Crohn’s disease is a type of inflammatory bowel disease prevalent in teenagers and young adults. Studies have shown that cannabis is effective in reducing inflammation of the digestive tract, and in some cases can offer long-term relief.

Crohn’s Disease Overview

Crohn’s is a type of medical condition classified as IBD, or inflammatory bowel disease, that affects the lining of the digestive tract. In Brazil there are still no official statistics, while in the United States, more than 700,000 people suffer from the disease, according to the American Colitis and Crohn’s Foundation. Common symptoms include abdominal pain, rectal bleeding, severe diarrhea, fever, weight loss, fatigue and malnutrition. The pain can be so intense that it becomes debilitating. In some cases, the disease can be fatal.

The most commonly affected area of ​​the digestive tract is the end of the small intestine (the ileum) and the beginning of the colon. However, the disease can affect any part of the digestive system, and it is common to eventually spread to all layers of tissue.

Abnormal behavior of the immune system and hereditary factors are probably the causes of Crohn’s disease. Those who have a family member diagnosed with the clinical condition are more likely to also develop it. Sometimes, when the immune system fights viruses, bacteria, fungi and other microorganisms, it can overreact and attack healthy cells in the digestive tract, causing inflammation.

There is no confirmed cure for Crohn’s disease, but some treatments can significantly reduce symptoms and, sometimes, offer complete remission. The main treatments include antibiotics, anti-inflammatories, anti-diarrhea and analgesics to manage symptoms. In some cases, tube feeding can help reduce inflammation, giving the digestive tract a rest. In others, a surgical procedure may be necessary to remove the damaged part.

Effects of cannabis on Crohn’s disease

Studies have found that cannabis effectively combats symptoms associated with Crohn’s disease. Cannabinoids offer anti-inflammatory and analgesic effects, relief from nausea and generalized malaise 5,12. A study in which IBD patients were treated with cannabis for three months revealed improvements in general health, ability to work and socialize, offering relief from physical pain and depression. Participants also noted an increase in weight and BMI or body mass index 7.

In another study, patients suffering from IBD reported that marijuana was “very helpful” in relieving abdominal pain, nausea and diarrhea 11. Cannabis was also found to reduce depression, abdominal pain and fatigue, improving appetite, activities and sleep in patients with Crohn’s disease 3,6. Apparently, in addition to improving symptoms associated with the disease, cannabis is also associated with a reduction in the dose of other medications used by patients 9.

Research also suggests that cannabis may be effective in long-term disease remission. The use of the plant has been associated with an improvement in clinical condition 10. In one study, cannabis rich in THC (tetrahydrocannabinol) produced significant benefits in 10 of 11 patients with active disease – without side effects – and 5 of these 11 individuals achieved complete remission 9. In another, 21 of 30 patients diagnosed with Crohn’s disease improved considerably after treatment with cannabis. The plant has demonstrated positive effects on the manifestation of the disease, reducing the need for other medications and surgeries 8.

Recent studies on cannabis and Crohn’s disease

• A clinical study demonstrated that cannabis produces significant clinical benefits in patients with Crohn’s disease, including reduced sensations of pain, relief from nausea and generalized discomfort. Cannabis in the treatment of Crohn’s disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4076530/
• THC-rich cannabis produced considerable steroid-free clinical benefits in 10 of 11 patients with active Crohn’s disease when compared with placebo, without side effects. Cannabis induces clinical response in patients with Crohn’s disease: a prospective placebo-controlled study. http://www.cghjournal.org/article/S1542-3565(13)00604-6/fulltext
• Three months of treatment with inhaled cannabis led to an improvement in quality of life, disease activity index and increase in weight and body mass index in patients with inflammatory bowel disease. Impact of cannabis treatment on quality of life, weight and disease activity in patients with inflammatory bowel disease: a prospective pilot study. https://www.karger.com/Article/Purchase/332079

References:

1. Acharya, N., Penukonda, S., Shcheglova, T., Hagymasi, A.T., Basu, S., and Srivastava, P.K. (2017, March 27). Endocannabinoid system acts as a regulator of immune homeostasis in the gut. Proceedings of the National Academy of Sciences of the United States, 114(19), 5005-5010. Retrieved from
   http://www.pnas.org/content/114/19/5005.full.
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4. Fouad, A.A., Al-Mulhim, A.S., and Gomaa, W. (2013, October). Protective effect of cannabidiol against cadmium hepatoxicity in rats. Journal of Trace Elements in Medicine and Biology, 27(4), 355-363. Retrieved from
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6. Jamontt, J., Molleman, A., Pertwee, R., and Parsons, M. (2010). The effects of Δ9-tetrahydrocannabinol and cannabidiol alone and in combination on damage, inflammation and in vitro motility disturbances in rat colitis. British Journal of Pharmacology, 160(3), 712–723. Retrieved from
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7. Lahat, A., Lang, A., and Ben-Horin, S. (2012). Impact of cannabis treatment on the quality of life, weight and clinical disease activity in inflammatory bowel disease patients: a pilot prospective study. Digestion, 85(1), 1-8. Retrieved from
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8. Naftali, T., Lev, L.B., Yablecovitch, D., Half, E., and Konikoff, F.M. (2011, August). Treatment of Crohn’s disease with cannabis: An observational study. The Israel Medical Association Journal, 13(8), 455-8. Retrieved from
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9. Naftali, T., Bar-Lev Schleider, L., Dotan, I., Lansky, E.P. Sklerovsky Benjaminov, F. and Konikoff, FM. (2013, October). Cannabis induces a clinical response in patients with Crohn’s disease: a prospective placebo-controlled study. Clinical Gastroenterology and Hepatology, 11(10), 1276-1280. Retrieved from
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11. Ravikoff Allegretti, J., Courtwright, A., Lucci, M., Korzenik, J.R., and Levine, J. (2013, December). Marijuana use patterns among patients with inflammatory bowel disease. Inflammatory Bowel Diseases, 19(13), 2809-14. Retrieved from
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12. Schicho, R., and Storr, M. (2014). Cannabis finds its way into treatment of Crohn’s disease. Pharmacology, 93(1-2), 1-3. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4076530/.
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