Inflammatory bowel diseases (IBD), such as Crohns and Colitis, are chronic diseases which negatively impact the lives of many, interfering with their overall quality of life and well being. Currently there is no cure, and standard pharmacological interventions are not always effective and tend to expose users to undesirable side effects. As such, many individuals suffering from IBD have taken agency in the management of their health and turned to complementary and alternative medicines for symptom relief and disease management. Cannabis has a long-standing history of medicinal use, specifically for the treatment of gastrointestinal pain and diarrhea. This is fitting as we know cannabis has anti-inflammatory properties, and that the endocannabinoid system (ECS) plays a key role in maintaining gut homeostasis1,2. In studies using mice, THC (main psychoactive component of cannabis), has been shown to protect against experimentally induced colitis, and CBD (a non-psychoactive component of cannabis) has been shown to reduce injury to the colon in mice with colitis3,4,5,6. These findings are very promising; however, we need more evidence from human studies to draw clear conclusions.
In examining past survey research, it is evident that individuals suffering from IBD have long since been using cannabis to better manage their symptoms, and improve their quality of life. Cannabis use is more common amongst those with IBD as compared to the general population, and individuals with IBD often specifically site symptom relief as their reason for using cannabis1,7. Patients report successful management of symptoms such as abdominal pain, nausea, loss of appetite and diarrhea through medicating with cannabis7,8,9,10. In an interview based retrospective study involving 30 patients living with Crohns disease and medicating with cannabis, all patients reported it had a positive impact on their disease activity11. Patients also reported a reduction in both their number of bowel movements per day, and their need for other drugs. Specifically, the number of patients requiring steroid treatments before beginning treatment was reduced from 26 to 4. While survey and interview data cannot be taken as conclusive proof of the efficacy of cannabis as a treatment for IBD, the data does largely point towards a positive impact on disease activity.
Some of the most promising research in this area has been conducted by a group of researchers in Israel. They ran the first experimentally controlled study looking at the impact of medicating with cannabis on disease activity in 21 patients with Crohns that had been unresponsive to treatment with steroids12. Of the 21 patients 11 were treated with cannabis cigarettes, and 10 with placebo cigarettes devoid of any substantial amount of cannabinoids. Of those that received cannabis, 45% reached full clinical remission after 8 weeks of treatment, as compared to 10% who reached remission in the placebo group. This finding was not statistically significant, however that may be due to the small sample size. What was found to be significant were patients scores on the Crohns Disease Activity Index, when treated with cannabis the patients, on average, saw over a 100-point improvement in their scores, indicating a positive impact of cannabis on disease activity.
Due to a lack of available research on the topic it is too soon to draw any full conclusions about the efficacy of medicinal cannabis to treat IBD. However, taken together, research from animal and human studies as well as personal testimony from those with IBD, points to a positive effect of cannabis on symptomology and disease activity. For patients with IBD finding a treatment plan that is effective without exposing them to unwanted side-effects can be frustrating. Medicinal cannabis is a viable complementary and alternative form of medicine which can allow individuals to take greater agency in the management of their disease activity, and improve their quality of life. It may be especially helpful for those who have failed to find relief through standard pharmacological intervention. This is a research area which is ripe with promise, and we look forward to future research to further substantiate what many people treating their IBD with cannabis have been saying for years, it works.
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11. Naftali, T., Bar Lev, L., Yablekovitz, D., Half, E., Konikoff, F. M. (2011). Treatment of Crohn’s disease with cannabis: An observational study. Israel Medical Association Journal, 13, 455-458.
12. Naftali, T., Schleider L. B., Dotan, I., Lansky, E. P., Benjaminov, F. S., Konikoff, F. M. (2013). Cannabis induces a clinical response in patients With Crohn’s disease: A prospective placebo-controlled study. Clinical Gastroenterology and Hepatology 11, 1276-1280.I am text block. Click edit button to change this text.