Cannabis and Its Potential Protective Role Against Inflammatory Bowel Disease: A Scoping Review

Abstract

Globally, around 15%-40% of patients suffering from inflammatory bowel disease (IBD) use Cannabis for pain reduction, increased appetite, and reduced need for other medications. Although many patients report having benefited by using Cannabis in IBD, there is still a lack of consensus regarding the use of Cannabis in IBD. The aim is to identify, explore and map literature on the potential protective role of Cannabis against IBD through this scoping review. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed during the search to answer the focal question: (1) Does Cannabis play a protective role against IBD as assessed by clinical remission; (2) If yes, what is the mechanism of action for this protective role. There were only three randomized controlled trials (RCTs) and three observational studies that satisfied the selection criteria of this scoping review. Although promising results including the improvement in general well-being/ Harvey-Bradshaw Index, health perception enhancement [4.1±1.43 to 7±1.42 (p = 0.0002)], weight gain, Crohn's Disease Activity Index (CDAI) score<150, Mayo scores (4-10), and reduction in clinical complications have been found in some studies, its medical use in IBD is still questionable due to the lack of high-quality evidence. Future RCTs studies should determine the cannabis treatment parameters and validate its safety and effectiveness in the IBD setting. The highlights include: the current literature provides inconclusive evidence concerning the protective role of cannabis for IBD patients; limited research evidence regarding the therapeutic use of cannabinoids for IBD warrants future investigation via RCTs; cannabis provides some benefits to IBD patients by improving their general wellbeing perceptions, Harvey-Bradshaw Index, Mayo scores, and minimizing their clinical complications.

Differential Effects of D9 Tetrahydrocannabinol (THC)- and Cannabidiol (CBD)-Based Cannabinoid Treatments on Macrophage Immune Function In Vitro and on Gastrointestinal Inflammation in a Murine Model

“…Cannabinoid receptor stimulation attenuates murine colitis, while cannabinoid receptor antagonism and cannabinoid receptor deficient models reverse these anti-inflammatory effects [ 4 ]. Phytocannabinoids have been used in preclinical models of gastrointestinal inflammation [ 42 , 43 ] and several clinical trial have tested the efficacy of cannabinoid-based treatments in IBD patients [ 42 , 44 ]. Indeed, in our DSS murine colitis model, cannabinoid treatments improved the clinical condition of the mice.…”

Effects of CB2 and TRPV1 Stimulation on Osteoclast Overactivity Induced by Iron in Pediatric Inflammatory Bowel Disease

“… 51 Although clinical studies are limited, cannabis has been shown to alleviate these symptoms in patients with IBD, improving their quality of life. 52–54 Chronic abdominal pain is among the most debilitating symptoms of IBD, and TRPV1 is known to modulate pain. 55 Recently, Defaye et al 56 proved that the inhibition of the visceral TRPV1 prevents microglial activation in the spinal cord and, subsequently, prevents persistent visceral hypersensitivity in colitis mice, suggesting that the channel could induce the transition from acute to chronic pain during active remission.…”

Marijuana-Induced Acute Hepatitis: A Case Report

“…Marijuana is not a single-agent compound but a complex mixture of compounds in variable proportions, including terpenoids, cannabinoids, and flavonoids [6,7]. According to a study conducted on chronic marijuana users to determine chemical changes, 76.9% had transaminitis, 57.7% had hepatomegaly, 73.1% had splenomegaly, and 46.2% had hepatosplenomegaly [1].…”