Researchers believe cannabis alters the gut biome to favor beneficial bacteria.
New data from the United European Gastroenterology conference in Vienna shows cannabis oil significantly improves symptoms of Crohn’s disease and the patients’ quality of life. Most interestingly, the mechanism does not appear to involve resolution of gut inflammation, but rather a change in gut biome. This is in contrast to the previously hypothesized mode of action. Therefore, scientists rationalize cannabis’ therapeutic benefits come from the anti-inflammatory properties of cannabinoids.
In this randomized, placebo-controlled study, Israeli researchers observed eight weeks of cannabis oil treatment. They found the treatment produced clinical remission in up to sixty five percent of patients. This happened without downregulation of inflammation assessed endoscopically. This study includes forty six people with mild to moderate Crohn’s disease, randomized and receiving treatment consisting of fifteen percent CBD and four percent THC in an oil form or placebo.
Gut Inflammation Might not be the Culprit in IBD
The study assesses gut inflammation endoscopically, and measures inflammatory markers in blood and stool samples. Most of the treatment group (fifteen out of twenty three patients) after eight weeks entered clinical remission compared to the placebo group (eight out of twenty three patients). The question then remains: Which therapeutic principles other than anti-inflammatory could this cannabinoid-based treatment be operating on?
The etiology of Crohn’ disease, and inflammatory bowel disease in general, divides into at least four factors: genes and genetic predisposition, external environment, microbiome (the ‘good’ bacteria living inside the gut) and the immune response. Doctors frequently hypothesisize that cannabis-based therapy affects the immune system. This study indicates this may not be the case.
However, the environment plays a role in the pathophysiology of Crohn’s disease. Therefore, because this study focuses on one geographical location (Israel), these findings don’t easily extrapolate to the rest of the world.
Furthermore, the interactions between genes and the environment further complicate the situation. It has been discovered that about thirty genetic mutations, or changes, are associated with Crohn’s disease. Among these, a small point mutation in the gene encoding one of the inflammatory mediator receptors, interleukin 23 (IL-23).
Additionally, the function of the anti-inflammatory mediator IL-10 has also been associated with Crohn’s disease. Given these mutations in the mediators which play prominent roles in regulation of inflammation, it is difficult to discern whether the study patients showed no reduction in inflammation in response to cannabis oil because of any possible mutations in the relevant genes since no genotyping data has been provided.
If They Ran the Study Longer, Would Inflammation Reduce Further?
Finally, doctors are yet to determine whether the duration of the treatment affects inflammation outcomes. It’s quite possible that eight weeks may not be enough. Available evidence suggests that adaptive immunity and Th1 T cell recruitment is responsible for the aberrant inflammatory response in Crohn’s disease. This arm of the immunity is slower to develop (takes several days), and thus may take longer to resolve.
Furthermore, one of the effectors is IL-23 for which a genetic mutation has been associated with Crohn’s disease. This highlights the importance of knowing patients’ genotypes in clinical trials involving cannabis-based therapy. When we know these, different inflammation outcomes may occur.
Cannabis may Target Gut Biome Populations
Cannabis-based therapy could also target another aspect of Crohn’s disease etiology that doesn’t involve inflammation: the microbiome. There are approximately 1150 bacterial species in the gut that work together with our gastrointestinal system to process food and extract the nutrients. The association between Crohn’s disease and changes of the gut microbiome has already been established, with some studies demonstrating biodiversity reductions and others instability of the microbiome.
We are only at the forefront of the microbiome function research. Still, we know that specific bacterial species live in the healthy gut. Other species (called enterobacteria) represent an oversize sample in the Crohn’s disease gut.
In conclusion, cannabis oil could create new clinical outcomes. It would do this if we use it to restore the balance in the microbiome, rather than resolve inflammation. It could also be that CBD/THC oil sequentially acts on the various aspects of the disease’s etiology. This would mean resolving gut microbiome functions first, and eventually starting prolonged treatment (more than eight weeks) to resolve inflammation.
Would love to be a part of cannabis study for Crohns.
