Cannabis and Crohn’s Disease: Navigating the Evidence

Crohn’s disease, a type of inflammatory bowel disease (IBD), poses significant challenges to those affected by it. Characterized by inflammation of the digestive tract, Crohn’s disease can lead to symptoms like abdominal pain, severe diarrhea, fatigue, weight loss, and malnutrition. Despite conventional medical therapies, many patients continue to struggle with symptom management [1]. In recent years, medical cannabis has emerged as a potential complementary wellness treatment for Crohn’s disease and other inflammatory bowel diseases [2]. But does it really help? This article explores the evidence behind cannabis use in Crohn’s disease, focusing on its potential benefits and risks for patients.

Understanding Crohn’s disease

Crohn’s disease is a chronic condition involving inflammation of the gastrointestinal (GI) tract. Notably, it can affect any part of the GI tract from the mouth to the anus but most commonly impacts the end of the small intestine (ileum) and the beginning of the colon. The exact cause of Crohn’s disease remains unclear. However, researchers believe it involves a combination of genetic predisposition, immune system dysfunction, and environmental factors [1].

Traditional treatments for Crohn’s disease include anti-inflammatory medications, immunosuppressants, antibiotics, and biologic therapies [1]. Despite these treatments, many patients experience persistent symptoms and seek alternative therapies, such as acupuncture or cannabis, in the effort to relieve symptoms [2]. However, opinions differ regarding the efficacy of such alternative approaches.

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Cannabis and its mechanisms

The cannabis plant is in the family Cannabaceae and contains numerous compounds known as cannabinoids, the most well-known being tetrahydrocannabinol (THC) and cannabidiol (CBD). These compounds interact with the body’s endocannabinoid system (ECS), which plays a role in regulating various physiological processes, seemingly including pain, mood, appetite, and inflammation [3].

Cannabinoid receptors, particularly CB1 and CB2 receptors, reside throughout the body, including the GI tract. These receptors are part of the enteric nervous system and immune system, likely making them relevant to conditions that affect GI functioning [2]. Some researchers suggest that cannabis formulations can target these receptors and cause beneficial changes in the body [3].

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Evidence from clinical research

Clinical research on cannabis use in Crohn’s disease and inflammatory bowel disease (IBD) has produced mixed results. For example, a pilot prospective study and other clinical trials have explored the effects of cannabis on IBD symptoms, including clinical symptoms, disease activity, and quality of life [3].

One notable study is a prospective placebo-controlled study conducted by the Crohn’s and Colitis Foundation. Notably, this study found that patients with Crohn’s disease who used cannabis had a different experience compared to the placebo group. The Crohn’s Disease Activity Index (CDAI), a tool used to quantify disease severity, showed remarkable scores for the cannabis group [4]. However, the foundation states in their literature about the study that, even with these findings, there is not enough evidence to conclude that “medical cannabis can reduce IBD inflammation or improve disease activity [4].”

Other studies have not shown evidence of clinical remission and symptom improvement, or have highlighted potential risks and adverse effects associated with cannabis use. Additionally, some experts have expressed concerns about the long-term effects of cannabis use, particularly in young patients and those with a history of mental health issues [6]. Thus, it’s important to follow the advice of a physician and to treat Crohn’s disease cases on an individual basis.

Potential benefits and risks of cannabis and Crohn’s disease

Benefits

Symptom relief: Could there be improvements in overall wellness from consuming cannabis [7]? Though evidence is inconclusive regarding symptoms, cannabis can help people in other ways.
Quality of life: Cannabis use has been associated with enhanced quality of life for many people. This outcome can lead to better overall well-being and daily functioning [7].
Clinical response: Studies will show if cannabis can induce a clinical response in patients with Crohn’s disease [5]. In the meantime it’s crucial to follow the advice of a physician and weigh the evidence on each side.

Risks

Potential adverse effects: Long-term cannabis use may pose risks, especially for younger individuals [5].
Increased risk: There is significant heterogeneity in patient responses, making it crucial for healthcare providers to closely monitor Crohn’s and IBD patients [5].
Interactions with conventional therapy: Cannabis may interact with conventional therapies and medications, potentially affecting their efficacy. For this reason, patients with Crohn’s disease should consult their healthcare providers about using cannabis [5].

Guidelines for cannabis use

Medical consultation

Patients with Crohn’s disease considering cannabis use should seek guidance from their healthcare providers. A personalized treatment plan, considering the patient’s medical history and current medications, is essential to minimize risks and optimize benefits.

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Dosage and administration

Starting with a low dose and gradually increasing it, often referred to as “start low, go slow,” is a common approach. Also, monitoring and adjusting the dosage based on the patient’s response and any adverse effects is crucial [8].

Legal and regulatory considerations

The legal status of cannabis varies widely by region. Therefore, consumers should be aware of local regulations and ensure that they are using cannabis legally and safely [9]. Cannabis with no more than 0.3% Delta-9 THC is legally defined as hemp by the 2018 Farm Bill. Hemp and hemp-derived products are federally compliant in the US, whereas marijuana, which is cannabis with more than 0.3% Delta-9 THC, is a DEA federally controlled substance.

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Future directions and research

The potential of cannabis to treat Crohn’s disease and other inflammatory bowel diseases warrants further investigation. Emerging studies and clinical trials aim to provide more robust evidence on the efficacy and safety of cannabis for IBD patients. For example, the Crohn’s and Colitis Foundation and other research organizations continue to explore new areas of investigation and innovation in cannabis-based therapies [4].

Unanswered questions remain, particularly regarding the long-term safety of cannabis use and its broader implications for Crohn’s and other inflammatory diseases. Therefore, ongoing research and evidence-based medicine are essential to better understand the role of cannabis in managing Crohn’s and IBD.

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Cannabis for overall wellness and uplift

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Conclusion

Ongoing cannabis research presents encouragement for managing Crohn’s disease and other inflammatory bowel diseases. Potential improvements in symptoms and quality of life, as well as potential risks and adverse effects must be carefully considered. Healthcare providers play a crucial role in guiding patients through the use of cannabis, ensuring that it is integrated safely and effectively into their treatment plans when warranted. As research continues to evolve, a clearer understanding of cannabis’s role in IBD management will hopefully emerge, offering new hope to those affected by these challenging conditions.

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Medical Disclaimer / Legal Disclaimer – Information is provided for educational purposes. It does not and is not intended to constitute legal advice or medical advice. We attempt to be accurate and up-to-date, but the legality of cannabinoids and the science of cannabis are evolving. The author is neither a legal professional nor a medical expert. Before buying or using any products, you should check with your local authorities and medical providers.

References

Frequently Asked Questions

Can cannabis help with symptoms of Crohn’s disease?

While some patients report promising things, the effectiveness of cannabis for Crohn’s disease is still under scientific investigation [2]. It’s important to discuss any potential treatment with a healthcare provider.

What are the potential risks of using cannabis?

Potential risks include side effects like dry mouth or cloudy thinking. However, long-term effects and interactions with medications should also be considered.

How should I approach using cannabis if I have Crohn’s disease?

Consult with your healthcare provider to develop a personalized plan.