Impact of Cannabis Treatment on the Quality of Life, Weight and Clinical Disease Activity in Inflammatory Bowel Disease Patients: A Pilot Prospective Study

Lahat, Adi; Lang, Alon; Ben‐Horin, Shomron

doi:10.1159/000332079

Cited by 97 publications

(92 citation statements)

References 100 publications

(60 reference statements)

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“…This is consistent but slightly higher than the 10% prevalence rates previously reported in Canada and Israel. 5,6 We found that patients perceive that medical marijuana is helpful for treating abdominal pain, poor appetite, and nausea associated with IBD. Patients felt it was less helpful in treating diarrhea related to their disease.…”

Section: Discussionmentioning

confidence: 88%

“…An Israeli study found that 10% of patients with IBD were using recreational drugs for disease-related purposes, the majority of which was cannabis. 5 Similarly, a Canadian study found that 11.4% of patients with IBD had used cannabis in the previous year and 43.9% had used it at some point in their lifetime. 6 Patients with IBD were primarily using cannabis to alleviate abdominal pain.…”

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confidence: 97%

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Marijuana Use Patterns Among Patients with Inflammatory Bowel Disease

Allegretti¹,

Courtwright

Lucci³

et al. 2013

Inflammatory Bowel Diseases

106

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Background The prevalence and perceived effectiveness of marijuana use has not been well studied in inflammatory bowel disease (IBD) despite increasing legal permission for its use in Crohn's disease. Health care providers have little guidance about the IBD symptoms that may improve with marijuana use. The aim of this study was to assess the prevalence, sociodemographic characteristics, and perceived benefits of marijuana use among patients with IBD. Methods Prospective cohort survey study of marijuana use patterns in patients with IBD at an academic medical center. Results A total of 292 patients completed the survey (response rate = 94%); 12.3% of patients were active marijuana users, 39.0% were past users, and 48.6% were never users. Among current and past users, 16.4% of patients used marijuana for disease symptoms, the majority of whom felt that marijuana was “very helpful” for relief of abdominal pain, nausea, and diarrhea. On multivariate analysis, age and chronic abdominal pain were associated with current marijuana use (odds ratio [OR], 0.93; 95% confidence interval [CI], 0.89–0.97; P < 0.001 and OR, 3.5; 95% CI, 1.24-9.82; P = 0.02). Age and chronic abdominal pain were also multivariate predictors of medicinal use of marijuana (OR, 0.93; 95% CI, 0.89–0.97; P < 0.001 and OR, 4.7; 95% CI, 1.8–12.2; P = 0.001). Half of the never users expressed an interest in using marijuana for abdominal pain, were it legally available. Conclusions A significant number of patients with IBD currently use marijuana. Most patients find it very helpful for symptom control, including patients with ulcerative colitis, who are currently excluded from medical marijuana laws. Clinical trials are needed to determine marijuana's potential as an IBD therapy and to guide prescribing decisions.

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Section: Discussionmentioning

confidence: 88%

mentioning

confidence: 97%

Marijuana Use Patterns Among Patients with Inflammatory Bowel Disease

Allegretti¹,

Courtwright

Lucci³

et al. 2013

Inflammatory Bowel Diseases

106

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“…This was accompanied by an improvement in the disease activity index, perception of general health status, and ability to perform daily activities [42]. …”

Section: Human Datamentioning

confidence: 99%

Cannabis for Inflammatory Bowel Disease

Naftali

Mechulam

Lev³

et al. 2014

Dig Dis

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The marijuana plant Cannabis sativa has been used for centuries as a treatment for a variety of ailments. It contains over 60 different cannabinoid compounds. Studies have revealed that the endocannabinoid system is involved in almost all major immune events. Cannabinoids may, therefore, be beneficial in inflammatory disorders. In murine colitis, cannabinoids decrease histologic and microscopic inflammation. In humans, cannabis has been used to treat a plethora of gastrointestinal problems, including anorexia, emesis, abdominal pain, diarrhea, and diabetic gastroparesis. Despite anecdotal reports on medical cannabis in inflammatory bowel disease (IBD), there are few controlled studies. In an observational study in 30 patients with Crohn's disease (CD), we found that medical cannabis was associated with improvement in disease activity and reduction in the use of other medications. In a more recent placebo-controlled study in 21 chronic CD patients, we showed a decrease in the CD activity index >100 in 10 of 11 subjects on cannabis compared to 4 of 10 on placebo. Complete remission was achieved in 5 of 11 subjects in the cannabis group and 1 of 10 in the placebo group. Yet, in an additional study, low-dose cannabidiol did not have an effect on CD activity. In summary, evidence is gathering that manipulating the endocannabinoid system can have beneficial effects in IBD, but further research is required to declare cannabinoids a medicine. We need to establish the specific cannabinoids, as well as appropriate medical conditions, optimal dose, and mode of administration, to maximize the beneficial effects while avoiding any potential harmful effects of cannabinoid use.

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“…Cannabis/Cannabinoids in IBD The inflamed gut is highly amenable to treatment with cannabinoids, which is documented for human IBD not only by anecdotal reports but, importantly, also by several questionnaire studies [70][71][72][73] as well as observational studies and prospective clinical trials [74][75][76][77]. Many of the questionnaires have revealed that patients with IBD frequently self-medicate with Cannabis to alleviate abdominal pain and diarrhea.…”

Section: Are Cannabinoids a Therapeutic Option For Inflammation And Nmentioning

confidence: 99%

Medical Cannabis and Cannabinoids: An Option for the Treatment of Inflammatory Bowel Disease and Cancer of the Colon?

Grill

Hasenoehrl

Storr

et al. 2018

Med Cannabis Cannabinoids

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In the past few years, we have witnessed a surge of new reports dealing with the role of cannabinoids, synthetic as well as herbal, in the mechanisms of inflammation and carcinogenesis. However, despite the wealth of in vitro data and anecdotal reports, evidence that cannabinoids could act as beneficial drugs in inflammatory bowel disease (IBD) or in neoplastic development of the human gastrointestinal tract is lacking. Some insight into the effects of medical Cannabis (usually meaning dried flowers) and cannabinoids in IBD has been gained through questionnaires and small pilot studies. As to colorectal cancer, only preclinical data are available. Currently, Δ⁹-tetrahydrocannabinol (THC) and its synthetic forms, dronabinol and nabilone, are used as an add-on treatment to alleviate chronic pain and spasticity in multiple sclerosis patients as well as chemotherapy-induced nausea. The use of medical Cannabis is authorized only in a limited number of countries. None of the mentioned substances are currently indicated for IBD. This review is an update of our knowledge on the role of cannabinoids in intestinal inflammation and carcinogenesis and a discussion on their potential therapeutic use.

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Impact of Cannabis Treatment on the Quality of Life, Weight and Clinical Disease Activity in Inflammatory Bowel Disease Patients: A Pilot Prospective Study

Cited by 97 publications

References 100 publications

Marijuana Use Patterns Among Patients with Inflammatory Bowel Disease

Marijuana Use Patterns Among Patients with Inflammatory Bowel Disease

Cannabis for Inflammatory Bowel Disease

Medical Cannabis and Cannabinoids: An Option for the Treatment of Inflammatory Bowel Disease and Cancer of the Colon?

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