Add me to this to being a part of cannabis study for Crohns.
Hi Jackie – I wish we could! This study is complete and we do not have access to adding volunteers. This is something we are working to provide to patients – a portal to studies accepting volunteers.
I’ve been dealing with this since 15yrs of age I’m now 34 … I’ve been smoking Marijuana ever since i was 18yrs of age … had my check up over 4yrs ago doctors couldn’t find my Crohn’s disease anywhere… I’ve tried lots of medicines and injections unfortunately that just made my body refuse or react negatively in some way…
so I turned to weed and a stress free well balanced diets and stay away from Triggers that brings flare ups … would luv to sit down and chat with people about this topic and help as much as I can… positivity dose play a big roll …
keep your smile brighter than the pain … xoxo
That same thing happened to me
Smoking put it in remission
The dr said there no sign of crohn’s
I was told there is no cure for it. God is great putting this plant on earth.
Tammy, what strain do you smoke? I’ve researched it and discovered there are so many different strains. Thanks
What’s strains ???
I was diagnosed with Chrons when I was 30 years old. I am now 70. Beside several bowel resections & many hospital stays, I have been on just about oral medication including Prefnidone, as well as Humira and Remicade. I’m now on CIMZIA & it’s so-so. I would love to volunteer for case studies for Chrons.
Please keep me informed on this ,
Would love to here more about this i would love to try this but i work in a job that drug and alcohol test are carried out so i would fail test and could lose my job
Let me know when this happens in Washington D.C.
Would this work for Ulcerative Colitis/proctitis?
Doctors think I was born with Crohns
Father and his family members had Crohns
So if I purchase CBD oil to attempt to replicate the results, what would I try to get? Thanks
Would love to hear more about this.
In recent years I seem to have developed IBS to varying degrees. Sometimes it flares up due to not eating right, but it can also do so even when being good. I’ve never been officially diagnosed as such, but about 2 years ago I found a company that makes a CBD/THC drink in which the THC is from Indica rather than Sativa. Sativa based produicts seem to hurt more than help in m case. It has a 10-1 ratio of CBD to THC. I have found straight CBD without any THC doesn’t work for me.
When my bowel issues flare up I can drink one “energy shot” of this product, which comes in a similar sized bottle The ratio and strenth varies slightly with each batch, but normally it’s about 40 mg. CBD to 4 mg. THC….not enough to make me fuzzy headed or high (which is good!) but it sure shuts down the sometimes severe diarrhea fast! It also keeps me from feeling like someone pulled the plug on my energy level after an emergency run to the nearest toilet. The ONLY “side effect” that can happen is if I use more than one dose (once in while required when a flare up is really bad) then I am a bit stopped up for a couple days. That’s FAR more preferable. I’m sure glad I live in the West where I can buy this anytime I want.
The Federal Government. needs to allow us to drag us out of the stone age, Harry Anslinger Reefer Madness mentality but I’m sure the Pharmaceutical Industry is trying their best to keep this from happening. They’d rather push their “Biologics,” which is nothing more than instant AIDS in a pill or injection form. No, I don’t prefer to have my immune system weakened to the point of getting Cancer, deadly infections and other nasty surprises. One of my former co-workers died from PML, the rare viral brain infection that happened after using such “medicine.” Insanity.
What is this drink?
Can you recommend a product name with a good ratio to duplicate the study? Would Care by design CBD oil 18:1 be about right?
I suffer from crohns and would love to try this .
Listen up people,i got crohns back in 1967, only then it was called regional illyitis and it so happens thats when i started weed. I had 4 resections and was told i would have a short life. I spent years in the hospital fighting to live. When i turned around and told the Doctors i would live to 70 thats my goal. Any way pot was available so i used it to cut the pain down and every since the last operation i have not had any bit of the disease. I was scoped both ends in Febuary of this year and the doctors said they could not see any bit of crohns for the last 35 years.
If inflammation isn’t stemmed, won’t this just allow Crohns to start up again, along with other things, like colon cancer?