cbd treatment for ulcerative colitisDecember 15, 2021
Now that we’ve established CBD can help with ulcerative colitis, you’re probably wondering if it can have similar effects on Crohn’s disease. After all, this condition, too, belongs to the IBD group.
Although there have not yet been clinical trials that would investigate the use of CBD oil for ulcerative colitis, preliminary research carried out for the last decade shows promising results.
Researchers mention Aloe Vera as a potential therapeutic agent in treating IBD, based on the positive outcomes of clinical trials on patients with the disease. Other herbs, such as Boswellia serrata and turmeric, are also reported to promote an anti-inflammatory response in the body.
Studies Exploring Use of CBD for Ulcerative Colitis.
Ulcerative colitis (UC) is a chronic inflammatory condition affecting the colon and causing persistent ulcers, or sores, in the digestive tract. It falls into the category of inflammatory bowel diseases (IBD) along with Crohn’s disease and irritable bowel syndrome (IBS).
The study showed that patients who took CBD felt better and no longer experienced colitis symptoms. A few participants reported mild reactions, such as nausea and dizziness.
Here are the most common ways people take CBD for ulcerative colitis:
It’s time to elaborate on the aforementioned study from Israel. The study observed and evaluated the effects of cannabis use on patients with different types of IBD, including Crohn’s disease. The research team gathered 127 medical cannabis patients and closely monitored them using several assessment methods. These included forms of cannabis consumption, the use of other medications, side effects, and the long-term effects of cannabis use. The authors also took into consideration the exact THC and CBD levels the study’s subjects consumed.
Let’s take a look at these cannabinoids from a more practical point of view.
The disease causes damage to the inner lining of the large intestine, which may lead to frequent bowel movements. Ulcerative colitis commonly affects adults aged thirty to forty years old and generates up to $15 billion in government spendings on healthcare in the United States (1).
Can CBD Oil Help Ulcerative Colitis?
The authors of the study (Naftali et al.) concluded that cannabis can induce clinical improvements in people with IBD and that it can lead to decreased medication use and weight gain. They also noted that the subjects responded well to a dose of 21 mg THC and 170 mg CBD per day.
Several studies have suggested that CBD and cannabis, in general, are possible medical treatment options for ulcerative colitis, Crohn’s disease, and other inflammatory bowel conditions. Researchers found that CBD could prevent injury in the colon’s lining as well as inflammation, which is the underlying cause of all IBD’s.
However, these symptoms aren’t chronic in nature; a person with ulcerative colitis may go several months without any symptoms, only to be taken aback by severe flare-ups from time to time.
Some CBD supplements are formulated with herbs such as Aloe Vera, Boswellia serrata, and turmeric. You can also mix different herbal remedies on your own, but we first recommend consulting a doctor knowledgeable about complementary medicine before you start your first trials.
The cause of inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease isn’t fully understood. However, scientists suspect that hereditary factors are the major players in the development of these conditions.
Other Remedies for IBD.
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Researchers hypothesize that CBD may be an effective alternative for ulcerative colitis due to its remarkable anti-inflammatory properties.
There are no official recommendations when it comes to dosing CBD for ulcerative colitis and other inflammatory bowel diseases. If you want to get a decent point of reference, we suggest that you review the dosage of past human clinical trials to determine the safe amount for intake.
While conventional treatments provide short-term relief from the symptoms of ulcerative colitis, they lose efficacy in the long run on top of having dangerous side effects.
For example, Italian complementary medicine mentions herbal therapies as frequently practiced by patients with IBD. In a similar manner, herbal remedies are recognized by Chinese literature that describes them as helpful in the treatment of ulcerative colitis.
This question is difficult to answer due to the current state of scientific knowledge on using cannabis for IBD. In other words, the majority of studies suggest that using whole-plant extracts with various ratios of CBD and THC appear to provide the best results for ulcerative colitis and Crohn’s disease. No clinical trial has yet investigated the safety and efficacy of isolated CBD and THC for IBD.
What did the researchers investigate?
We searched MEDLINE, Embase, WHO ICTRP, AMED, PsychINFO, the Cochrane IBD Group Specialized Register, CENTRAL, ClinicalTrials.Gov and the European Clinical Trials Register from inception to 2 January 2018. Conference abstracts and references were searched to identify additional studies.
