beginning of the colon. The disease can affect any part of the digestive tract, however, and will often spread deep into the layers of bowel tissue.

Heredity and abnormal immune system behavior are likely what cause Crohn’s disease to develop. Those who have family members with the disease are more common to acquire it themselves. When the immune system responds to fight off a virus, bacteria, fungi and other microorganisms, at times it can respond abnormally and also attack the harmless cells in the digestive tract, which in turn leads to inflammation.

There is no confirmed cure for Crohn’s disease, but certain treatment methods can significantly reduce symptoms and in some cases, even bring about remission. Treatment efforts primarily include antibiotics, and anti-inflammatory, anti-diarrhea and pain relief medications to manage the symptoms associated with the disease. In some cases, the use of a feeding tube to allow the digestive tract to rest and decrease inflammation, or surgery to remove the damaged portion of the digestive tract, may be required.

Findings: Effects of Cannabinoids and CBD on Crohn’s Disease / Colitis

Studies have found cannabis to effectively combat the symptoms associated with Crohn’s disease. Cannabinoids provide anti-inflammatory effects, subsequently reducing pain, offering nausea relief, and reducing the feelings of unpleasantness⁶. One study, in which inflammatory bowel disease patients were treated with cannabis for three months, improvements in the patients’ general health perception, social functioning, ability to work, physical pain and depression were found. Participants also saw increases in body weight and BMI². In another study, patients suffering from inflammatory bowel disease reported that cannabis was “very helpful” in relieving their abdominal pain, nausea and diarrhea⁵. Cannabis has also been found to improve appetite and sleep in Crohn’s disease patients³. In what is likely due to cannabis’ ability to improve symptoms associated with Crohn’s disease, cannabinoids have also been associated with a reduced need of other medications in patients with Crohn’s disease³.

Research also suggests that cannabis may be effective at helping Crohn’s disease reach long-term remission. Medical cannabis use has been determined to be associated with an improvement in disease activity⁴. In one study, cannabis rich in tetrahydrocannabinol (THC) produced significant benefits to 10 or 11 patients with active Crohn’s disease, without side effects, and 5 of those 11 subjects achieved complete remission³.

States That Have Approved Medical Cannabis for Crohn’s Disease / Colitis

Currently, 22 states have approved medical cannabis to be used to treat Crohn’s disease. These states include: Arizona, Arkansas, Connecticut, Florida, Georgia, Hawaii, Illinois, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Montana, New Hampshire, New Jersey, New Mexico, New York (inflammatory bowel disease), North Dakota, Ohio, Pennsylvania, Rhode Island, Washington, and West Virginia.

A number of other states will allow medical cannabis to be used for the treatment of Crohn’s Disease, but require an approval or a recommendation by a physician. These states include: California (any debilitating illness where the medical use of cannabis has been recommended by a physician), Nevada (other conditions subject to approval), and Oregon (other conditions subject to approval).

In Washington D.C., any condition can be approved for medical cannabis as long as a DC-licensed physician recommends the treatment.

Recent Studies on Cannabinoids and CBD’s Effect on Crohn’s Disease / Colitis

A clinical study showed that cannabis produces significant clinical benefits in patients with Crohn’s disease, including a reduction in pain sensation, nausea relief and reduce the feeling of unpleasantness.
Cannabis finds its way into treatment of Crohn’s disease.
(http://www.ncbi.nlm.nih.gov/pubmed/24356243)

THC-rich cannabis produced significant clinical, steroid-free benefits to 10 or 11 patients with active Crohn’s disease, compared with placebo, without side effects.
Cannabis induces a clinical response in patients with Crohn’s disease: a prospective placebo-controlled study.
(http://www.ncbi.nlm.nih.gov/pubmed/23648372)

Three months of inhaled cannabis treatment caused an increase in quality of life measurements, disease activity index and caused gains in weight and body mass index in patients with inflammatory bowel disease.
Impact of cannabis treatment on the quality of life, weight and clinical disease activity in inflammatory bowel disease patients: a pilot prospective study.
(http://www.ncbi.nlm.nih.gov/pubmed/22095142)

Resources:

1. Crohn’s disease. (2014, August 13). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/crohns-disease/basics/definition/con-20032061.
2. Lahat, A., Lang, A., and Ben-Horin, S. (2012). Impact of cannabis treatment on the quality of life, weight and clinical disease activity in inflammatory bowel disease patients: a pilot prospective study. Digestion, 85(1), 1-8.
3. Naftali, T., Bar-Lev Schleider, L., Dotan, I., Lansky, E.P. Sklerovsky Benjaminov, F. and Konikoff, FM. (2013, October). Cannabis induces a clinical response in patients with Crohn’s disease: a prospective placebo-controlled study. Clinical Gastroenterology and Hepatology, 11(10), 1276-1280.
4. Naftali, T., Mechulam, R., Lev, L.B., and Konikoff, FM. (2014). Cannabis for inflammatory bowel disease. Digestive Diseases, 32(4), 468-74.
5. Ravikoff Allegretti, J., Courtwright, A., Lucci, M., Korzenik, J.R., and Levine, J. (2013, December). Cannabis use patterns among patients with inflammatory bowel disease. Inflammatory Bowel Diseases, 19(13), 2809-14.
6. Schicho, R., and Storr, M. (2014). Cannabis finds its way into treatment of Crohn’s disease. Pharmacology, 93(1-2), 1-3.
7. What Are Crohn’s & Colitis? (n.d.). Crohn’s & Colitis. Retrieved from http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/.