Crohn’s Disease and Ulcerative Colitis are two related, auto-immune diseases that cause vast burden on their sufferers.  They are characterized by damage done to the gut by a person’s own immune system; hence they are called auto-immune or Inflammatory Bowel Disease (IBD).  IBD should not be confused with IBS (Irritable Bowel Syndrome) which is felt to have a different cause.  

IBD leads to abdominal pain, diarrhea (often bloody), poor appetite, poor nutritional absorption, and weight loss.  Sometimes bowel obstruction or fistulae (tunnels from the bowel to other parts of the body) can result, leading to infections.  

Conventional treatment of IBD can be quite successful.  These treatments focus on medications that calm down the immune system to hopefully stop attacking the person.  This may include a range of types of medications including steroids, classic immunosuppressants like Azathioprine or Methotrexate, and newer agents like Adalimumab (Humira) or Infliximab (Remicade). 

In some cases, the conventional medications are not sufficient to achieve full remission of the disease and its symptoms.  This is where cannabis can play a helpful role.  To better understand this, we need to think about treatment in two ways:  symptom management and disease modification.  

Long ago Crohn’s patients discovered that cannabis could help their symptoms.  Since then, numerous studies have shown that cannabis can decrease the burden of symptoms for OBD patients.  This includes diminishing abdominal pain, nausea and vomiting, as well as increasing appetite and helping to regain lost weight.  While most of these studies looked at patients using cannabis via smoking, which we don’t recommend as smoke exposure is not a great idea, there are newer safer approaches that work as well if not better.  (Incidentally, this does not include vape pens which have been shown to be worse for you than smoking). Your Cannabinoid Specialist can help formulate a treatment plan that will be helpful and safe.  

Yet, interestingly, these same studies of cannabis for IBD have repeatedly shown that ordinary (THC-dominant) cannabis does NOT lead to calming down the immune system or modifying the disease itself.  So cannabis can make you feel better, but won’t prevent the more serious complications of the disease.  

The science behind our understanding of other cannabinoids found in cannabis is just beginning.  There are many to explore.  We know already that CBD can be an anti-inflammatory, but does not seem to exert much benefit in IBD (as well as having many drug interactions).  Other cannabinoids like CBG that are anti-inflammatory in the lab have yet to be investigated in humans with IBD.  THC-A, which is a non-psychotropic precursor of THC, has the best data so far, demonstrating 20x the anti-inflammatory power of CBD, with no drug interactions, no intoxication, and is readily available in cannabis plants (see recipe for home extraction of THC-A). 

At present, THC-A is our best bet for actually changing the course of the underlying IBD.  In the course of my practice, I have helped many Crohn’s and Ulcerative Colitis sufferers feel better with cannabis, and in many instances get them across the finish line into complete remission using THC-A in conjunction with their conventional medications.  

For patients with IBD, cannabis treatment using a range of available options presents an exciting pathway to both feeling better and halting the progression of the disease.