Cannabinoids and Inflammatory Bowel Diseases (IBD)

Crohn’s disease and ulcerative colitis are part of a family of diseases known as inflammatory bowel diseases (IBD).

Crohn’s disease is characterized by an irregular inflammation that can affect any part of the gastrointestinal tract (GI tract). Symptoms of this disease include:

  • Abdominal pain
  • Diarrhea
  • Weightloss
  • Discomfort
  • Intestinal obstructions may occur due to the formulation of fistulas or abscesses, secondary to chronic inflammatory processes, in the walls of the GI tract [1] .

Crohn’s disease mainly affects the lower end of the small intestine and the beginning of the large intestine but can affect any part of the digestive tract, from the mouth to the end of the rectum (anus). Although the cause of this condition is unknown, it is believed that it could be caused by a combination of bacterial, environmental, and immunologic factors (autoimmune disorders).

Ulcerative colitis is characterized by diffuse mucosal inflammation that is limited to the colon. Symptoms usually include bloody diarrhea, abdominal cramping, urgency, and tenesmus.

Both diseases are associated with an equivalent increase in the risk of developing colon carcinoma.

treatment with cannabis medicinal for Crohn

Effects of cannabinoids

  • Anti-inflammatory
  • Improve intestinal motility
  • Analgesic
  • Sense of well-being
  • Decreases the rate of activity of the syndrome.

Summary

The anti-inflammatory and analgesic effect of cannabinoids improve the symptoms of patients with inflammatory bowel diseases. Several studies suggest that cannabinoids could offer improvements in the progression and symptomatology of these conditions.

The effect of cannabinoids at an intestinal level

The effect of cannabinoids for these types of ailments are:

  • They are anti-inflammatories [2]
  • They regulate intestinal motility [3]
  • They are natural analgesics [4]

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How cannabinoids interact with inflammatory bowel diseases

The GI tract contains CB1 and CB2 receptors along its’ entire path [5].

The distribution of these cannabinoid receptors can change during the evolution of various intestinal diseases [6]. Several clinical studies have shown that cannabinoids can act through CB2 receptors and reduce inflammation. This suggests that there is a therapeutic potential for this type of drug in the treatment of inflammatory bowel diseases [7].

Clinical trials have shown that the intestine contains higher levels of CB1 and CB2 receptors, and that is why both THC and CBD are used for the treatment of these types of diseases. They seem to reduce symptomatology and improve metabolic processes which is why patients who decide to use cannabinoids for the treatment of Crohn’s will decrease their traditional medication drastically due to improvements in their symptoms. Other clinical trials also report a decrease in the rate of activity of the syndrome by more than 40%.

A study conducted by Nftali, T. et al [8], determined that the benefits observed during the use of cannabis in patients with Crohn’s are mainly due to its anti-inflammatory properties. However, cannabinoids could also play an important role as they have antidiarrheal effects as well as having influence over gastrointestinal motility (as seen in mice injected with cholera toxins). Another property to consider is the sensation of well-being that cannabinoids can produce.

Bibliography for cannabinoids and inflammatory bowel diseases

[1] Mowat, C., Cole, A., Windsor, A., Ahmad, T. and others. (2011). Guidelines for the management of inflammatory bowel disease in adults.

[2] Márquez, Lucía y otros. Sistema endocannabinoide e inflamación intestinal. Medicina Clínica. Volume 131, Issue 13, October 2008

[3] Angelo A Izzo. Cannabinoids and intestinal motility: welcome to CB2 receptors. 2004

[4] Jaseena Elikottil, MBBS, Pankaj Gupta and Kalpna Gupta. The Analgesic Potential of Cannabinoids. J Opioid Manag. 2009 Nov-Dec

[5] Wright, K., Rooney, N., Feeney, M., Tate, J. and others. (2005). Differential expression of cannabinoid receptors in the human colon: cannabinoids promote epithelial wound healing. Gastroenterology. 129: 437-453.

[6] Márquez, L., Suarez, J., Iglesias, M., Bermúdez-Silva, F. J. and others. (2009). Ulcerative colitis induces changes on the expression of the endocannabinoid system in the human colonic tissue.

[7] Federico Massa and others. The endogenous cannabinoid system protects against colonic inflammation

[8] Rimna Naftali MD, Lihi Bar Lev BA, Doron Yablekovitz MD, Elisabeth Half MDand Fred M.Konikoff MD (2011). Treatment of crohn’s disease with cannabis: An observational study.

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 Treatment with medicinal cannabis for Crohn
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