Inflammatory bowel disorders are categorized based on the main symptoms, usually characterized by constipation, diarrhea, or alternating symptoms of both, and made worse by stress (see our articles on Anxiety, Depression, and Stress). These disorders include ulcerative colitis and Cronh’s disease, which are gut-based conditions that can affect other parts of the body. The epithelium of the gastrointestinal (GI) system is connected with the enteric nervous system, which is a web of neurons that regulate gut function and where both CB1 and CB2 receptors are found in abundance. This is one aspect of the overall relationship between metabolism and energy balance and the endocannabinoid system (ECS). For more, see our article The Endocannabinoid System Explained. This system could assist with Diabetes and Weight Loss as explained in previous articles.
Inflammatory bowel disease affects millions of individuals; nevertheless, current treatments in pharmacology are severely disappointing and unsatisfactory. Cannabidiol has both pharmacological and antioxidant effects that are potentially advantageous in gut disorders involving inflammation. 
A variety of studies from the past decade have shown that chemical messengers and endocannabinoid receptors (part of the ECS) are involved in adjusting and balancing the GI system. More specifically, the enzyme FAAH, which is we explained in our article The Synergy of Hemp and Maca, is vitally involved in the adjustment and modulation of intestinal physiology through anandamide, 2-AG, and other endocannabinoids produced by the body. The plant-based cannabinoid, CBD, has been found to assist the endocannabinoid system through blocking the FAAH enzyme responsible for the breakdown of anandamide, which keeps anandamide levels in the blood longer.
A study from 2016 was the first to reveal in the lab that preventing the breakdown of FAAH with CBD may suppress colitis by reducing activated T cells and inflammatory response in the colon. 
“These processes might link stress with abdominal pain," researchers wrote that year. “The endocannabinoid system (ECS) is also involved centrally in the manifestation of stress, and endocannabinoid signaling reduces the activity of hypothalamic-pituitary-adrenal pathways via actions in specific brain regions, notably the prefrontal cortex, amygdala, and hypothalamus. Agents that modulate the ECS are in early stages of development for treatment of gastrointestinal diseases. Increasing our understanding of the ECS will greatly advance our knowledge of interactions between the brain and gut and could lead to new treatments for gastrointestinal disorders.” 
In your search for knowledge, just remember that the information contained in this article is considered useful for informational purposes only and is not considered medical advice. Our policy, is that prior to making changes to your lifestyle or treatment plan, or exploring the use of cannabidiol or medical cannabis, always consult with your doctor. At the same time, educated and aware person’s, may become their own highly informed health consultants.
CBD products with a ratio of 20:1 or higher are generally recommended and given as drops in oil, edibles, or capsules. Patients should consider which delivery system is the least disruptive and best absorbed by their bodies. Cannabinoids can be extremely effective in reducing chronic inflammation, helping with temporary stress, and protecting the body from the physiological effects of both. Another promising cannabinoid for gastrointestinal inflammation is CBG. The hybrid strains “purple kush” and “afghan” and others high in the terpene limonene are sought after in those with inflammatory bowel disorders.  Tinctures based in alcohol are best avoided for those with IBS. Also, it’s important to note that indica or sativa strains high in THCV may suppress appetite. 
As always, start with a micro dose of cannabidiol to test for sensitivity before going up using the titration method until symptoms subside. The micro to standard dose is typically recommended to assist with inflammatory bowel disorders such as Crohn's disease and Ulcerative Coliitis.
For nausea relief, or other more immediate symptoms, smoking or vaporizing CBD works well. The effect is immediate, and lasts one to three hours, whereas most ingestible products take thirty to sixty minutes to take effect, but last six to eight hours. Vaporizers utilizing a CO2 concentrate are very effective, which can be found in varying ratios of cannabidiol to THC. Herbal vaporizers using the whole plant are also an effective delivery method. Tinctures or sublingual sprays are also absorbed quickly and generally last longer than inhaled products.
The Cannabis Health Index is a scoring system for cannabis based on the best available evidence to date, which currently rates cannabis (including cannabidiol) in the possible-to-probably range based on studies related specifically to Crohn’s disease, and rates in the possible range of efficacy for treatment of inflammatory bowel disorders.
Research from 2012 showed that intrarectal delivery of cannabinoids via a suppository may be a useful administration route for the treatment of colonic inflammation.  The next year, the same researchers made a comment that the activity of cannabinoids had been enigmatic for pharmacologists and gastroenterologists, but that new evidence pointed toward cannabidiol as a new potential candidate for the development of a new class of anti-IBD drugs. 
Acetaminophen is generally prescribed for mild pain of Crohn's disease, steering clear of ibuprofen, naproxen, and aspirin, which can all aggravate symptoms of the disorder. Cannabidiol can assist with relieving pain, inflammation, and cramping in response to intestinal upset by attaching itself to the cannabinoid receptors found on the intestinal walls and gut, easing cramping and normalizing bowel movements.
Current medical treatments include the use of antimetabolites azathioprine and 6-mercaptopurine which work through suppressing the immune system. This can help to decrease the use of typical steroid requirements commonly used on Crohn's such as prednisone and budesonide. Ustekinumab (Stelara) is the most recent biologic approved to treat Crohn's, which works by blocking certain pathways of inflammation. Biologics are products made in a lab from living organisms or contain components of living organisms.
For more information, read our article on Hemp for Digestive and Bowel Disorders.
Given the side effects to benefit ratio of cannabis products, most well educated on the topic will conclude that if it doesn't resolve symptoms on the first attempt, give it another strain a try, as there are many different ratio's that each bring their own unique properties worth exploring.
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