Gut Health

Treating Crohn's Disease with CBD (An Introduction)

By Mary Sauer

Crohn’s is a chronic gastrointestinal disorder caused by inflammation in the digestive tract. Crohn’s is distinguished from other inflammatory bowel diseases because the inflammation associated with this disease is most commonly found in the small intestine and the first portion of the colon. Crohn’s often presents differently from patient to patient, but there are specific symptoms that set this disease apart from other irritable bowel diseases.

Individuals with Crohn’s often experience diarrhea regularly and may even experience bleeding in the rectum. Crohn’s is also associated with chronic constipation, feeling as if you can’t empty your bowels, and an urgent need to empty your bowels.

The symptoms of Crohn’s can affect other areas of your life. If you have Crohn’s, you may experience weight loss, a reduced appetite, feel fatigued, run a fever, or develop problems with menstruation.

How is Crohn’s Treated?

At this time, there is no cure for Crohn’s disease. Instead, treating Crohn’s is all about finding the right combination of lifestyle changes and medications to manage the symptoms of the disease for the long term. The medications used are typically meant to suppress the immune system and the inflammation it causes. Corticosteroids, biologics, and immunomodulators are some of the most common types of medications used for the treatment of Crohn’s, according to the Crohn’s and Colitis Foundation.

Lifestyle is an important part of managing Crohn’s. Individuals with this disease often have trouble getting the nutrients they need since their gut isn’t functioning properly. This means that a nutritious diet is crucial. It is also important to take careful notice of which foods cause flare-ups—rich and spicy foods are often a problem for people with Crohn’s.

Unfortunately, a large percentage of people with Crohn’s end up requiring surgery at some point in their life, as many as 70 percent according to the Crohn’s and Colitis Foundation.

Life With Crohn’s Disease

Living with Crohn’s does change things, even when treatment is going well. For example, socializing might require adjustments, as some people with Crohn’s have difficulty with alcohol. You might have to stay home from work during flare-ups. While stress doesn’t cause Crohn’s, it can exacerbate the symptoms so it is important to manage stress as well as possible.

For that reason, if you travel it is important to maintain a routine and diet similar to what you keep at home.

About CBD

Cannabidiol (CBD) is one of over 100 cannabinoids that can be obtained from the marijuana plant. Unlike THC, CBD doesn’t cause a psychoactive response so it will not create a high for users. CBD oil that has been derived from hemp is legal even in states that have not jumped on board with legalized medical marijuana.

We are always learning more about CBD and how its effect on the body can be used to manage pain, decrease anxiety, and lower inflammation. We have a lot more to learn, but here is what we know about using CBD to manage the symptoms of Crohn’s disease.

Can CBD Oil Treat Crohn’s?

CBD has become incredibly popular as an alternative treatment for many chronic disorders but is it a good choice for management of Crohn’s? Since there is no cure for Crohn’s, the main goal for using CBD would be to reduce the difficult symptoms like pain and discomfort.

Unfortunately, the research on the effectiveness of CBD to treat Crohn’s isn’t conclusive at this point. In 2009, the Journal of Molecular Medicine published a study that found that CBD effectively reduced inflammation in mice after an inflammatory bowel disease was induced by the researchers.

A 2017 study published in Digestive Diseases and Sciences examined the effect of CBD on Crohn’s disease over the course of two weeks. While they did conclude that the low dose they used was safe, they also determined that it was not effective. The researchers concluded that they were not certain if this meant that CBD doesn’t help the symptoms of Crohn’s or if it meant that the dose the used was too small.

According to Rachna Patel, MD, who specializes in the treatment of chronic disease using CBD and medical marijuana, it is likely THC that is the missing component when using CBD to manage Crohn’s.

“Crohn’s is one of those conditions where you do need some amount of THC to benefit the condition,” she says. “That is typically because there is underlying inflammation with Crohn’s and both CBD and THC are anti-inflammatories and when used together you have what’s called the entourage effect.”

Published research agrees with this claim. For example, a 2010 study published in the British Journal of Pharmacology observed that the combination of CBD and THC together was more effective for reducing inflammation in patients with Crohn’s. CBD oil derived from marijuana, not hemp, is rich in THC — making it illegal in many states due to its psychoactive effect. However, full-spectrum hemp-derived products do have small amounts of THC.

Even though hemp-derived CBD may not directly decrease the inflammation caused by Crohn’s, many patients are using CBD to managing the symptoms of their condition, according to Arun Swaminath, MD, director of the Inflammatory Bowel Diseases Program at Lenox Hill Hospital and representative for the Crohn’s and Colitis Foundation.

“Some older studies suggested about 10 to 12 percent of patients with IBD are regular users of cannabis,” he says. “It was to control diarrhea, to control abdominal pain, to improve their appetite. Clearly, people are finding some benefit from it. Whether it is sort of controlling the symptoms so they feel better versus changing what is happening with the disease may be different questions and we don’t have the answer to that yet.”

What You Need to Know About Using CBD

Cannabidiol (CBD) oil has very few side effects and is recognized as safe by the World Health Organization. That being said, some individuals might experience mild side effects like drowsiness, appetite changes, nausea, or dizziness.

We also know that there are specific medications that can interact with CBD so it is important to find a provider who is willing to review your current medications and advise you on adding CBD to your treatment plan. If you are already using cannabis or CBD to manage the symptoms of your Crohn’s, this is important information to disclose to your care provider, according to Swaminath, who points out that some people are experiencing adverse side effects like dependence and abdominal pain related specifically to cannabis use. In order to properly monitor you for those side effects, your doctor needs full knowledge of your use.

Additionally, Swaminath suggests that speaking with your doctor about why you are using cannabis will open a conversation about why you are using it that could lead to better treatment options for your Crohn’s condition.

“Is it because there is not complete control of the underlying disease process? If that’s true then I think it’s fair to give a chance for standard therapy to be improved or changed or optimized so that those symptoms that can be controlled will be controlled.”

Finally, Swaminath believes that all Crohn’s patients should have the opportunity to have their symptoms managed well. When optimization of conventional treatment doesn’t provide to improved quality of life each patient deserves, he feels comfortable with idea that cannabis might need to be a part of the treatment plan. The hope of the Crohn’s and Colitis Foundation is that policy change will allow for better research to be done in order to provide clear answers about the role of CBD and cannabis for managing or treating Crohn’s.

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