What did the researchers find?
Two studies including 92 adult participants with ulcerative colitis were included. Both studies assessed cannabis therapy in participants who had active ulcerative colitis. No studies that assessed cannabis therapy in participants with ulcerative colitis in remission were identified. One study (60 participants) compared 10 weeks of treatment with capsules containing cannabis oil with up to 4.7% D9-tetrahydrocannabinol (THC) to placebo in participants with mild to moderately active ulcerative colitis. The starting dose of cannabidiol was 50 mg twice daily which was increased, if tolerated, to a target of 250 mg twice daily. The other study (32 participants) compared 8 weeks of treatment with two cannabis cigarettes per day containing 0.5 g of cannabis, corresponding to 11.5 mg THC to placebo cigarettes in participants with ulcerative colitis who did not respond to conventional medical treatment.
Randomized controlled trials (RCTs) comparing any form or dose of cannabis or its cannabinoid derivatives (natural or synthetic) to placebo or an active therapy for adults ( > 18 years) with UC were included.
What are cannabis and cannabinoids?
The effect of cannabidiol capsules (100 mg to 500 mg daily) compared to placebo on clinical remission and response is uncertain. Clinical remission at 10 weeks was achieved by 24% (7/29) of the cannabidiol group compared to 26% (8/31) in the placebo group (RR 0.94, 95% CI 0.39 to 2.25; low certainty evidence). Clinical response at 10 weeks was achieved in 31% (9/29) of cannabidiol participants compared to 22% (7/31) of placebo patients (RR 1.37, 95% CI 0.59 to 3.21; low certainty evidence). Serum CRP levels were similar in both groups after 10 weeks of therapy. The mean CRP in the cannabidiol group was 9.428 mg/L compared to 7.638 mg/L in the placebo group (MD 1.79, 95% CI -5.67 to 9.25; moderate certainty evidence). There may be a clinically meaningful improvement in quality of life at 10 weeks, measured with the IBDQ scale (MD 17.4, 95% CI -3.45 to 38.25; moderate certainty evidence). Adverse events were more frequent in cannabidiol participants compared to placebo. One hundred per cent (29/29) of cannabidiol participants had an adverse event, compared to 77% (24/31) of placebo participants (RR 1.28, 95% CI 1.05 to1.56; moderate certainty evidence). However, these adverse events were considered to be mild or moderate in severity. Common adverse events included dizziness, disturbance in attention, headache, nausea and fatigue. None (0/29) of the cannabidiol participants had a serious adverse event compared to 10% (3/31) of placebo participants (RR 0.15, 95% CI 0.01 to 2.83; low certainty evidence). Serious adverse events in the placebo group included worsening of UC and one complicated pregnancy. These serious adverse events were thought to be unrelated to the study drug. More participants in the cannabidiol group withdrew due to an adverse event than placebo participants. Thirty-four per cent (10/29) of cannabidiol participants withdrew due to an adverse event compared to 16% (5/31) of placebo participants (RR 2.14, 95% CI 0.83 to 5.51; low certainty evidence). Withdrawls in the cannabidiol group were mostly due to dizziness. Withdrawals in the placebo group were due to worsening UC.
Two RCTs (92 participants) met the inclusion criteria. One study (N = 60) compared 10 weeks of cannabidiol capsules with up to 4.7% D9-tetrahydrocannabinol (THC) with placebo capsules in participants with mild to moderate UC. The starting dose of cannabidiol was 50 mg twice daily increasing to 250 mg twice daily if tolerated. Another study (N = 32) compared 8 weeks of therapy with two cannabis cigarettes per day containing 0.5 g of cannabis, corresponding to 23 mg THC/day to placebo cigarettes in participants with UC who did not respond to conventional medical treatment. No studies were identified that assessed cannabis therapy in quiescent UC. The first study was rated as low risk of bias and the second study (published as an abstract) was rated as high risk of bias for blinding of participants and personnel. The studies were not pooled due to differences in the interventional drug.
The second study comparing two cannabis cigarettes (23 mg THC/day) to placebo cigarettes showed lower disease activity index scores in the cannabis group compared to the placebo group. C-reactive protein and fecal calprotectin levels (both measures of inflammation in the body) were similar in both groups. No serious side effects were reported. This study did not report on remission rates.
