Gut Cannabinoid Receptors And IBD
Patients suffering from IBD have seen significant relief from all clinical symptoms when activating cannabinoid receptors in the gut with cannabis medicine.
Inflammatory Bowel Disease (IBD), including Crohn’s and ulcerative colitis, are conditions of chronic intestinal inflammation. Progression of symptoms can lead to hospitalization and even surgery. Due to this inflammation, patients suffer from symptoms such as: fatigue, nausea, weakness, pain, loose stool, constipation, and loss of appetite. These are significant enough to negatively impact day to day life. The good news is that the gut is rich in cannabinoid receptors, making cannabis a good medicine to relieve these symptoms.
The Endocannabinoid System – Cannabinoid Receptors
Cannabis contains about 500 compounds, two of which are fairly well studied: cannabidiol (CBD) and ∆9-tetrahydrocannabinol (THC). CBD plays a role as an anti-inflammatory medicine with immunomodulatory properties, and THC has well-known pain killing and anti-cancer abilities. These, and other, cannabinoids act at the two endogenous cannabinoid receptors, CB1 and CB2.
Since CB2 is highly expressed in immune cells and gastrointestinal cells, this is an area of interest for IBD research. In fact, a study in 2009, in a mouse model of colitis, determined that when CB2 receptors are activated there is a definite decrease in inflammation in the gut. Therefore, there is a rationale for using cannabis to treat IBD and IBD-related symptoms, even though research is lagging.
What’s The Latest Research on Gut Cannabinoid Receptors?
Jami Kinnucan, MD, University of Michigan, is emphatic about how desperately patients need alternative treatments for their IBD: “There is currently a large unmet need in the treatment of inflammatory bowel disease (IBD) with conventional medical therapy. Despite improvement in disease activity, many patients have persistent clinical symptoms that have significant impact on their quality of life. Patients have been seeking out alternative therapies (including cannabis) to help manage persistent symptoms associated with IBD. “
Surveys in the US and Canada have determined that 15-20% of people use cannabis, and around 40% of patients have tried to relieve IBD symptoms with cannabis, which are mainly pain, appetite, and diarrhea. These patients report an improvement in abdominal pain, nausea, diarrhea, and appetite. Also very important, is that their social life improved dramatically, with general good health perception and ability to work.
Significant improvements were observed with the Crohn’s disease as well. One study found that smoking 2 joints per day for 8 weeks was associated with the significant improvement in Crohn’s Disease Activity Index (CDAI) compared to the patients on placebo. Clinical remission was seen in 45% of these patients on daily cannabis, and even 25% of them were able to stop the corticosteroid therapy. As in some previous studies, patients reported significant improvement in the quality of life.
Concerns About Dropping Meds for Cannabis
Some concerns were that patients tended to stop conventional treatments, such as corticosteroids, as soon as they experienced improvement in clinical symptoms (while using cannabis). However, all studies thus far have focused on the role of cannabis as a complementary therapy to existing medical treatment. That requires a period of overlap and perhaps permanent complementary therapy. There are no long term studies to demonstrate that activation of gut cannabinoid receptors, alone, will keep IBD at bay.
The next steps in the research in this area depend on the federal status of cannabis in certain states to allow for larger, more randomized trials in the US. Legislation plays a major role in the advancement of cannabis therapy, not only in the gastroenterology but in other medical fields as well. Demand access now!