Can Marijuana or CBD Help With My Crohn’s Disease?

If you are in treatment and still have symptoms of Crohn’s disease, it is reasonable to ask if alternative therapies might help. Two related options that have become increasingly popular recently are marijuana and CBD. Both come from different varieties of a plant known as Cannabis sativa, or just cannabis. People also call herbal products that come from hemp CBD.

Some people with inflammatory bowel disease (IBD), including Crohn’s disease, use cannabis of one type or another to relieve their symptoms. There is also some evidence that cannabis can help with certain symptoms of Crohn’s disease, including improved appetite and sleep. But there are a lot of things to consider before you run out of trying. On the one hand, while some people seem to feel better when they use cannabis, it is not certain that it helps to fight their disease.

“We know that the effects of cannabis on the gut and the brain can have an impact,” says Jami Kinnucan, MD, gastroenterologist at the University of Michigan. “So the question asked is, is there an objective improvement? Is the inflammatory burden changing? “

The answer is no, she said. There is no objective improvement in inflammation.

This is important because Crohn’s disease is an inflammatory disease. Many treatments prescribed by your doctor help you feel better by controlling inflammation. So far, it seems like cannabis makes you feel better too, but without controlling your IBD. According to Kinnucan, one of the reasons this is a problem is that cannabis could mask or hide the symptoms.

“If you regularly experience abdominal pain, you need to look at the disease,” she says. “Often it is not processed or contracted out. You don’t want to use cannabis as a dressing. “

What the studies say

Experts generally agree that cannabis data for Crohn’s disease is uncertain at this time. The only data on people with Crohn’s disease comes from three small clinical studies. In total, these studies include less than 100 people with active Crohn’s disease.

Only one of the three suggests that cannabis in the form of marijuana cigarettes could help people who had not done well with other treatments to control their disease. Five in 11 people who smoked cannabis cigarettes for 8 weeks in the study had remission, compared to one in the group who smoked placebo cigarettes. The other two studies looked at CBD oil. Neither has found that CBD helps people control their Crohn’s disease. One of them showed that the treatment helped improve the quality of life.

Continued

More research is needed in more people with Crohn’s disease, and studies are ongoing. One of the reasons it’s complicated is that cannabis comes in many varieties. The plant contains two main active ingredients: THC (short for delta-9 tetrahydrocannabinol) and CBD (short for cannabidiol). It’s the THC in marijuana that gives you a high. The CBD products you can buy are usually made from hemp and shouldn’t contain a lot of THC. We need more time to study the different compounds found in cannabis.

The available evidence – while not convincing – does not rule out the possibility that cannabis may help some people with Crohn’s disease. Kinnucan says that one of the reasons the studies so far don’t show a benefit is that they might not use the best formulations of cannabis. There is experimental evidence that cannabinoids can help fight inflammation. But, she says, it might take a more targeted approach to see these benefits in people with IBD. The existing studies have also been small in scope and short term.

“If we followed patients for longer, we might see benefits,” Kinnucan says. “Maybe 8 weeks is not long enough.”

To consider

For someone with Crohn’s disease interested in using cannabis, Kinnucan says there’s no reason to think it will help if you’re already feeling well and your disease is in remission. For someone who has Crohn’s disease but doesn’t have obvious symptoms, it is possible that adding cannabis to other medications could have benefits, although these are unproven. If you want to replace their prescribed drugs with cannabis, she says, “we certainly don’t have any evidence to back it up.”

People who use cannabis are more likely than those who do not stop traditional therapy. And there are risks when you stop taking the treatment you need. “One of the biggest risks of relapse is hospitalization requiring steroids or surgery,” says Kinnucan.

She says to talk to your doctor about your interest in cannabis and the symptoms you hope to control. Many doctors may not be comfortable having these conversations, but she encourages them as a way to learn more about the symptoms, and people use cannabis alone. Ultimately, given the limited evidence on cannabis and the uncertainty over its safety, it is difficult for doctors to give advice.

Continued

“Providers don’t know what to say to patients who say, ‘OK, I want to start cannabis. What should I do? Kinnucan says. “Advice on how to counsel patients is limited.”

Your doctor may have other ideas on how to help you feel better. For now, if you’re ready to give it a try, Kinnucan suggests starting with the lowest concentration of THC and going from there to limit potential side effects. Work with a medicinal pharmacy who may have further advice on what is available.

The Crohn’s and Colitis Foundation’s official position statement on medical cannabis notes that while there is some evidence that cannabinoids found in our bodies might naturally help fight inflammation, it is less clear than similar compounds in cannabis. do. There is some evidence that cannabis can help relieve symptoms, but its use is limited by other concerns about side effects and safety.

There are also legal issues to consider when it comes to cannabis. CBD is federally legal and it’s getting easier to get. Marijuana is not federally legal. More and more states allow it, but the rules and restrictions vary. If you are considering using or recommending medical cannabis, CBD, or marijuana, you should carefully check the laws in your state. Employers may also have drug use policies to consider.

Sources

SOURCES:

Mayo Clinic: “Medical Marijuana”.

Expert review in gastroenterology and hepatology: “An Overview of Cannabis Treatment in Crohn’s Disease.”

Clinical gastroenterology and hepatology: “Cannabis induces a clinical response in patients with Crohn’s disease: a prospective placebo-controlled study.”

Jami Kinnucan, MD, gastroenterologist, University of Michigan.

Cochrane Database of Systematic Reviews: “Cannabis for the treatment of Crohn’s disease.”

Crohn’s and Colitis Foundation: “Foundation Position Statement: Medical Cannabis”, “Medical Cannabis”.


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