Medical Cannabis as a treatment option
Inflammatory Bowel Disease
What is IBD?
Inflammatory bowel disease (IBD) is a medical term that describes a group of conditions in which the intestines become inflamed. The two major types of IBD are Cohn's Disease and Ulcerative Colitis. Crohn’s disease can occur in any part of the intestines. Ulcerative colitis affects the large intestine (colon).
The cause is unknown. Risk factors include a positive family history, cigarette smoking (Crohn’s Disease), use of Non-steroidal anti-inflammatory’s (NSAIDS) and diet with a possible link to a diet higher in processed foods
Signs and symptoms common to both Crohn's disease and ulcerative colitis include diarrhoea, fever, fatigue, abdominal pain and cramping, blood in stool, loss of appetite and weight loss
Symptoms depend on both where the location of disease in the gastrointestinal tract and how severe the inflammation is within the affected area. Symptoms of IBD may range from mild to severe and fluctuate without “rhyme or reason” Some people have ongoing symptoms, some periodic symptoms, others can go years with no symptoms.
Complications can include vitamin and mineral deficiencies, fistulas, intestinal abscesses and bowel cancer ( Ulcerative Colitis).
Treatments for IBD
Lifestyle measures include eating small meals, stress management and use of appropriate supplements. There is no specific IBD diet although spicy foods, dairy and excess fibre may worsen symptoms in some.
Medications to ease symptoms include antidiarrhoeal agents (e.g. diphenoxylate and atropine, loperamide ) , antispasmodics (e.g. hyoscine, mebeverine) and aanalgesics including opiates.
There are several medications used in the treatment of IBD. They divide into three main groups being Amino salicylates (e.g. Sulphasalazine ,Mesalazine), steroids, and immunomodulators (e.g. Azathioprine). Biologic and biosimilar agents are also now used.
Some people require surgery to some or all of the colon.
Treatment with Medicinal Cannabis
Treatment with medicinal cannabis for IBD
Medicinal cannabis has been shown in clinical trials to have benefits for symptoms in IBD.A trial in Crohn’s Disease showed that those receiving cannabis reported improved appetite and sleep, with no significant side effects. Another trial showed that a CBD-rich botanical extract may be beneficial for symptomatic treatment in ulcerative colitis. Medicinal cannabis can be prescribed if registered pharmaceuticals have failed to help or caused unacceptable side effects.
There are a few groups in Australia which provide information and support to people with IBD and their families. Below are links to their websites:
Impact of Cannabis Treatment on the Quality of Life, Weight and Clinical Disease Activity in Inflammatory Bowel Disease Patients
Our aims were to assess whether treatment with inhaled cannabis improves quality of life, disease activity and promotes weight gain in these patients.
A Pilot Prospective Study
2.5mg THC or PlaceboLink to publication