IBD – Inflammatory Bowel Disease
More than 10 million people worldwide have some form of inflammatory bowel disease. Half of those suffer from severe, painful and life-altering conditions. Some examples include ulcerative colitis and Crohn’s disease.
Ulcerative colitis mainly affects the large intestine. Crohn’s disease can affect any part of the gastrointestinal tract, from mouth to anus. Researchers don’t know what causes these illnesses – but it’s believed that they are autoimmune disorders. They also tend to be hereditary.
Both UC and CD are chronic diseases that aren’t curable, according to our current medical knowledge. What we do know is that they can be managed effectively. Various medications and lifestyle changes are used as part of treatment.
With successful treatment strategies, sufferers can go into remission for long periods of time.
Symptoms of Inflammatory Bowel Disease
The symptoms of both ulcerative colitis and Crohn’s disease include:
- Persistent, urgent diarrhea
- Painful abdominal cramps
- Loss of appetite and weight loss
- Extreme fatigue
- Bowel stricture, perforation and fistula
Current Treatment Options for IBD
Treatment options include a controlled diet, steroid use, and even surgery. However, managing pain can be very tricky. Even well-managed IBD can still cause severe pain in sufferers.
Nonsteroidal anti-inflammatory drugs (NSAIDs) include ibuprofen or aspirin. Unfortunately, these can make sometimes make UC and CD symptoms even worse. NSAIDs work by blocking prostaglandins, which cause swelling and inflammation in the body. This type of medication can be very effective for pain relief in other conditions but tend to make ulceration and inflammation worse in a diseased bowel.
Opioid medications are also not recommended for IBD. They decrease pain in the short term, but they also stimulate the growth of harmful gut microbes. This causes problems even in people with a healthy digestive system. It’s potentially very dangerous for IBD patients, as it triggers the immune system. This can then cause the bowel to become inflamed.
Avoiding opioid tolerance and addiction are also serious considerations for chronic pain sufferers.
Alternative Treatment for IBD
Because the most common pain relief medications are not recommended for people with IBD, what can you do to manage pain?
Psychotropics work on the parts of the brain that secrete serotonin and norepinephrine – which control anxiety. Medical trials have shown that certain psychotropic medications (such as Xanax) also work to relieve abdominal pain. It’s thought that these drugs work to lessen the stress and anxiety caused by a painful disease. Researchers are unsure whether they work at the actual site of pain itself.
Selective serotonin reuptake inhibitors
Studies show that drugs like Celexa have some effectiveness in treating IBD abdominal pain. As with psychotropics, the effect of SSRIs is thought to act on the mind’s perception of pain, rather than the source of pain itself.
Transcutaneous electrical nerve stimulation
TENS has been shown to reduce abdominal pain in patients, compared to placebo. Nerve stimulation affects the electrical nerve impulses that move from the abdominal area to the spinal cord. These impulses then move to different parts of the brain. Although the mechanism of how TENS acts on abdominal pain isn’t completely clear, it shows some promise.
Cannabis or Cannabidiol Treatment
There is growing research in the field of using cannabis to control chronic pain from IBD.
We don’t yet fully understand the endocannabinoid system in the human body. But studies have shown that cannabis works on the peripheral nerves that detect pain sensations.
These nerves have a large number of cannabinoid receptors. Cannabinoids appear to help block peripheral nerve pain for many conditions, including IBD.
It’s not clear yet whether cannabis can help to cause remission in IBD patients. But its effectiveness in pain and nausea relief, as well as stimulation of appetite, is well known.
IBD Patient Case Study
Here follows a case study of how cannabidiol or CBD can help IBD patients.
Patient B has severe Crohn’s disease present in the small bowel, with strictures. Strictures are a narrowing of the bowel that complicates eating and digestion.
While surgery and a medical regime has helped, patient B struggles with daily pain and loss of appetite. Medications don’t seem to offer any relief and the patient also experiences side effects.
A small daily dose of CBD alleviates these symptoms to the point where patient B is able to function on a day-to-day basis. Patient B now can avoid harmful medications except in the case of an emergency.
Patient B insists that medical cannabis oil is the only solution that has offered relief from the pain and side effects caused by anti-inflammatory medications and other drugs such as Prednisone and Revellex.
This is not an isolated case, and a quick search done online to reputable sites such as The Cannabis Inforium will also reveal that thousands of IBD sufferers swear by this solution and seems to indicate that medical cannabis is the answer to several medical conditions.
So what’s the verdict?
More and more studies are being done on pain management in IBD. The mechanisms of how pain is transmitted from the visceral abdomen aren’t well understood – but luckily there are a few options for sufferers in search of alternative options of treatment without relying on harmful or addictive medications.