Cannabis and Crohn’s Disease: What You Need to Know

There’s a blog titled “medical marijuana defeats Crohn’s Disease” (SFGate). That’s a dangerous and misleading claim. It’s our contention that cannabis can relieve the symptoms of Crohn’s Disease, but that’s different from “defeating” it.

People suffer terribly from this disease, and if cannabis can help them, we need to be as clear and forthcoming as possible about what it can do.

What is Crohn’s Disease?

Dr. Burrill B. Crohn described the disease in 1932 along with his colleagues Dr. Leon Ginzburg and Dr. Gordon D. Oppenheimer. A chronic inflammatory condition of the gastrointestinal tract (GI tract), it is classified as an inflammatory bowel disease (IBD).

It is not ulcerative colitis because Crohn’s affects a different area of the GI tract. Crohn’s affects the ileum (small bowel) at the start of the colon. But, it can attack any part of the GI tract from mouth to anus. But, ulcerative colitis only occurs in the innermost lining of the colon (large intestine).

Crohn’s disease, however, can affect the entire thickness of the bowel wall and skip, leaving normal areas in between patches of diseased intestine.

Causes of Crohn’s Disease

Crohn’s runs in families. According to the Crohn’s & Colitis Foundation, “Studies have shown that 5% to 20% of affected individuals have a first – degree relative (parents, child, or sibling) with one of the diseases. The risk is greater with Crohn’s disease than ulcerative colitis. The risk is also substantially higher when both parents have IBD.” These conditions are also most common among people of eastern European backgrounds, Jews of European descent, and African American populations.

Of the 780,000 affected Americans, Crohn’s affects men and women equally between the ages of 15 to 35. But, the causes are not clear.

Diet and stress do not cause Crohn’s Disease even though they may irritate the condition. Researchers are convinced that the causes are genetic and environmental.

It would appear the victims of Crohn’s have systems that are confused. When things are normal, the GI tract houses the harmless bacteria that help the digestion. It’s the immune system’s job to attack and destroy foreign bacteria, fungi, viruses, and other enemy microorganisms.

During digestion, those harmless bacteria are protected from the immune system’s action. But, victims of IBD find their immune system mistakes these harmless bacteria for dangerous invaders. So, the immune system creates inflammation that can become Crohnic, ulcerative, and difficult to manage.

Symptoms of Crohn’s Disease

The Mayo Clinic lists the symptoms of Crohn’s Disease, pointing out they may appear mild to severe. And, pain and discomfort may accompany them.

• Diarrhea
• Fever
• Fatigue
• Abdominal pain and cramping
• Blood in your stool
• Mouth sores
• Reduced appetite and weight loss
• Pain or drainage near or around the anus due to inflammation from a tunnel into the skin (fistula)
• Inflammation of the skin, eyes, and joints
• Inflammation of the liver or bile ducts
• Delayed growth or sexual development, in children

And, you should see a doctor if you have any of these symptoms or z combination of them.

Standard treatment

Doctors may prescribe medications to control the inflammation.

• Aminosalicylates, but their side effects include diarrhea, headaches, heartburn, nausea, vomiting, and abdominal pain.
• Corticosteroids may decrease the inflammation by reducing the activity of the immune system. Doctors prescribe corticosteroids for people with moderate to severe symptoms. Side-effects can cause acne, bone mass loss, high blood pressure, increased chance of developing infections, mood swings, and weight gain.
• Immunomodulators reduce immune system activity, resulting in less inflammation, but they can take up to three months to work. They are prescribed when other treatments don’t work. Side effects include a low white blood cell count, fatigue, nausea, vomiting, and pancreatitis.

Surgery may be necessary to remove fistulas, stop life-threatening bleeding, open intestinal obstructions, or problems that do not respond to medication. The National Institute of Diabetes and Digestive and Kidney Diseases (DIDDK)says, “nearly 60 percent of people had surgery within 20 years of having Crohn’s disease.” They list small bowel resection, laparoscopic surgery, subtotal colectomy, proctocolectomy, and ileostomy. All these operations take you out of work and action for days to weeks, and the more colon they remove, they more problems you will have.

The cannabis treatment

A 2016 study published in Gastroenterology & Hepatology claimed cannabis and derivatives “have grown increasingly popular as a potential therapy for inflammatory bowel disease (IBD).” It worked on laboratory mice, but “has yet to be determined in human populations whether cannabinoids have therapeutic anti-inflammatory effects in IBD or are simply masking its many debilitating symptoms.”

A 2017 study in Cochrane Library revisits the research conclusions in earlier studies.Studies have found a higher prevalence of cannabis use in patients with IBD who claim it relieves symptoms such as abdominal pain, diarrhea, and reduced appetite (Lal 2011; Weiss 2015). It is unclear if this is due to the known psychotropic effects of cannabis such as analgesia and euphoria or if it is related to anti-inflammatory effects demonstrated in recent studies and experimental animal models (Hasenoehrl 2016; Klein 2006; Singh 2012).”

Both articles caution that we need more serious and long-term study on human subjects. But, they do not deny the relief of symptoms in at least the mile and moderate cases of Crohn’s disease.

Recent articles say cannabis can defeat Crohn’s Disease or lead to its remission. But, these are based on a 2013 study that more current research has put in some perspective. And, it’s just plain wrong to mislead patients who may have a lifetime of suffering.

Cannabis is known to have a modulating effect on smooth muscle tissue and involuntary spasms. Patients will find these properties in the following strains of cannabis if you smoke:

• Medicine Man: An Indica-dominant strain with an 80:20 Indica/Sativa ratio. Medicine Man has strong sedating effects that will overpower you as soon as you smoke it, so it is not recommended for new users.
• Chemo (UBC Chemo): A 100 percent pure Indica was created to treat patients going through chemotherapy. It promises a complete sedative impact that starts with a quick hit behind your eyes and the back of your neck. Its high THC content (18-21%) creates the couch-lock that numbs Crohnic pain, improves appetite, and reduces cramping for chemo and Crohn’s patients.
• Jean Guy: This 80: 20 is a Sativa-dominant hybrid that leaves you uplifted and energetic in the morning. An heir to the White Widow family, the flavorful Jean Guy treat pain and nausea attached to fibromyalgia, chemotherapy, and Crohn’s.
• Bubblegum: An Indica-dominant hybrid (80: 20) with a hefty 15 to 19 percent THC, Bubblegum kills pain and inflammation. Patients of Crohn’s disease use Bubblegum for pain relief, but they also value its anti-depression properties.

Crohn’s Disease patients need to know they have options.

Cannabis marijuana strains have anti-inflammatory and anti-spasmatic properties in addition to its ability to create uplifting effects that distract from the suffering. But, for those who don’t wish to smoke, there are a wide variety of edibles, oils, and other remedies.

Perhaps, the clinching argument for using cannabis for Crohn’s Disease is the lack of negative side-effects. Compared to those that follow the use of prescription medications, cannabis remains the gold standard for self-medicating Crohn’s Disease.