The effects of cannabis and cannabis oil on ulcerative colitis are uncertain, thus no firm conclusions regarding the effectiveness and safety of cannabis or cannabis oil in adults with active ulcerative colitis can be drawn. There is no evidence for cannabis or cannabis oil use for maintenance of remission in ulcerative colitis. Further studies with a larger number of participants are required to assess the effects of cannabis in people with active and inactive ulcerative colitis. Different doses of cannabis and routes of administration should be investigated. Lastly, follow-up is needed to assess the long term safety outcomes of frequent cannabis use.
The effects of cannabis and cannabidiol on UC are uncertain, thus no firm conclusions regarding the efficacy and safety of cannabis or cannabidiol in adults with active UC can be drawn.There is no evidence for cannabis or cannabinoid use for maintenance of remission in UC. Further studies with a larger number of patients are required to assess the effects of cannabis in UC patients with active and quiescent disease. Different doses of cannabis and routes of administration should be investigated. Lastly, follow-up is needed to assess the long term safety outcomes of frequent cannabis use.
The study comparing cannabis oil capsules to placebo found no difference in remission rates at 10 weeks. Twenty four (7/29) percent of cannabidiol participants achieved clinical remission compared to 26% (8/31) of placebo participants. The study also showed higher self reported quality of life scores in cannabis oil participants compared to placebo participants. More side-effects were observed in the cannabis oil participants compared to the placebo participants. These side effects were considered to be mild or moderate in severity. Common reported side effects include dizziness, disturbance in attention, headache, nausea and fatigue. No patients in the cannabis oil group had any serious side effects. Ten per cent (3/31) of the placebo group had a serious side effect. Serious side effects in the placebo group included worsening ulcerative colitis and one complicated pregnancy.
Cannabis and cannabinoids are often promoted as treatment for many illnesses and are widely used among patients with ulcerative colitis (UC). Few studies have evaluated the use of these agents in UC. Further, cannabis has potential for adverse events and the long-term consequences of cannabis and cannabinoid use in UC are unknown.
To assess the efficacy and safety of cannabis and cannabinoids for the treatment of patients with UC.
Cannabis is a widely used recreational drug that has multiple effects on the body via the endocannabinoid system. Cannabis contains multiple sub-ingredients called cannabinoids. Cannabis and cannabis oil containing specific cannabinoids can cause cognitive changes such as feelings of euphoria and altered sensory perception. However, some cannabinoids, such as cannabidiol, do not have a psychoactive effect. Cannabis and some cannabinoids have been shown to decrease inflammation in animal and laboratory models which suggests it may help people with ulcerative colitis. For example, cannabidiol is one such cannabinoid that has shown anti-inflammatory activity in mice.
The researchers evaluated whether cannabis or cannabis oil (cannabidiol) was better than placebo (e.g. fake drug) for treating adults with active ulcerative colitis or ulcerative colitis that is in remission. The researchers searched the medical literature extensively up to 2 January 2018.
Two authors independently screened search results, extracted data and assessed bias using the Cochrane risk of bias tool. The primary outcomes were clinical remission and relapse (as defined by the primary studies). Secondary outcomes included clinical response, endoscopic remission, endoscopic response, histological response, quality of life, C-reactive protein (CRP) and fecal calprotectin measurements, symptom improvement, adverse events, serious adverse events, withdrawal due to adverse events, psychotropic adverse events, and cannabis dependence and withdrawal effects. We calculated the risk ratio (RR) and corresponding 95% confidence interval for dichotomous outcomes. For continuous outcomes, we calculated the mean difference (MD) and corresponding 95% CI. Data were pooled for analysis when the interventions, patient groups and outcomes were sufficiently similar (determined by consensus). Data were analyzed on an intention-to-treat basis. GRADE was used to evaluate the overall certainty of evidence.
Avoid products and vendors that make broad, definitive statements or promises of a “cure” for something. If you are currently taking any other medications or supplements for your UC, speak with your healthcare provider before using CBD, as it may interact with other medications you are taking.
Read on to learn more about how CBD may be a useful supplemental therapy in the management of UC symptoms.
