CBD Oil for Crohn's Disease or Ulcerative Colitis

It's touted to treat a variety of health conditions but evidence is scarce

Research into cannabinoid oils.

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Cannabidiol (CBD) has become popular in recent years to treat a variety of health conditions. CBD, which is derived from the cannabis plant, is widely available for use in different types of products, such as oral supplements or skin products. The use of CBD oil to treat inflammatory bowel disease (IBD) is in question. There has been some initial study into how CBD may affect Crohn’s disease or ulcerative colitis, but this is mostly in mice and in laboratories, not on humans. This article will explore some of the work into how CBD might affect the body and if it could be effective for treating the symptoms of IBD. Keep in mind: a gastroenterologist should be consulted before trying any new therapies to treat IBD.

Basics of Cannabidiol Oil

CBD oil contains the compound cannabidiol, which is extracted from the cannabis plant (also called marijuana). CBD oil does not contain tetrahydrocannabinol (THC), which is the compound in cannabis that creates the “high” (or as it might be called in more clinical terms, psychoactive properties or euphoria). However, it should be noted that some forms of CBD oil are marketed as containing a certain amount of THC, so it’s important to carefully research products before purchasing and using them.

CBD oil is available in a variety of forms. It is often sold as an oil that is taken by mouth but can also be found in sprays, tinctures, creams, salves, capsules, and many other products.

The CBD is put in a carrier oil to make the product. The carrier oil could be olive, avocado, grape seed, palm, coconut, hemp seed, or something else. The carrier oil may or may not make a difference—it might have more to do with personal preference and any allergies or intolerances a person might have to the ingredients in the oil. Certain oils might be better suited to certain products than others.

There could also be other additives to the CBD oil, such as flavorings. In addition, the amount of CBD in a particular product is variable. Again, reading the label is important to understanding how to determine dosage.

How CBD Affects the Body

CBD is thought to have an effect on the endocannabinoid system. Research into how marijuana affects the body was scarce until the last two decades, largely because of legal reasons and concerns over addiction that began in the first part of the 20th century.

The discovery of the endocannabinoid system resulted in more interest in understanding how cannabinoid receptors work in the body. Endocannabinoids are chemicals produced by the body which are similar to those found in the cannabis plant.

Endocannabinoids and cannabinoids bind to receptors in the body and have an effect on regulating several different body systems, including digestion, inflammation, and the immune system (among many others). It makes sense that there could be problems in the endocannabinoid system which can then result in signs and symptoms in those body systems.

Evidence as to how the endocannabinoid system is affected by IBD, or the reverse—how this system is different in people who then develop IBD—is contradictory. IBD is complex and this is one more difference among people diagnosed with the same condition (ie, Crohn's disease or ulcerative colitis) that may point to there being more than two (or three) types of IBD.

Research into this system still in the early stages but it’s possible that in the future, cannabinoid compounds could be used to treat certain medical conditions. However, right now, there’s not much evidence to go on as to which compounds might work for which digestive conditions.

CBD and IBD

One step in finding out if cannabinoids have an effect on IBD is in learning if there is any difference in cannabinoid receptors in people who have IBD. There are two cannabinoid receptors currently being studied (called CN1 and CN2). The research being done is largely on chemical models and mouse models and not humans.

The authors of one meta-analysis of 51 papers on cannabinoid compounds and intestinal inflammation said that there was evidence that cannabinoid drugs do have anti-inflammatory effects on gut inflammation. This is considered pre-clinical work, which means that the results are not anything that can be applied to use in everyday treatment of a disease or condition. It does mean that more research and clinical trials need to be done in order to determine what, if any, role there is for cannabinoids to reduce the inflammation caused by digestive disease.

One trial was done on CBD and how it affected biopsies taken from the intestine of people with ulcerative colitis, so this was a study on human cells in a laboratory. This study showed that the CBD reduced the effect of intestinal damage caused by one receptor pathway. The authors concluded that their results show that CBD “unravels” a new treatment strategy for IBD. 

Another trial studied the effect CBD had on mice who were chemically treated to give them colitis. The mice were given CBD either orally or rectally. The results showed that giving the mice CBD through their rectums had more effect than it did in giving it to them by mouth.

