Irritable Bowel Disorder (IBD) actually refers to several different types of conditions that create inflammation in the stomach and intestinal tract. They are likely caused by infections or dietary factors. Most of those affected by IBDs are usually female between the ages 15-35.
Irritable Bowel Syndrome (IBS) is a condition in the small and large intestine, affecting in 1 in 6 people in the US. Symptoms include cramping or intestinal pains as well as bloating and mucus in the stools. Constipation or diarrhea can also occur. Symptoms are usually relieved with a bowel movement. IBS can be brought on (or made worse) by stress, food allergies and intestinal inflammation. It is not considered to be inflammatory bowel disease as that there is nothing structurally wrong with the bowels. People with IBS may have a problem with the way their muscles in their intestines work and have increased sensitivity to stretching or movement.
Crohn’s Disease is an autoimmune inflammatory disease of the bowel wall. It has a higher incidence in Jewish people and can be passed down through generations. Crohn’s patients essentially have an overactive immune system that attacks the normal parts of the intestinal tract. This leads to many different symptoms: cramping abdominal pain, bloating, fatigue, loss of appetite, pain when using the restroom, persistent diarrhea or constipation, unintentional weight loss, bloody stools, joint pain, and fistula formation.
Ulcerative Colitis is another autoimmune inflammatory disease of the lining of the colon and rectum. Often bloody diarrhea accompanies this disease. Just like Crohn’s, the cause of ulcerative colitis is unknown but symptoms of stress, smoking cigarettes and certain foods can trigger symptoms. The symptoms are similar to Crohn’s – abdominal pain, cramping, bloody stools, diarrhea, nausea, vomiting, fever, weight loss, joint pain and mouth sores.
Diverticulitis occurs when pouches in the wall of the large intestine become inflamed and painful, often as a result of bacterial overgrowth. The pouches themselves form naturally as we age which is called diverticulosis.
Patients with these conditions are advised to pay attention to their diet to see if certain foods make the symptoms worse. They should also try and lower their stress as this can worsen their condition. Medications that suppress inflammation and the immune system are sometimes prescribed but can have serious side effects.
Intestinal Disorders and Cannabis
NOTE FOR FIRST TIME READERS: Cannabinoids – such as THC, CBD – and terpenes are the main medically active components in cannabis (aka marijuana). For more information on these components, and much more about the plant, see our section on the Science of Cannabis.
The gastrointestinal (GI) tract houses 80% of the immune system. It also contains cannabinoid receptors that are part of the endocannabinoid system in all humans. Cannabis is both an anti-inflammatory and an immune modulator that can benefit the endocannabinoids that are found throughout the digestive system, which makes it a good choice of medicine for IBDs. In 2011 researchers at the University of Bath Hospital in England compared GI tract samples from healthy people and IBD patients. They found that as the disease progresses in IBD patients the presence of CB2 cannabinoid receptors increases in their GI tract. They also found that the CB1 receptor helps to heal wounds in the lining of the gut. In other words IBD patients’ bodies demand more cannabinoids to fight the disease. In addition, the CB1 receptor has specifically been found to inhibit the motility of (i.e. calm) the intestine. Therefore cannabis can help reduce diarrhea and intestinal spasms.
In one study, CBD was shown to normalize the flow of food and nutrients through the intestines by decreasing the inflammation. A normal flow of food means less diarrhea and constipation. In a human study from the Mayo Clinic in Minnesota, it was shown that one dose of synthetic THC relaxed the colon and eased post-eating cramping when compared to a placebo. Researchers in the UK found that the cannabinoids promoted healing in the gastrointestinal membrane, which may explain why many colitis patients report an improvement of their symptoms when they use cannabis. A recently published report in the Israel Medical Journal reported that Crohn’s patients using medical marijuana had reduced the impact of the disease and had less need for prescription drugs or surgery.
Ulcerative colitis and Crohn’s disease patients report that using medical cannabis relieves painful cramps and increases their appetite. This last effect is very important because Crohn’s patients are often undernourished. It is confirmed that both THC and CBD are effective for IBD, as they are both anti-inflammatory agents. Ingestion of cannabis (eating edibles) is a good way to treat intestinal disorders as the medicine is delivered directly to the digestive tract. For example, a digestible cannabis capsule is released into the small intestine, providing long-lasting relief for up to 8 hours. This is ideal for an overnight dose.
Wright K, et al. Differential expression of cannabinoid receptors in the human colon: cannabinoids promote epithelial wound healing. Gastroenterology. 2005, 129(2): 437-453.
Department of Experimental Pharmacology and Endocannabinoid Research Group, University of Naples Federico II, Naples, Italy, Cannabinoids and gastrointestinal motility: animal and human studies. European Review for Medical and Pharmacological Sciences. 2008, Aug: 81-93.
Borelli F, et al. Cannabidiol, a safe and non-psychotropic ingredient of the cannabis plant Cannabis sativa, is protective in a murine model of colitis. Journal of Molecular Medicine. 2009, 87: 1111-1121.
Esfandyari T, et al. Effects of a cannabinoid receptor agonist on colonic motor and sensory functions in humans: a randomized, placebo-controlled study. American Journal of Physiology/Gastrointestinal and Liver Physiology. 2007, 293: 137-145.
Izzo AA, Coutts AA. Cannabinoids and the digestive tract. Handbook of Experimental Pharmacology. 2005, 168: 573-598.
Naftali T, et al. Treatment of Crohn’s disease with cannabis: an observational study. Israel Medical Association Journal. 2011, 13(8): 455-8.