When shopping for CBD, you will notice different types available. These include:
There is no cure for ulcerative colitis, so treatment prioritizes symptom relief and reducing flare-ups. Many people with ulcerative colitis turn to alternative treatments, such as cannabidiol (CBD), to take control of the disease and improve their quality of life.
People with ulcerative colitis may want to consider alternative treatments such as CBD to help manage their symptoms. It’s important to remember that while CBD may help improve your symptoms, it will not treat or cure the condition.
A Word From Verywell.
In one study, patients with ulcerative colitis were given 50 mg of CBD oil twice a day. Some participants were able to increase to as much as 250 mg twice a day for a period of 10 weeks.
Though CBD is generally well tolerated, you may experience some side effects. Common side effects include:
Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York, where he is also a professor. He was the founding editor and co-editor in chief of Inflammatory Bowel Diseases.
You’ll also want to consider:
CBD has many therapeutic properties and is a known anti-inflammatory, antimicrobial, and antioxidant. Thanks to its anti-inflammatory properties, CBD may be a potential therapeutic treatment for ulcerative colitis.
Ulcerative colitis (UC) is a chronic disease that affects the large intestine (colon), causing inflammation and small sores (or ulcers). UC symptoms include diarrhea, abdominal cramps and pain, bloody stool, and the need to pass stool frequently.
CBD is available in:
While CBD won’t cure ulcerative colitis, it may help make your symptoms more manageable and help reduce flares.
CBD binds to and activates receptors in the brain that create a therapeutic effect in the body, helping users find relief from painful symptoms without feeling impaired.
Lindsay Curtis is a health writer with over 20 years of experience in writing health, science & wellness-focused articles.
CBD for Ulcerative Colitis Symptoms.
Although more research is needed, current study results show promise that CBD may be beneficial for treating symptoms of ulcerative colitis.
Cannabinoids have anti-inflammatory properties that may make them helpful in managing symptoms of gastrointestinal diseases like ulcerative colitis. Research suggests CBD is a promising therapeutic for inflammatory bowel diseases, helping reduce mucosal lesions, ulceration, and inflammation associated with IBD. CBD may also help manage gastrointestinal pain, as well as secondary symptoms that come with IBD, such as anxiety, nausea, and sleep disturbances.
It’s important to talk with your healthcare provider before adding any supplemental therapy, such as CBD, to your ulcerative colitis treatment. They will be able to determine if CBD will be beneficial for your individual case and can recommend the right dosage.
Both CBD and THC interact with the endocannabinoid system (ECS) in the body. The ECS is a complex biological system that regulates cardiovascular, nervous, and immune system functions.
CBD is best used as a supplemental therapy alongside conventional treatments recommended by your healthcare provider, as well as dietary modifications. As with any supplement or medication, talk with your healthcare provider before trying CBD.
Because CBD is still a relatively new therapeutic option for managing different health conditions, including inflammatory bowel diseases, there is currently no recommended standard dosage.
To date, CBD has only been approved by the Food and Drug Administration to treat epilepsy. As a result, there is no standard recommended dosage of CBD for treating ulcerative colitis.
Shopping for CBD.
As with many medications, it’s best to start with a lower dose and gradually increase the amount of CBD to determine the appropriate dosage.
There are many different forms of CBD, and you may need to try different delivery methods before finding the one that is right for you.
With so many different options available, it can be daunting to shop for CBD. CBD is generally safe and well tolerated, but the industry is poorly regulated, and consumers should be aware of what to look for before purchasing CBD.
Tinnakorn Jorruang / Getty Images.
Another study analyzed the efficacy of CBD use in adults with ulcerative colitis. The study concluded that CBD extracts may help alleviate symptoms of IBD and UC.
You’ll want to carefully read the label of any products you are considering and look for:
One study found that participants with UC who took 50 milligrams (mg) of CBD oil twice a day, increasing to 250 mg per dose if needed and tolerated, experienced significant improvements in their quality of life. However, more research and follow-up studies are needed.
CBD has been explored in several studies as a potential treatment for ulcerative colitis. Research shows that CBD may potentially help reduce inflammation in the gastrointestinal system caused by inflammatory bowel diseases (IBD), such as ulcerative colitis.