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Crohn’s disease and ulcerative colitis are inflammatory conditions affecting the digestive tract. CBD is an excellent anti-inflammatory aid that may be useful for relieving symptoms.
Inflammatory bowel diseases (IBD) can be overwhelming.
It isn’t just the pain or bowel urgency — it interferes with all aspects of your life — from missing work to embarrassing scenarios that can be difficult to predict.
A compound found in the hemp plant called cannabidiol — or CBD for short — has been shown to offer benefits towards some of the negative symptoms of inflammatory bowel diseases.
IBD treatment can be summed up with the 5 R’s:
The most recent evidence of CBD’s benefits to inflammatory bowel diseases is focused on reducing inflammation, — which in turn helps to repair the gut lining and restore the health of the intestinal environment.
Here, we’ll explain how CBD works and why IBD sufferers consider using CBD to address their most debilitating side-effects.
CBD influences many of the chemical messengers involved in controlling inflammation. This fantastic plant extract does this by acting on receptors within the endocannabinoid system.
What is the endocannabinoid system?
The endocannabinoid system (ECS) is a complex set of receptors found throughout the body, tasked with regulating inflammation and peristalsis (movement of intestines) in the gut and stress responses in the brain .
Since CBD has been shown to reduce inflammation and interacts with ECS receptors in the gut, it’s a promising supplement to help relieve some of the symptoms of IBD.
Inflammatory bowel disease (IBD) is an umbrella term for two closely related conditions affecting the digestive tract — ulcerative colitis and Crohn’s disease.
What’s the difference between these two conditions?
Ulcerative colitis (UC) is defined as a long-term inflammation of the large intestine and colon. The inflammation becomes so bad it eventually forms ulcers and erosions in the digestive lining.
The extensive damage to the digestive lining may reduce the number of nutrients we can absorb through the digestive tract and can affect our ability to keep harmful substances out of the bloodstream (leaky gut syndrome).
People with ulcerative colitis tend to have less healthy bacteria and more harmful species compared with healthy people — a condition called dysbiosis.
Dysbiosis in the gut causes disruptions to the intestinal environment due to the metabolites produced by the more harmful bacteria. These metabolites cause inflammation, which then causes more damage to the surface of the intestinal walls.
This all leads to a cycle of inflammation that gets increasingly worse over time .
Crohn’s disease is also a result of long-term inflammation. However, the inflammation involved with Crohn’s occurs in patches along the intestinal tract. This is different from ulcerative colitis which can affect the entire digestive tract.
These patches of inflammation from Crohn’s disease is most common at the end of the small intestine where it connects to the large intestine (called the terminal ileum).
The inflammation from Crohn’s disease goes deep. Compared with ulcerative colitis, which affects only the mucosa layer of the intestine, Crohn’s disease extends from the mucosa to the outer layer — causing severe pain and loss of digestive function.
Like UC, dysbiosis of the intestinal environment is present with Crohn’s disease. Harmful species of bacteria are able to outcompete healthy gut flora. These harmful bacteria wreak havoc by producing inflammation-inducing metabolites — making symptoms progressively worse over time.
IBD usually takes three to five months to be diagnosed after the first symptoms appear.
Doctors consider your medical history, family medical history, physical examinations, lab testing, and medical imaging to confirm their suspicions before making a diagnosis.
IBD is usually first diagnosed between the ages of 20 and 30 but can remain undiagnosed for years before it’s discovered. Symptoms are often subtle and hard to notice until the disease progresses.
The causes of both ulcerative colitis and Crohn’s disease are still not well understood.
However, four environmental factors have been shown to impact the genes of people predisposed to the condition — this means that certain environmental factors can trigger the condition.
Inflammation is a problem in both UC and Crohn’s disease. Therefore, it makes sense that all the above risk factors either cause inflammation directly or cause dysbiosis in the gut. This imbalance of the bacterial population then leads to inflammation, leaky gut syndrome, and even more inflammation.
Genetics play a large role since our genes determine our immune system, and our immune system determines our gut flora. This is why certain people are more at risk than others to develop IBD.
If you add poor lifestyle choices or stress to the mix, it further increases the chances of developing IBD .
The primary goal here is to restore the gut microbiome, allowing beneficial bacteria to thrive instead of harmful ones.
Stress and lack of exercise are closely linked with IBD symptoms since both affect immune function. Performing regular movement (circulating more lymph fluid) and stress reduction techniques like meditation reduce the intensity of flare-ups.
