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CBD for IBD: Can It Help with Crohn’s Disease & Ulcerative Colitis?

CBD is a powerful natural anti-inflammatory supplement.

New research suggests CBD oil as a promising new treatment option for IBD (Crohn’s & Colitis).

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Inflammatory bowel diseases (IBD) can be frustrating.

It isn’t just the pain or bowel urgency — it interferes with all aspects of your life. IBD can cause you to miss work and social events when symptoms flare-up.

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.

In this article, you’ll learn how it works and how to use it effectively.

We’ll also cover some of the best CBD oils to use for IBD.

MEDICALLY REVIEWED BY

Carlos G. Aguirre, M.D., Pediatric Neurologist

Updated on January 12, 2022

Table of Contents
  • 1. Ulcerative Colitis
  • Four Factors That May Trigger IBD:
  • Step 1: Source A High-Quality Full-Spectrum CBD Oil, Capsule, or Suppository
    • For More Information on Finding the Best CBD Products, Check Out Some of Our Guides:
    • Answer the Following Questions in Your Notes:
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    The Benefits of CBD For Inflammatory Bowel Disease

    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 [1].

    In the case of Crohn’s disease and ulcerative colitis, CBD has been shown to provide the following benefits:
    1. Reduces gut inflammation
    2. Supports the health of the microbiome
    3. Alleviates abdominal pain & cramping

    Since CBD has been shown to reduce inflammation and interact with ECS receptors in the gut, it’s a promising supplement to help relieve some of the symptoms of IBD.

    1. CBD Reduces Gut Inflammation

    CBD has been shown to fight 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 [16]. 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 of specialized cells known as mast cells to release histamine [17] — a powerful inflammatory compound associated with allergies.

    2. CBD May Support the Microbiome

    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 [13] — though more research is needed to understand this effect in more detail.

    3. THC & CBD May Alleviate Abdominal Pain & Cramping

    THC (tetrahydrocannabinol) 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 [14].

    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 [15].

    What is Inflammatory Bowel Disease?

    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?

    1. Ulcerative Colitis

    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 [4].

    Symptoms of Ulcerative Colitis

    2. Crohn’s Disease

    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.

    Symptoms of Crohn’s Disease

    How is IBD Diagnosed?

    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.

    What Causes IBD?

    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.

    Four Factors That May Trigger IBD:

    1. Smoking
    2. Diet low in fiber and high saturated fats
    3. Bacterial gut infection
    4. Low vitamin D levels [4]

    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 [5].

    How is IBD Treated?

    The 5 “R’s” Of Healing Inflammatory Bowel Disease

    CBD products fit into the third and fourth points:

    1. Remove foods that trigger a reaction.
    2. Reduce inflammation and excessive immune response.
    3. Repair the intestinal lining by supporting microbiome health.
    4. Restore the function of the intestinal lining.
    5. Repletion of vitamins and minerals that are not adequately absorbed through the damaged intestine.

    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.

    Supporting IBD With Dietary Changes

    The primary goal here is to restore the gut microbiome, allowing beneficial bacteria to thrive instead of harmful ones.

    Dietary Changes For IBD May Include:

    • Increasing fiber intake
    • Eating more fruits and vegetables
    • Lowering saturated fat consumption
    • Eating more anti-inflammatory foods

    Lifestyle Modifications For IBD

    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.

    Lifestyle Modifications May Include:

    • Daily exercise
    • Yoga and meditation
    • Getting more sun exposure (to build up vitamin D levels)
    • Ensure at least eight hours of sleep each night
    • Identify and eliminate stress triggers

    Prescription IBD Medications

    The Main Types of Medications Given for IBD Include:

    • Antispasmodics — such as dicyclomine, reduces spasms of the intestinal muscles. These spasms are what cause pain and discomfort for those suffering from IBD.
    • Antidepressants —tricyclic antidepressants or selective serotonin reuptake inhibitors are often used to treat IBD. The former is better for diarrhea-predominant IBD and the latter for constipation-predominant IBD.
    • Antibiotics — there are some studies that showed that taking the antibiotic Rifaximin reduced the severity of symptoms in some patients [6].
    • Fecal Transplant — feces donated from a healthy individual is transplanted into the colon of an individual suffering from IBD. This process introduces healthy bacteria into the IBD-affected intestines [7].

    What Is CBD?

    CBD (cannabidiol) 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 [8]:

    1. CB1 receptors are located in the mucosal lining and neuromuscular layer of the colon [9].
    2. CB2 receptors are found on cells of the immune system [10].

    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 [12].

    Let’s look more closely at why CBD should be included in the management of IBD.

    Tips For Using CBD For IBD

    Step 1: Source A High-Quality Full-Spectrum CBD Oil, Capsule, or Suppository

    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.

