Crohnâ€™s disease and ulcerative colitis, the two main types of inflammatory bowel disease (IBD), are a challenge to treat. Among the potential treatment options is marijuana, and several recent studies indicate that this unconventional option offers some significant benefits.
How we treat inflammatory bowel disease
The current treatment options for the more than 1.5 million Americans and millions more who suffer with inflammatory bowel disease include dietary measures (e.g., olive oil extract, vitamin D, probiotics) and a variety of drugs. These treatments attempt to alleviate the diarrhea, rectal bleeding, fever, weight loss and abdominal pain and cramps associated with the disease.
The more common treatments for IBD include anti-inflammatory drugs, such as sulfasalazine, corticosteroids (which have significant side effects and are only suitable for short-term use), mesalamine (e.g., Apriso, Dipentum, Lialda), immune system suppressors (e.g., azathioprine, cyclosporine, infliximab, adalimumab, certolizumab, methotrexate), which can have significant side effects, and antibiotics, which are of questionable benefit. Beyond these drugs are others that can address specific symptoms such as diarrhea, constipation, or pain, or address nutritional deficiencies (e.g., iron, calcium, vitamin B12). Surgery is a last resort.
Inflammatory bowel disease can be life-threatening and thus deserves focused attention. Ulcerative colitis typically affects only the large intestine (colon) and rectum and usually develops gradually over time. Crohnâ€™s disease can occur anywhere along the intestinal tract and can infiltrate the tissues.
Studies of marijuana and IBD
A review of investigations into the use of cannabis for inflammatory bowel disease reveals that its use â€śin the clinical therapy has been strongly limited by their psychotropic effects.â€ť The authors of this recent Italian study, however, point out that cannabidiol (a non-psychoactive and healthful ingredient in marijuana), â€śis a very promising compoundâ€ť because it does not have any psychotropic effects, and that it is a â€śpotential candidate for the development of a new class of anti-IBD drugs.â€ť
A 2012 study published in Digestion noted that people who had had IBD for a long time responded favorably to marijuana, experiencing an increase in appetite, weight gain, better social functioning, improved ability to work, and an improvement in depression and pain after three months of treatment with inhaled cannabis. Earlier studies have also indicated positive effects.
For example, an Israeli study was the first to show that use of marijuana in people with Crohnâ€™s disease could provide a positive result. Twenty-one of the 30 patients in the study experienced significantly improvement after using marijuana, and the need for drugs was significantly reduced as well.
In yet another study, Canadian researchers evaluated 100 people with ulcerative colitis and 191 with Crohnâ€™s disease and their use of marijuana. The investigators found a significant level of marijuana use among people with ulcerative colitis and Crohnâ€™s disease (about 50% in each group). People who had a history of surgery for IBD were more likely to use marijuana (60%) than were those who had not undergone surgery (32%).
The bottom line appears to be that use of marijuana among people who have inflammatory bowel disease may be beneficial. If you have ulcerative colitis or Crohnâ€™s disease, you should ask your healthcare provider or another healthcare professional about the possibility of using marijuana for symptom relief.
Esposito G et al. Cannabidiol in inflammatory bowel disease: a brief overview. Phytotherapy Research 2012 July; doi:10.1002/ptr.4781
Lahat A et al. Impact of cannabis treatment on the quality of life, weight and clinical disease activity in inflammatory bowel disease patients: a pilot prospective study. Digestion 2012; 85(1): 1-8
Lal S et al. Cannabis use amongst patients with inflammatory bowel disease. European Journal of Gastroenterology and Hepatology 2011 Oct; 23(10): 891-96
Naftali T et al. Treatment of Crohnâ€™s disease with cannabis: an observational study. Israel Medical Association Journal 2011 Aug; 1(8): 455-58