Crohn’s disease and marijuana. Can pot really treat Chrohn’s? Evidence suggests it can. Cannabis has long been a go-to remedy for people dealing with various conditions affecting the gut, including Crohn’s disease, gastrointestinal distress, nausea, and upset stomach. In fact, cannabis has been used for literally thousands of years to treat digestive issues. While the first medical texts reference cannabis as early as 1500 BCE, the first recorded use of it was 2700 BCE or earlier.
There’s a voluminous amount of evidence demonstrating marijuana’s ability to alleviate nausea, improve appetite, and shall we say – cough, cough – calm your bowels. However, this is not to say that using cannabis to treat digestive issues isn’t accompanied by a few risk factors.
Before we explore the good and the bad, let’s look at how cannabis impacts the gut in the first place. The primary cell receptors that cannabinoids interact with are the CB1 and CB2 receptors. Cannabis contains more than 100 active cannabinoids and dozens of terpenes. These phytocannabinoids (phyto- refers to plant) engage the various cells in the body through the endocannabinoid system (eCS), a massive and intricate communications network in the body. Similarly, the body naturally produces cannabinoids — called endocannabinoids (endo- means “within”) — that are identical to phytocannabinoids.
The endocannabinoid system (i.e. endogenous circulating cannabinoids) performs protective activities in the GI tract and presents a promising therapeutic target against various GI conditions such as inflammatory bowel disease (especially Crohn’s disease), irritable bowel syndrome, and secretion and motility-related disorders.
Interestingly, the eCS influences nearly every aspect of our physical and emotional health, particularly our digestive system. The primary responsibility of the eCS is to maintain homeostasis, a stable state or equilibrium.
Numerous interactions occur between the brain, the immune system, and the gut, triggering signal messages that produce many kinds of biochemical interactions. The gastrointestinal (GI) tract houses 80% of the immune system and also contains cannabinoid receptors. Research has shown that high levels of endocannabinoids are found throughout the digestive system.
The eCS plays an integral role in many aspects of the GI tract, including:
Scientific research into the eCS has revealed a number of potential roles for cannabis to improve symptoms of gastrointestinal diseases. While cannabis use is already common among patients with Crohn’s disease or GI, many patients and medical professionals lack a solid understanding of both the benefits and risks of using cannabis.
There’s a vast amount of research demonstrating how the endocannabinoid system plays a significant role in the digestive system, from gastric acid production and gastrointestinal motility to nausea and hunger, among other functions. However, placebo-controlled clinical studies (the gold-standard in research) were almost non-existent until recently.
An Israeli prospective placebo-controlled study , the first clinical study to study whether cannabis can induce remission in patients with Crohn’s disease, included 21 patients (13 men, 8 women with a mean age 40 years old) with Crohn’s Disease Activity Index (CDAI) scores greater than 200 who did not respond to therapy with steroids, immunomodulators, or anti-tumor necrosis factor-α agents. Patients were given cannabis cigarettes (aka “joints”) with 115 mg of Δ9-tetrahydrocannabinol (THC) or placebo (cannabis flowers with no THC).
5 of the 11 subjects achieved total remission compared to only 1 of the 10 subjects in the placebo group. At nearly 50%, that’s impressive! Perhaps even more impressive was the finding that 10 of 11 subjects in the cannabis group achieved a positive response, with 3 patients being able to get weaned off of steroid dependency. Among the positive effects observed, in addition to improved digestive function, were an improved appetite and sleep. No significant side effects were reported.
If you’re interested in reading the study, follow the link below:
Tel Aviv University, Israel: Cannabis induces a clinical response in patients with Crohn’s disease: a prospective placebo-controlled study.
Cannabis use also comes with certain risks. For one, its reduction in symptoms may mask ongoing inflammation, making patients think their disease is in remission when it’s not:
Dr. Ahmed’s paper published in November 2016 in the journal Gastroenterology & Hepatology.
And a study published in March 2014 in the journal Inflammatory Bowel Diseases showed that cannabis use might actually increase the risk of surgery in people with Crohn’s.