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CBD for Eosinophilic Esophagitis: What Your Patients Should Know

Medically Reviewed By Dominique Fontaine, BSN, RN, HNB-BC, HWNC-BC

People with eosinophilic esophagitis may face challenges finding relief, and may turn to alternative therapies like CBD. Learn what to share with your patients about trying CBD safely.

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Eosinophilic esophagitis is a chronic condition that presents several challenges for patients. Its symptoms can be confusing and it can limit food choices and make it harder to eat. People with this condition may be open to trying alternative treatments, such as cannabidiol (CBD), to alleviate these issues. But what does the evidence say?

CBD is a main component, along with tetrahydrocannabinol (THC), of the Cannabis sativa plant. Unlike THC, CBD does not give you a “high” and is legal Trusted Source Food and Drug Administration (FDA) Governmental authority Go to source  to use, according to the Food and Drug Administration (FDA). Because of this, many Americans have been willing to try it for a variety of medicinal purposes. 

A recent Forbes poll found that 60% of U.S. adult respondents say they have tried CBD and believe it has medical benefits. However, research supporting most uses of it is lacking. Available research mainly consists of preclinical laboratory or animal studies, or limited human studies.

If you have patients with eosinophilic esophagitis, this article summarizes what we know so far about CBD and the disease.

Potential benefits of CBD for eosinophilic esophagitis

Theoretically, it would seem like CBD would have some benefits in an allergic and inflammatory disease, such as eosinophilic esophagitis. Research in other diseases, such as rheumatoid arthritis Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source , suggest that CBD may have anti-inflammatory Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  properties. Similar results have been found in mice with induced allergic asthma. However, these studies are preclinical and this level of data does not always translate into benefits in humans. 

With eosinophilic esophagitis, there are no studies, preclinical or otherwise, evaluating its potential use. However, there is a current clinical trial looking at the potential role of cannabinoid receptors and ligands in the development of eosinophilic esophagitis. (The endocannabinoid system has a homeostatic Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  role in pain, immune function, and inflammation.)

There is also a case study Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  in the literature that potentially links chronic cannabidiol use to eosinophilic esophagitis in a patient taking the prescription form, Epidiolex. In the prescribing information for Epidiolex, increased eosinophil counts were a common adverse reaction in clinical studies. It occurred in 5% of Epidiolex-treated patients compared to zero in the placebo group. This raises concern about patients with eosinophilic esophagitis taking cannabidiol.

Potential risks of CBD for eosinophilic esophagitis

For most people, CBD is generally regarded as safe. While it can have side effects, they are usually mild and may include Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  diarrhea, fatigue, and sleepiness. However, the incidence of increased eosinophil counts in clinical trials of Epidiolex raises concern about the safety for people with eosinophilic esophagitis, as mentioned above.

In addition, CBD does have potential drug interactions. It is a substrate as well as an inhibitor of the cytochrome P450 enzyme system. Therefore, it has the potential to interact with some medications that treat eosinophilic esophagitis including:

  • Biologics, such as dupilumab (Dupixent), which antagonize interleukin and may influence the activity of cytochrome enzymes 
  • oral glucocorticoids
  • proton pump inhibitors (PPIs)

Another potential problem with CBD is product consistency. Let patients know that CBD formulations may contain other biologically active compounds Trusted Source Food and Drug Administration (FDA) Governmental authority Go to source . They should only purchase CBD products from reliable sources and look for a third-party lab certificate of analysis to verify the product’s purity.

Research still needed to learn more about CBD for eosinophilic esophagitis

Due to the current lack of research, there is no evidence to recommend using CBD for eosinophilic esophagitis. In fact, the little information that is available would recommend against using it. More research is necessary before patients should consider using it. 

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  1. CBD statistics, data and use. (2023). https://www.forbes.com/health/cbd/cbd-statistics/#:~:text=CBD%20Statistics%20at%20a%20Glance,-A%20Forbes%20Health&text=Nearly%2065%25%20of%20U.S.%20adults,to%20the%20Forbes%20Health%20survey
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Medical Reviewer: Dominique Fontaine, BSN, RN, HNB-BC, HWNC-BC
Last Review Date: 2023 Oct 18
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