CBD is the primary non-psychoactive compound in the marijuana plant (Cannabis sativa). It works by acting on the endocannabinoid system — a series of receptors that form a communication pathway throughout the nervous and immune systems.
Research has identified two main types of endocannabinoid receptors — the CB1 and CB2 receptors :
Endocannabinoid receptors are found throughout the nervous system, either in the brain or on the cells that regulate neuron activity. This is why there is so much interest in using phytocannabinoids to treat any neurologically-related issues, including IBD.
The nervous system is the regulatory system that allows the brain to “talk” the other body systems. Understanding how the ECS works will allow us to take advantage of certain pathways and block unwanted symptoms and/or debilitating issues .
Let’s look more closely at why CBD should be included in the management of IBD.
CBD has been shown to lower inflammation involved with many different types of inflammatory diseases — including IBD.
One of the ways it does this is by influencing the normal cycle of our cells. It binds to cell receptors known as the adenosine A2 receptors, which control what molecules are produced and secreted by cells around the body . CBD binds to the A2 receptors to stop the cells from releasing compounds that trigger and perpetuate the inflammatory process — effectively halting inflammation at the source.
A second way CBD lowers inflammation with IBD is through its effect on the CB1 receptors of the endocannabinoid system itself. Its effect on these receptors stops the ability for specialized cells known as mast cells to release histamine  — a powerful inflammatory compound associated with allergies.
Some research suggests that CBD can also impact the health of the microbiome. A dysfunctional microbiome is thought to be one of the main causes of inflammatory bowel disease.
Early research has suggested that the endocannabinoid system is involved with maintaining a healthy diversity of microorganisms in the gut lining  — though more research is needed to understand this effect in more detail.
THC is also a well-known muscle relaxant — which can be used to stop the painful muscle contractions going on in the intestinal tract with IBD. This lowers abdominal cramping pain and improves motility in the digestive tract — resulting in less bloating, constipation, cramping, and feelings of fullness .
CBD also modulates the sensation of pain by stopping certain neurons from firing.
This occurs between secreted endocannabinoids and their receptors. While endocannabinoids have been shown to indirectly affect opioid receptors, it’s important to remember that endocannabinoids work within their own systems and do not interfere with other pain regulating systems. This is why THC and CBD do not have the same addictive qualities as morphine .
CBD comes in many different forms — so there’s a product for everybody.
If you don’t mind swallowing capsules, these are an excellent option for people with ulcerative colitis or Crohn’s disease.
CBD oil is another good option as it’s easy to measure individual doses, takes a long time to break down in the intestinal tract (ensuring it reaches the target area), and has a very long shelf-life.
Suppositories are also a good option but can be uncomfortable to use. These are best for IBD affecting the colon specifically (the last section of the digestive tract before leaving the body).
Always follow the directions on the packaging when using CBD suppositories.
Dosing CBD can be a challenge for first-time users. You can use our CBD dosing guide to assess the daily dose of CBD based on desired strength and weight (see chart below).
When using CBD for the first time, we recommend taking the smallest recommended dose and building up slowly over a week. This is a wise thing to do when starting any new supplement to see how it affects you.
|Weight (lbs)||Low Strength||Medium Strength||High Strength|
Your IBD symptoms didn’t appear overnight — they took several months or years to manifest, and the truth of the matter is that it’s going to take a while to control as well. With patience and perseverance, IBD can be managed.
It’s important to be consistent with CBD (or any medication for that matter) when treating IBD.
It’s also a good idea to first consult with your doctor before taking any supplements.
After a solid month of use, go back and answer these questions again. Are there any improvements? Is anything worse?
CBD will likely take between 1 to 6 months of regular use before any noticeable changes are noted. Be patient and persistent.
CBD may be an excellent add-on supplement for managing IBD symptoms through its pain-relieving and anti-inflammatory benefits. By decreasing inflammation, supporting healthy bacteria populations in the gut, and slowing peristalsis, CBD can relieve many of the symptoms of the IBD.
As the gut recovers, the health of the microbiome also recovers, reducing symptoms even further and restoring function to the protective effects of the gut lining.
For best results, it’s recommended that you use CBD oils or capsules in the higher potency range. Suppositories may be a good option for people with IBD specifically involving the colon. Always start with a small dose first, then build up over time.
Remember, IBD is a condition that involves many factors and took years to develop. In order to treat it properly, you’ll need to be patient, speak with your doctor, and try various treatments to find a combination that works for you.