Inflammatory Bowel Disease (IBD) is an umbrella term for two major conditions known as Crohn’s disease and ulcerative colitis. These diseases are characterized by chronic inflammation in all or parts of the digestive tract. According to the latest statistics from the Centers for Disease Cotrol and Prevention, in 2015, an estimated 1.3% of US adults (3 million) reported being diagnosed with IBD (either Crohn’s disease or ulcerative colitis). The symptoms associated with these gastrointestinal diseases can be extremely uncomfortable, and at times, debilitating. These diseases cannot be cured; however, their symptoms are typically managed with immune suppressive or anti-inflammatory drugs. The downside is that these drugs don’t always work and many carry long lists of side effects—but there is hope!
CBD offers an all-natural, plant-based remedy for gastrointestinal issues.
In order to gauge the medical efficacy of treating IBD with CBD, we turn to a series of medical studies conducted over the past ten years.
A 2008 study suggested that diseases like Irritable Bowel Syndrome (IBS) are actually caused by an endocannabinoid deficiency in the body. Migraine, fibromyalgia, IBS and related conditions display common clinical, biochemical and pathophysiological patterns that suggest an underlying clinical endocannabinoid deficiency that may be suitably treated with cannabinoid medicines.
A 2009 study found investigated the effect of CBD in a murine model of colitis. In DNBS-induced colitis, cannabidiol reduced colon injury, decreased expression of inflammatory markers and inducible nitric oxide synthase, and decreased reactive oxygen species production…In conclusion, cannabidiol, a likely safe compound, prevents experimental colitis in mice.
A 2010 study evaluated the effects of CBD and THC (alone and combined) in animal models of colitis. In conclusion, treatment with THC, CBD and sulphasalazine reduced signs of damage, inflammation and functional disturbances in a rat model of Crohn’s disease. CBD on its own also displayed beneficial actions, such as improved spontaneous activity and contractility to carbachol, which extends previous findings (Malfait et al., 2000; Borrelli et al., 2009) and further suggests that this phytocannabinoid, which is devoid of psychoactive properties, could help alleviate symptoms in human IBD. Combined treatment with CBD and THC proved beneficial in TNBS-induced colitis in the rat, as it resulted in additive effects on some functional parameters and as CBD caused an ineffective dose of THC (5 mg·kg−1) to produce beneficial effects of the same magnitude as those produced by a higher dose of THC (10 mg·kg−1) in the absence of CBD. It is possible therefore that the benefit-to-risk ratio may well be greater when CBD and THC are co-administered to ameliorate colitis than when THC is administered alone.
A 2011 study proved that CBD reduces intestinal inflammation in both humans and mice through control of the neuroimmune axis. CBD targets enteric reactive gliosis, counteracts the inflammatory environment induced by LPS in mice and in human colonic cultures derived from UC patients. These actions lead to a reduction of intestinal damage mediated by PPARgamma receptor pathway. Our results therefore indicate that CBD indeed unravels a new therapeutic strategy to treat inflammatory bowel diseases.
A 2012 study concluded that topical and systemic (but not oral) CBD improves colitis in mice. To summarize, CBD was given via 3 different routes of delivery to mice and its effect on the severity of TNBS colitis was compared. It was confirmed that CBD given intraperitoneally is protective, and CBD given per rectum also offers protective effects, suggesting that rectal application of cannabinoids for the therapy of intestinal inflammation may be a feasible option.
A 2013 medical review further substantiated CBD’s potential as an anti inflammatory bowel diseases (IBD) drug. CBD is a very promising compound since it shares the typical cannabinoid beneficial effects on gut lacking any psychotropic effects. For years, its activity has been enigmatic for gastroenterologists and pharmacologists, but now it is evident that this compound may interact at extra-cannabinoid system receptor sites, such as peroxisome proliferator-activated receptor-gamma. This strategic interaction makes CBD as a potential candidate for the development of a new class of anti-IBD drugs.
A 2016 study found that high CBD extracts reduce chemically induced intestinal inflammation and hypermotility in mice. In conclusion, CBD Botanical Drug Substance (BDS), given after the inflammatory insult, attenuates injury and motility in intestinal models of inflammation. These findings sustain the rationale of combining CBD with other minor Cannabis constituents and support the clinical development of CBD for IBD treatment.
As indicated by the studies above, CBD has proven to be very effective in treating various types of inflammatory bowel diseases.
Inflammatory bowel disease (IBD). (2018, April 23). Retrieved from https://www.cdc.gov/ibd/data-statistics.htm
Russo, E. B. (2008, April). Clinical endocannabinoid deficiency (CECD): Can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions? Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18404144
Borrelli, F., Aviello, G., Romano, B., Orlando, P., Capasso, R., Maiello, F., . . . Izzo, A. A. (2009, November). Cannabidiol, a safe and non-psychotropic ingredient of the marijuana plant Cannabis sativa, is protective in a murine model of colitis. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19690824/
Jamontt, J., Molleman, A., Pertwee, R., & Parsons, M. (2010, June). The effects of Δ9-tetrahydrocannabinol and cannabidiol alone and in combination on damage, inflammation and in vitro motility disturbances in rat colitis. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931570/
De, D., Esposito, G., Cirillo, C., Cipriano, M., De, B. Y., Scuderi, C., Iuvone, T. (2011, December). Cannabidiol reduces intestinal inflammation through the control of neuroimmune axis. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22163000/
Schicho, R., & Storr, M. (2012, April). Topical and Systemic Cannabidiol Improves Trinitrobenzene Sulfonic Acid Colitis in Mice. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668621/
Esposito, G., Filippis, D. D., Cirillo, C., Iuvone, T., Capoccia, E., Scuderi, C., Steardo, L. (2013, May). Cannabidiol in inflammatory bowel diseases: A brief overview. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22815234
Pagano, E., Capasso, R., Piscitelli, F., Romano, B., Parisi, O. A., Finizio, S., Borrelli, F. (2016, October 04). An Orally Active Cannabis Extract with High Content in Cannabidiol attenuates Chemically-induced Intestinal Inflammation and Hypermotility in the Mouse. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27757083/