A small study of CBD was done was on 20 people with moderately active Crohn’s disease for eight weeks. In this study, CBD was found to be safe because participants reported no adverse effects. However, the CBD had no effect on the Crohn’s disease. The authors speculate that there were no results because the dose was too low, that other supplements that might help with the delivery of the CBD were not used, or that there weren’t enough patients in the study. However, some of the patients included in the study were also cigarette smokers, which is a factor known to worsen Crohn’s disease.

So far, there's not been any good evidence to show that taking CBD oil by mouth to treat IBD would have any benefits on inflammation.

Most of the studies conclude that there's something to the idea of using cannabinoids to treat IBD; it shows promise in the pre-clinical work. On paper the idea has merit but there is more work that needs to be done to bridge the gap between what's seen as theoretically possible and what happens in real patients.

A Note on CBD Oil and Anxiety

It’s known that people who have IBD may be at a greater risk for developing anxiety. (This does not mean that stress or anxiety causes IBD; they do not.) Some studies show that about 20% of people who live with IBD also meet the criteria for being diagnosed with anxiety. There has been some research that shows that CBD oil may be helpful in treating anxiety.

The authors of one study concluded that while CBD oil might be helpful in "reducing anxiety behaviors," more study is needed, especially because much of the preliminary research about the dosing and effects of CBD has been done on healthy people. More studies need to be conducted on people who live with chronic illness or other medical conditions.

A Word from Verywell

In one summary of the research into IBD and cannabinoids, the authors say this: "It is interesting to hypothesize why the experimental data are not yet translating into meaningful improvements for patients.” It does seem as though the research done so far has shown that there is something to the idea of using CBD to treat IBD, but there’s a connection that’s being missed.

The good news is that CBD has been shown to be safe in clinical trials. That means that it might not cause any harmful effects on the body, but it does cost money and won't be covered by insurance. The cost, if it doesn't work, is a potential harm.

However, it should be noted that CBD is not a substance that’s regulated and the buyer must beware. The amount of CBD in any particular product that can be bought in a drugstore on online is highly variable and optimal dosing for IBD isn’t known. For those who wish to try CBD oil, it’s best to consult with a gastroenterologist and find a safe, reputable source for CBD. 

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Article Sources

  1. Hasenoehrl C, Storr M, Schicho R. Cannabinoids for treating inflammatory bowel diseases: where are we and where do we go?Expert Rev Gastroenterol Hepatol. 2017;11(4):329–337. doi:10.1080/17474124.2017.1292851

  2. Couch DG, Maudslay H, Doleman B, Lund JN, O'Sullivan SE. The Use of Cannabinoids in Colitis: A Systematic Review and Meta-Analysis. Inflamm Bowel Dis. 2018;24(4):680-697. doi:10.1093/ibd/izy014 

  3. De Filippis D, Esposito G, Cirillo C, et al. Cannabidiol reduces intestinal inflammation through the control of neuroimmune axisPLoS One. 2011;6(12):e28159. doi:10.1371/journal.pone.0028159.

  4. Schicho R, Storr M. Topical and systemic cannabidiol improves trinitrobenzene sulfonic acid colitis in micePharmacology. 2012;89(3-4):149-55. doi:10.1159/000336871.

  5. Naftali T, Mechulam R, Marii A, et al. Low-Dose Cannabidiol Is Safe but Not Effective in the Treatment for Crohn's Disease, a Randomized Controlled TrialDig Dis Sci. 2017;62(6):1615-1620. doi:10.1007/s10620-017-4540-z.

  6. Byrne G, Rosenfeld G, Leung Y, et al. Prevalence of Anxiety and Depression in Patients with Inflammatory Bowel DiseaseCan J Gastroenterol Hepatol. 2017;2017:6496727. doi:10.1155/2017/6496727

  7. Mikocka-Walus A, Knowles SR, Keefer L, Graff L. Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases. Inflamm Bowel Dis. 2016;22(3):752-62. 

  8. Ambrose T, Simmons A. Cannabis, Cannabinoids, and the Endocannabinoid System-Is there Therapeutic Potential for Inflammatory Bowel Disease? J Crohns Colitis. 2019;13(4):525–535. doi:10.1093/ecco-jcc/jjy185

Additional Reading

  • Pacher P, Bátkai S, Kunos G. The endocannabinoid system as an emerging target of pharmacotherapy. Pharmacol Rev. 2006;58(3):389–462. doi:10.1124/pr.58.3.2