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Medical Marijuana and Inflammatory Bowel Disease
TruthOnPot.com – Inflammatory bowel disease affects over 1.5 million individuals in the United States and approximately 0.5% of the Canadian population. And while there are a variety of treatments on the market today, many patients seem to be turning to medical marijuana for relief.
In fact, a Canadian survey published in 2011 found that 50% of patients with ulcerative colitis or Crohn’s disease had tried marijuana before. Of these patients, 33% with ulcerative colitis and 50% with Crohn’s disease said that cannabis helped them to deal with a number of symptoms, including abdominal pain, diarrhea and reduced appetite.
Likewise, research seems to confirm what many patients have already discovered for themselves – medical marijuana can provide effective relief from inflammatory bowel disease.
What is Inflammatory Bowel Disease?
Inflammatory bowel disease is a broad term used to describe conditions that involve chronic inflammation of the gastrointestinal tract. The two main types of inflammatory bowel disease are ulcerative colitis and Crohn’s disease.
While both diseases involve gastrointestinal inflammation and symptoms of frequent bowel movements, diarrhea, abdominal pain, fever and weight loss, ulcerative colitis only affects the colon whereas Crohn’s disease can occur anywhere between the mouth and the rectum.
Treatment of inflammatory bowel disease usually may involve various medications or, in severe cases, colorectal surgery. On the other hand, a growing body of evidence suggests that medical marijuana might be an effective treatment option for sufferers of inflammatory bowel disease that poses a lesser risk of side-effects and even reducing the need for surgery.
Endocannabinoids and Bowel Regulation
Cannabinoids are produced naturally by all humans and act on cannabinoid receptors located in various parts of the body. These components, which together make up the endocannabinoid system, are known to play a role in a number of digestive processes, including food intake, protection of the intestinal tract and inhibition of nausea and vomiting.
Interestingly, studies reveal altered endocannabinoid and cannabinoid receptor levels in patients with ulcerative colitis and Crohn’s disease, especially during flare-ups. Likewise, studies have also identified higher levels of cannabinoid receptors in colon tissues sampled from patients with inflammatory bowel disease.
Based on these findings, experts believe that the endocannabinoid system could be targeted in the treatment of ulcerative colitis and Crohn’s disease in order to regulate gastrointestinal overactivity, inflammation, abdominal pain and other symptoms associated with the disorders.
Animal Studies – The Evidence
Studies conducted on animal models of inflammatory bowel disease have revealed a number of positive results from cannabinoid treatment.
For example, numerous studies show that cannabinoids can reduce overactivity of the intestinal tract caused by inflammation, helping to normalize gastrointestinal movements in inflammatory disease states. In fact, a study published in 2010 found that treatment with THC alone or a combination of THC and CBD could be more effective at reducing intestinal overactivity than sulfasalazine – a drug that is widely-prescribed for patients with ulcerative colitis and Crohn’s disease.
Cannabinoids are also known to possess strong anti-inflammatory properties, which seem to extend to inflammatory bowel disease. For instance, the same 2010 study demonstrated that both THC and CBD were able to reduce intestinal inflammation and damage in rats. Other studies have explained how cannabinoids act to reduce inflammation by suppressing or even killing inflammatory molecules.
Finally, a study published in 2006 found that activation of either CB1 or CB2 receptors resulted in a reduction in abdominal pain (measured by number of abdominal contractions) related to intestinal inflammation in rats.
Human Studies – The Evidence
Research on humans mostly comes from cell cultures of ulcerative colitis and Crohn’s disease, although the results of 2 clinical trials have already been published.
The first trial, published in 2012 by Tel Aviv University researchers, involved 13 patients with inflammatory bowel disease. The study found that after 3 months of using medical marijuana, patients scored higher on disease activity and overall quality of life assessments. Furthermore, the patients gained an average of 4.3 kg in weight over the 3 month period, suggesting that cannabis treatment could counter the weight loss symptoms that many patients with inflammatory bowel disease are faced with.
The second trial, published in 2013 by researchers at the Meir Medical Center (Israel), found that smoking cannabis twice a day over an 8 week period helped to relieve symptoms of Crohn’s Disease in 10 out of the 11 patients that were treated, with 5 of these patients achieving complete remission. Patients that underwent cannabis treatment also reported improvements in sleep and appetite with no significant side-effects.
In addition to clinical trials, the results of an observational study were also published by a group of Israeli researchers in 2011. The study involved 30 patients with Crohn’s disease, 21 of which experienced significant improvements after using medical marijuana. Notably, the average number of bowel movements among the patients decreased from 8 a day to 5. Furthermore, medical marijuana seemed to reduce the patients’ need for other medications and surgical interventions.
Interestingly, studies involving cell cultures also suggest a protective effect of cannabinoids against oxidative stress, which is believed to play a role in the progression of ulcerative colitis and Crohn’s disease as well as related tissue damage.
Likewise, a study published in 2005 found that activation of cannabinoid receptors induced wound-closure in human colon cells, suggesting that cannabinoids might be able to counter the delayed healing of intestinal lesions in patients with inflammatory bowel disease.