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.
However, many of the studies done on cannabinoids are on mice and not humans. Mice also have an endocannabinoid system and are often used in research. Not every effect of marijuana has been well studied in humans.
Why People With IBD Consider Cannabis
The researchers looked for the patients in this study to go into remission, which they defined as a CDAI score of 150 or less. Other things they were looking for included a reduction of the CDAI by 100 points, a lowering of C-reactive protein levels by 0.5 mg, or improvements in quality of life as defined by the 36-question Short Form Health Survey.
Studies on Ulcerative Colitis
One survey showed that about half of all patients included in the study were either actively using marijuana (12%) or had used it in the past for their IBD (39%).