Inflammatory Bowel Disease: Treating Crohn’s Disease / Ulcerative Colitis with Cannabis 

Approximately 1 in every 150 Canadians is diagnosed with Inflammatory Bowel Disease (IBD)- which includes Crohn’s and Ulcerative Colitis. A significant number of individuals diagnosed with IBD are using cannabis as a means of managing their symptoms and some have found cannabis to be an effective alternative to traditional medication. So, let’s look at treating inflammatory bowel disease with cannabis and what the research says about its effectiveness.

What is Inflammatory Bowel Disease? (IBD)

Ulcerative colitis and Crohn’s disease are the two main forms of inflammatory bowel diseases. They’re both characterized by chronic inflammation of the digestive tract.  

Crohn’s disease causes inflammation of the digestive tract – most commonly the last part of the small intestine and the colon- which leads to abdominal pain, severe diarrhea, fatigue, weight loss and malnutrition. 

The inflammation caused by Crohn’s disease often spreads deep into the layers of affected bowel tissue. Crohn’s disease can be painful and debilitating. Sometimes it may lead to life-threatening complications (such as bowel obstruction, ulcers, fistulas colon cancer and other health problems in other areas of the body; like anemia, skin disorders, osteoporosis, arthritis, and gallbladder or liver disease).

Signs and symptoms of Crohn’s disease can range from mild to severe. They usually develop gradually, but sometimes will come on suddenly, without warning.

Symptoms include:

  • Diarrhea
  • Fever
  • Fatigue
  • Abdominal pain and cramping 
  • Blood in your stool
  • Mouth sores
  • Reduced appetite and weight loss
  • Pain or drainage near or around the anus due to inflammation from a tunnel into the skin (fistula)

People with severe Crohn’s disease also may experience:

  • Inflammation of skin, eyes and joints
  • Inflammation of the liver or bile ducts
  • Delayed growth or sexual development, in children

What’s the difference between Crohn’s and Ulcerative Colitis?

The symptoms of ulcerative colitis and Crohn’s disease are very similar. The differences are as follows: 

  • Ulcerative colitis is limited to the colon while Crohn’s disease can occur in any part of the digestive system
  • In Crohn’s disease, healthy parts of the intestine mixed in between inflamed areas. Ulcerative colitis, on the other hand, is continuous inflammation of the colon
  • Ulcerative colitis only affects the innermost lining of the colon while Crohn’s disease can occur in all the layers of the bowel walls

In approximately 10% of cases, IBD exhibits features of both Crohn’s disease and ulcerative colitis. This is typically referred to as indeterminate colitis.

Traditional Treatment

As there is currently no cure for Chron’s disease, treatment focuses on symptom management. This is accomplished through medication – anti-inflammatories, immune suppressors, antibiotics, antidiarrheals, pain medication, and supplements including iron, calcium, B12, and vitamin D. 

Doctors also typically recommend nutritional therapy such as a low residue or low-fibre diet to reduce the risk of intestinal blockage as well as limiting dairy products, eating low-fat food and eating smaller meals

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Treating Inflammatory Bowel Disease with Cannabis 

A significant number of individuals with Crohn’s disease or ulcerative colitis currently use cannabis to treat their symptoms and report that it improved their pain, nausea and diarrhea. 

What the research says

Studies suggest that the endocannabinoid system plays an important role in the gastrointestinal system. Research provided evidence that endocannabinoid receptors are present in the colon as well as in the stomach. In the digestive tract, the endocannabinoid system appears to be involved in regulating a number of functions, including the speed of digestion, motility in the bowel and the emptying of the bowel. And activation of the cannabinoid receptors appears to decrease hypersensitivity which is likely the cause of abdominal pain associated with IBD. 

We already know that cannabis is effective in managing inflammation, but is this true in the gastrointestinal system?

A 2011 study demonstrated significant improvement in subjective disease activity following cannabis treatment. Cannabis use was associated with reduced need for other medications as well as surgery. The same research group performed the first randomized controlled trial of medical cannabis in Crohn’s Disease in 2013. Clinical remission, as defined by a Crohn’s Disease Activity Index, was achieved by 45% of those treated with cannabis, 90% demonstrated a clinical response and 25% were also able to stop corticosteroid therapy. Cannabis use was associated with significant improvements in quality of life, pain scores. 

A 2011 study found that CBD decreased inflammation in the intestines through the regulation of the immune system. 

The current research shows promise but it still preliminary, more research is necessary to understand the potential benefits of cannabis for treating IBD. 

How to Use Cannabis for IBD

There are many different ways of consuming cannabis with the most common being; inhaled (CBD vapes), CBD oil (taken sublingually, and CBD capsules. Though there are other methods that may be helpful for treating symptoms associated with IBD. These include cannabis topicals and suppositories. 

Cannabis topicals

Cannabis topicals are specifically formulated for treatment at the site of pain. Topicals are salves and lotions that can be applied to the abdomen and lower back to relieve pain associated with IBD.

More clinical research is necessary to fully understand the mechanisms involved in using cannabis topicals to treat pain (and skin conditions).

Cannabis topicals

Read more about the use of cannabis topicals (and suppositories) for premenstrual pain.

Cannabis suppositories

Suppositories are any medications that are inserted into the vagina or rectum. They’ve been used as a delivery method for a number of reasons: (1) delivering medication to the site of pain/discomfort (ex: constipation or menstrual cramps), (2) medication is quickly absorbed, (3) the person is unable to swallow medication due to problems with severe nausea vomiting or compromised esophageal or gastrointestinal tracts

Rectal suppositories are used for treating anal fissures, hemorrhoid pain, irritable bowel syndrome and Chron’s Disease, prostate issues, pain, and anal intercourse.

One of the advantages of cannabis suppositories as a treatment method for IBD is that a person can tolerate higher levels of THC without experiencing a significant ‘high’.

Making Cannabis Suppositories

Cannabis suppositories are made by combining CBD/THC oils in a carrier oil, such as cacao butter, that hardens at low temperatures. This method allows the suppository to be inserted smoothly and to dissolve quickly at body temperature.

Cannabis suppositories are relatively easy to make on your own, here’s how:

Ingredients

  • A cannabis oil of your choice (we recommend a combination of CBD and THC)
  • A base (organic cacao butter or coconut oil are recommended)
  • Suppository molds (these can be metal, silicone, or plastic and you can buy them online)

Instructions

  1. Gently heat the base in a pan.
  2. Add in the cannabis oil of your choice and mix well.
  3. Pour the mixture into the suppository mold and pop it into the freezer.

When making cannabis suppositories make sure to record the amount of cannabis you use to accurately calculate the dose per capsule. This is important in the process of determining the most effective dose. Research is still in the preliminary stages, therefore, there is no accepted effective dose for cannabis suppositories. We suggest to start at a low dose and slowly increase until you find the most effective dose for you. Note: if you want to start at a lower dose you can cut the suppository into pieces.

Final Thoughts

The research is not conclusive in regards to treating inflammatory bowel disease with cannabis, but it shows promise and many individuals are seeing success with cannabis treatment. If you have experience with using cannabis for treating inflammatory bowel disease we want to hear from you. Let us know your experience in the comments or send us a message at support@missenvy.ca.

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