    For More Information on Finding the Best CBD Products, Check Out Some of Our Guides:
    1. CBD Oils — Best for all-purpose CBD use
    2. CBD Capsules — Best option if taking other supplements or medications at the same time
    3. CBD Suppositories — Best for inflammation in the large intestine (delivers CBD directly to the source)

    Step 2: Assess Optimal Starting Dosage

    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.

    Using CBD for Ulcerative Colitis

    Lindsay Curtis is a health writer with over 20 years of experience in writing health, science & wellness-focused articles.

    Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.

    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.

    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.

    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.

    Read on to learn more about how CBD may be a useful supplemental therapy in the management of UC symptoms.

    Tinnakorn Jorruang / Getty Images

    Inflammation, CBD, and Ulcerative Colitis

    Cannabis plants contain chemicals called cannabinoids, which are compounds unique to the plant. The two primary cannabinoids are:

    • Tetrahydrocannabinol (THC), which has psychoactive effects that make a person feel “high”
    • Cannabidiol (CBD), which has no psychoactive effects but can provide a number of therapeutic benefits

    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 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.

    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.

    CBD for Ulcerative Colitis Symptoms

    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.

    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.

    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.

    Although more research is needed, current study results show promise that CBD may be beneficial for treating symptoms of ulcerative colitis.

    Are There Any Side Effects?

    Though CBD is generally well tolerated, you may experience some side effects. Common side effects include:

    • Changes in mood (e.g., irritability)
    • Diarrhea
    • Decreased appetite
    • Drowsiness
    • Dry mouth

    CBD and Your Liver

    CBD is metabolized by the liver, and large doses may lead to liver toxicity. Talk with your healthcare provider before using CBD. If you are on any prescription medications, they may recommend regularly monitoring your liver through bloodwork to ensure CBD is safe for you.

    How to Use CBD for Ulcerative Colitis

    While CBD won’t cure ulcerative colitis, it may help make your symptoms more manageable and help reduce flares.

    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.

    CBD is available in:

    • Edibles (e.g., gummies, CBD-infused beverages)
    • Plants (to be inhaled/smoked)
    • Capsules and pills
    • Tinctures and oils
    • Topicals (e.g., lotions, creams)

    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

    When shopping for CBD, you will notice different types available. These include:

    • Full-spectrum CBD: Contains all the natural components found in the cannabis plant, including terpenes, flavonoids, fatty acids, and cannabinoids. Full-spectrum CBD products contain trace amounts of THC. These compounds work in synergy in the body to obtain the desired therapeutic effects.
    • Broad-spectrum CBD: Similar to full-spectrum CBD, broad-spectrum CBD contains compounds in the cannabis plant, but with all traces of THC removed, so you will not experience any mind-altering effects.
    • CBD isolates: All other cannabinoids, terpenes, and flavonoids are removed to create a 99% pure CBD product.

    For the best results, look for broad-spectrum or full-spectrum CBD products. These may combine the effects of multiple cannabis compounds that work together in synergy, creating an “entourage effect” to offer the most health benefits.

    Dosage

    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.

    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.

    Another study also recorded dose ranges of 50 mg to 250 mg CBD capsules twice daily. Many participants were able to tolerate the higher dosage and saw improvements, though the study authors suggested that more research is needed.

    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.

    Talk to Your Healthcare Provider

    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.

    How to Buy CBD

    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.

    You’ll want to carefully read the label of any products you are considering and look for:

    • Amount of CBD per serving
    • Suggested use/dosage
    • Type (full-spectrum, broad-spectrum, or isolate)
    • List of ingredients
    • Manufacturer and distributor name

    You’ll also want to consider:

    • Cannabis source: Ensure the product you are purchasing is sourced from a company that ensures the quality and safe cultivation of their plants. Look for products that come from organic cannabis/hemp plants when possible.
    • Certificate of Analysis (CoA): CoAs are conducted by independent, accredited labels that verify third-party testing of the products.
    • Customer reviews: Testimonials from other users can tell you a lot about a product’s efficacy.

    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.

    A Word From Verywell

    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.

    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.

    Frequently Asked Questions

    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.

    The cannabis plant (to be smoked/vaped) comes in different strains, with varying CBD and THC levels. CBD-dominant cannabis strains may provide the best relief for inflammation. These strains tend to be high in the terpene called myrcene, which helps reduce inflammation.

    There are many delivery methods for CBD, including edibles (e.g., gummies), flowers, oils, tinctures, topicals, and suppositories. Finding the right one for you may require a little trial and error. The best method for you depends on personal preference and how quickly you may need relief. For example, you may get relief from painful symptoms sooner by vaping oil vs. consuming an edible. Start off with smaller doses and gradually increase the amount you use until you find the amount that offers you relief from your symptoms. Make sure to talk with your healthcare provider before you begin use.

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