Recent studies have been carried out investigating the effects of cannabis in patients with Inflammatory Bowel Disease (IBD), including Chrohn’s Disease and Ulcerative Colitis, providing evidence of this plant having significant therapeutic potential.

Dr. Timna Nafatli, a gastroenterologist at the University of Tel Aviv, was the first researcher to evaluate the efficiency of medicinal cannabis in treating IBD and its effect in both Crohn’s and Ulcerative Colitis disease. Until now, studies have been limited in their placebo control groups, however, two notable studies have previously reported ‘significant clinical improvements’ but no development in markers of inflammation.

Dr Nafalti’s Clinical Trial on 50 Chrohn’s Disease Patients

Dr Nafatli’s recent clinical trial involved a total of 50 Chrohn’s disease patients, with those who received medical cannabis reporting less severe symptoms over the 8 week trial period¹. Participants receiving either CBD or THC (at a ratio of four to one) described a reduction in abdominal pains, an increase in appetite, and less diarrhea. The majority of patients reported an overall improved quality of life, however, no significant change was detected in the actual inflammation caused by the disease. According to Dr Nafatli, each participant underwent a colonoscopy before and after the trial in order to monitor any endoscopic changes, however, the inflammation inside each patient remained as it was prior. It is worthy to note that this was a short trial of only eight weeks, thus, further studies investigating the effects of the various cannabis compounds are required to fully determine if cannabis has the potential to treat inflammation associated with IBD.

Inflammation and Cannabis

The majority of research into the effects of medical cannabis (THC & CBD compounds) on IBD has involved both studies with animals and biopsied human tissue. The results are promising but more research and human studies are needed before a more comprehensive understanding of how effective THC & CBD are in treating IBD.

The researchers in one study induced intestinal inflammation also known as colitis in rodents. The researchers then tested the effectiveness of THC and CBD in comparison with sulphasalazine (a longstanding anti-inflammatory medication) on relieving associated inflammation. The findings illustrated that THC was most effective of the three substances when used on its own in a sufficient dose. CBD was ineffective on its own and the sulphasalazine was only mildly effective. The study discovered a synergy when they combined a lower dose of THC with CBD. This treatment proved to be even more effective than an effective dose of THC previously mentioned. This means that future treatment of IBD could consist of a lower dose of THC in combination with CBD, this would also lead to less side effects, as CBD does not cause intoxication. In contrast to sulphasalazine, THC on its own and combined with CBD also improved the function of colonic muscle activity.

Conclusion

In Israel, the Ministry of Heath allows the use of medical cannabis for individuals suffering from Crohn’s disease who meet certain criteria, such as, those who have not responded well or experienced adverse effects from biological treatments. As cannabis possesses several different compounds, isolating the active ingredients and establishing the most efficient delivery methods is key to determining if the plant is an effective treatment for IBD and related conditions.  At present, cannabis is considered extremely useful for symptomatic improvement, however, until further research is carried out, its anti-inflammatory effects are yet to be fully elucidated.