<span><b>Introduction</b>: Cannabis use among inflammatory bowel disease (IBD) patients is common. There are many studies of various laboratory models demonstrating the anti-inflammatory effect of cannabis, but their translation to human disease is still lacking.<b>Areas covered</b>: The cannabis plant co</span> … In small studies, smoking cannabis (marijuana — the dried parts of the cannabis plant) has improved IBD symptoms, including pain, nausea, and decreased appetite. However, there is currently no evidence that medical cannabis can reduce IBD inflammation or improve disease activity. Further research is needed, and underway now, regarding the impact of cannabis on IBD.
An overview of cannabis based treatment in Crohn’s disease
Introduction: Cannabis use among inflammatory bowel disease (IBD) patients is common. There are many studies of various laboratory models demonstrating the anti-inflammatory effect of cannabis, but their translation to human disease is still lacking.Areas covered: The cannabis plant contains many cannabinoids, that activate the endocannabinoid system. The two most abundant phytocannabinoids are the psychoactive Tetrahydrocannabinol (THC), and the (mostly) anti-inflammatory cannabidiol (CBD). Approximately 15% of IBD patients use cannabis to ameliorate disease symptoms. Unfortunately, so far there are only three small placebo controlled study regarding the use of cannabis in active Crohns disease, combining altogether 93 subjects. Two of the studies showed significant clinical improvement but no improvement in markers of inflammation.Expert opinion: Cannabis seems to have a therapeutic potential in IBD. This potential must not be neglected; however, cannabis research is still at a very early stage. The complexity of the plant and the diversity of different cannabis chemovars create an inherent difficulty in cannabis research. We need more studies investigating the effect of the various cannabis compounds. These effects can then be investigated in randomized placebo controlled clinical trials to fully explore the potential of cannabis treatment in IBD.
Keywords: Cannabis; Crohn’s disease; inflammatory bowel disease; marihuana; ulcerative colitis.
Kafil TS, Nguyen TM, MacDonald JK, Chande N. Kafil TS, et al. Cochrane Database Syst Rev. 2018 Nov 8;11(11):CD012853. doi: 10.1002/14651858.CD012853.pub2. Cochrane Database Syst Rev. 2018. PMID: 30407616 Free PMC article.
Hasenoehrl C, Storr M, Schicho R. Hasenoehrl C, et al. Expert Rev Gastroenterol Hepatol. 2017 Apr;11(4):329-337. doi: 10.1080/17474124.2017.1292851. Epub 2017 Feb 16. Expert Rev Gastroenterol Hepatol. 2017. PMID: 28276820 Free PMC article. Review.
Carvalho ACA, Souza GA, Marqui SV, Guiguer ÉL, Araújo AC, Rubira CJ, Goulart RA, Flato UAP, Bueno PCDS, Buchaim RL, Barbalho SM. Carvalho ACA, et al. Int J Mol Sci. 2020 Apr 22;21(8):2940. doi: 10.3390/ijms21082940. Int J Mol Sci. 2020. PMID: 32331305 Free PMC article. Review.
Naftali T, Bar-Lev Schleider L, Dotan I, Lansky EP, Sklerovsky Benjaminov F, Konikoff FM. Naftali T, et al. Clin Gastroenterol Hepatol. 2013 Oct;11(10):1276-1280.e1. doi: 10.1016/j.cgh.2013.04.034. Epub 2013 May 4. Clin Gastroenterol Hepatol. 2013. PMID: 23648372 Clinical Trial.
Kafil TS, Nguyen TM, MacDonald JK, Chande N. Kafil TS, et al. Inflamm Bowel Dis. 2020 Mar 4;26(4):502-509. doi: 10.1093/ibd/izz233. Inflamm Bowel Dis. 2020. PMID: 31613959 Review.
De Conno B, Pesce M, Chiurazzi M, Andreozzi M, Rurgo S, Corpetti C, Seguella L, Del Re A, Palenca I, Esposito G, Sarnelli G. De Conno B, et al. Foods. 2022 Apr 4;11(7):1044. doi: 10.3390/foods11071044. Foods. 2022. PMID: 35407131 Free PMC article. Review.
McDew-White M, Lee E, Alvarez X, Sestak K, Ling BJ, Byrareddy SN, Okeoma CM, Mohan M. McDew-White M, et al. EBioMedicine. 2022 Jan;75:103769. doi: 10.1016/j.ebiom.2021.103769. Epub 2021 Dec 23. EBioMedicine. 2022. PMID: 34954656 Free PMC article.
Abyadeh M, Gupta V, Paulo JA, Gupta V, Chitranshi N, Godinez A, Saks D, Hasan M, Amirkhani A, McKay M, Salekdeh GH, Haynes PA, Graham SL, Mirzaei M. Abyadeh M, et al. Biomolecules. 2021 Sep 27;11(10):1411. doi: 10.3390/biom11101411. Biomolecules. 2021. PMID: 34680044 Free PMC article. Review.
Silvestri C, Pagano E, Lacroix S, Venneri T, Cristiano C, Calignano A, Parisi OA, Izzo AA, Di Marzo V, Borrelli F. Silvestri C, et al. Front Pharmacol. 2020 Oct 8;11:585096. doi: 10.3389/fphar.2020.585096. eCollection 2020. Front Pharmacol. 2020. PMID: 33162890 Free PMC article.
In small studies, smoking cannabis (marijuana — the dried parts of the cannabis plant) has improved IBD symptoms, including pain, nausea, and decreased appetite.
However, there is currently no evidence that medical cannabis can reduce IBD inflammation or improve disease activity. Further research is needed, and underway now, regarding the impact of cannabis on IBD.
Video Length 00:01:20
What is the role of medical cannabis in the management of IBD? You may be hearing more and more about medical cannabis. How can it help patients with IBD? Watch this video to learn more about cannabis as well as its potential benefits and risks.
Cannabis is composed of over 70 active compounds called phytocannabinoids or cannabinoids.
The first is delta-9-tetrahydrocannabinol, or THC. THC is most known for its effects on one’s mental state. It has been known to alleviate nausea and chronic pain and improve one’s appetite.
The second is cannabidiol, or CBD, which has more anti-inflammatory or immune properties. Therapeutic uses may include reducing inflammation and treating insomnia, sleep apnea, spasticity, and pain.
Potential side effects
It is important to remember that cannabis can cause side effects including severe nausea and vomiting (a condition called cannabis hyperemesis syndrome), impaired short-term memory, difficulty concentrating, altered judgment, impaired coordination, anxiety, worsening mood, and long-term problems with behavior and reasoning, particularly in adolescents. There are also increased risks for fetuses and newborns if used during pregnancy or breastfeeding.