Inflammatory Bowel Disease and Cannabis


Two forms of IBD are Crone’s disease and ulcerative colitis.

The main difference between Crohn's disease and UC is the location and nature of the inflammatory changes.  Crohn's can affect any part of the gastrointestinal tract, from mouth to anus (skip lesions), although a majority of the cases start in the terminal ileum.  Ulcerative colitis, in contrast, is restricted to the colon and the rectum.

Microscopically, ulcerative colitis is restricted to the mucosa (epithelial lining of the gut), while Crohn’s disease affects the whole bowel wall.

Symptom Crohn's disease Ulcerative Colitis
Defacation Often porridge-like,sometimes steatorrhea Often mucus-like & with blood
Tenesmus Less common More common
Fever Common Indicates severe disease
Fistulae Common Seldom
Weight Loss Often More seldom

Finally, Crohn’s disease and ulcerative colitis present with extra-intestinal manifestations (such as liver problems, arthritis, skin manifestations and eye problems) in different proportions.

Rarely, a definitive diagnosis of neither Crohn's disease nor ulcerative colitis can be made because of idiosyncrasies in the presentation.  In this case, a diagnosis of indeterminate colitis may be made.

Crohn's disease remains a disease of unknown etiology.  It occurs in about seven out of 100,000 population, typically in people of European decent.  What can be said about it is that the immune system in the GI tract is over reactive, misguided and destructive to the intestine. 

Both of these diseases  are thought to be caused by a mix of environmental and genetic factors – so if you have the genetic susceptibility to the disease and are then subjected to environmental triggers, such as diet, stress, or bacterial imbalance,  the chances are you will develop the defective immune response that leads to the unpleasant symptoms.

In 2005,  New Scientist published a joint study by Bristol University and the University of Bath on the apparent healing power of cannabis on IBD.  Reports that cannabis eased IBD symptoms indicated the possible existence of cannabinoid receptors in the intestinal lining, which respond to molecules in the plant-derived chemicals.  CB1 cannabinoid receptors – which are known to be present in the brain – exist in the endothelial cells, which line the gut.  It is thought that they are involved in repairing the lining of the gut when damaged.  The team deliberately damaged the cells to cause inflammation of the gut lining and then added synthetically produced cannabinoids;  the result was that the gut started to heal:   the broken cells were repaired and brought back closer together to mend the tears.  It is believed that in a healthy gut, natural endogenous cannabinoids are released from endothelial cells when they are injured, which then bind to the CB1 receptors.  The process appears to set off a wound-healing reaction, and when people use cannabis, the cannabinoids bind to these receptors in the same way.  Previous studies have shown that CB1 receptors located on the nerve cells in the gut respond to cannabinoids by slowing gut motility, therefore reducing the painful muscle contractions associated with diarrhea.  The team also discovered another cannabinoid receptor, CB2, in the guts of IBD sufferers, which was not present in healthy guts.  These receptors, which also respond to chemicals in cannabis, appear to be associated with apoptosis – programmed cell death – and may have a role in suppressing the overactive immune system and reducing inflammation by mopping up excess cells.

Researchers in the United Kingdom have shown that two compounds found within the cannabis plant – THC and CBD (Cannabidiol) – do interact with gut function.  This proves,  as many sufferers have testified,  that medical marijuana does provide an effective treatment for inflammatory bowel diseases such as Crohn’s and Ulcerative Colitis.

What Type of Cannabis Helps Crohn’s Disease?
Purple Kush, Super Silver Haze, Black Domina, Blueberry (many others as well)

While it has been known for a long time that cannabis is a powerful anti-inflammatory, the discovery that it actually reintegrates the intestinal lining is a new one.

Researchers found that plant-derived cannabinoids--  encouraged tighter bonds between the cells that form that gut barrier, therefore making it less leaky.

In very basic terms, people with Crohn’s disease have a defective barrier to their gut, which allows bacteria to leak into the intestinal tissue and set up an inflammatory response.  It seems then that the answer to the problems posed by this illness is to restore integrity to the gut barrier.

Physicians in the Society of Cannabis Clinicians conducted a pilot study of the effect of cannabis on Crohn’s disease in California.  For all signs and symptoms evaluated in the study,  the patients described marked improvements with the use of cannabis.  Beneficial effects were reported for appetite, pain, nausea, vomiting, fatigue, activity, and depression.  Patients also reported that cannabis use resulted in weight gain, fewer stools per day and fewer flare-ups.  Cannabis-using Crohn's patients not only report significant relief of their symptoms, they are also able to reduce the amount of immunosuppressive medications that have been a mainstay of conventional treatment.  Imuran, methotrexate, 6 MP, and Remicade (an anti-TNF drug) are greatly reduced.  Asacol and Pentasa brands of Mesalamine, an anti-inflammatory medication with immuno-modulating properties is also reduced in many cases.  Steroids are noted to be reduced and often eliminated.

The immunosuppressives cause the same side effects that the disease causes:  nausea, vomiting, abdominal pain, and diarrhea.  Mesalamine frequently was reported to cause rash, itching, and photosensitivity.  Steroids have a host of common side effects including anxiety, depression, irritability, nausea, vomiting, abdominal pain;  and, with chronic use, bone thinning, glucose intolerance, peptic ulcers, and the Cushingoid state.

Cannabis has shown few if any side effects!

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