Ulcerative colitis and marijuana

Cannabis and cannabis oil for the treatment of ulcerative colitis

What is ulcerative colitis?

Ulcerative colitis is a chronic, long-term illness that causes inflammation of the colon and rectum. Symptoms may include diarrhea, rectal bleeding, passage of mucus, and abdominal pain. It is characterized by periods of acute flares when people experience symptoms as well as periods of remission when symptoms stop.

What are cannabis and cannabinoids?

Cannabis is a widely used recreational drug that has multiple effects on the body via the endocannabinoid system. Cannabis contains multiple sub-ingredients called cannabinoids. Cannabis and cannabis oil containing specific cannabinoids can cause cognitive changes such as feelings of euphoria and altered sensory perception. However, some cannabinoids, such as cannabidiol, do not have a psychoactive effect. Cannabis and some cannabinoids have been shown to decrease inflammation in animal and laboratory models which suggests it may help people with ulcerative colitis. For example, cannabidiol is one such cannabinoid that has shown anti-inflammatory activity in mice.

What did the researchers investigate?

The researchers evaluated whether cannabis or cannabis oil (cannabidiol) was better than placebo (e.g. fake drug) for treating adults with active ulcerative colitis or ulcerative colitis that is in remission. The researchers searched the medical literature extensively up to 2 January 2018.

What did the researchers find?

Two studies including 92 adult participants with ulcerative colitis were included. Both studies assessed cannabis therapy in participants who had active ulcerative colitis. No studies that assessed cannabis therapy in participants with ulcerative colitis in remission were identified. One study (60 participants) compared 10 weeks of treatment with capsules containing cannabis oil with up to 4.7% D9-tetrahydrocannabinol (THC) to placebo in participants with mild to moderately active ulcerative colitis. The starting dose of cannabidiol was 50 mg twice daily which was increased, if tolerated, to a target of 250 mg twice daily. The other study (32 participants) compared 8 weeks of treatment with two cannabis cigarettes per day containing 0.5 g of cannabis, corresponding to 11.5 mg THC to placebo cigarettes in participants with ulcerative colitis who did not respond to conventional medical treatment.

The study comparing cannabis oil capsules to placebo found no difference in remission rates at 10 weeks. Twenty four (7/29) percent of cannabidiol participants achieved clinical remission compared to 26% (8/31) of placebo participants. The study also showed higher self reported quality of life scores in cannabis oil participants compared to placebo participants. More side-effects were observed in the cannabis oil participants compared to the placebo participants. These side effects were considered to be mild or moderate in severity. Common reported side effects include dizziness, disturbance in attention, headache, nausea and fatigue. No patients in the cannabis oil group had any serious side effects. Ten per cent (3/31) of the placebo group had a serious side effect. Serious side effects in the placebo group included worsening ulcerative colitis and one complicated pregnancy.

The second study comparing two cannabis cigarettes (23 mg THC/day) to placebo cigarettes showed lower disease activity index scores in the cannabis group compared to the placebo group. C-reactive protein and fecal calprotectin levels (both measures of inflammation in the body) were similar in both groups. No serious side effects were reported. This study did not report on remission rates.

Conclusions

The effects of cannabis and cannabis oil on ulcerative colitis are uncertain, thus no firm conclusions regarding the effectiveness and safety of cannabis or cannabis oil in adults with active ulcerative colitis can be drawn. There is no evidence for cannabis or cannabis oil use for maintenance of remission in ulcerative colitis. Further studies with a larger number of participants are required to assess the effects of cannabis in people with active and inactive ulcerative colitis. Different doses of cannabis and routes of administration should be investigated. Lastly, follow-up is needed to assess the long term safety outcomes of frequent cannabis use.

G&H What is the current legal status of cannabis?

JK As of March 2018, 9 US states have legalized cannabis (also known as marijuana) for recreational use and 22 US states have legalized cannabis for medical use. Fourteen additional states have legalized cannabis strains with a high cannabidiol (CBD) to low delta-9-tetrahydrocannabinol (THC) ratio (which is thought to have less psychoactive effects). A total of 13 states have moved to decriminalize cannabis, but not legalize it. (The definition of decriminalization varies from state to state.)

G&H In which disease states has medical cannabis been studied?

JK An international survey from the World Health Organization found that medical cannabis has been primarily studied and utilized for chronic back pain, sleep disorders, depression, injury-related pain, and multiple sclerosis. The more robust data on the use of medical cannabis, in the form of randomized, controlled trials, come from the study of patients with neuropathic pain, chronic pain, or multiple sclerosis. There are also limited data in patients with glaucoma, HIV and AIDS cachexia, cancer-related symptoms (nausea and vomiting), and posttraumatic stress disorder. In addition, significantly smaller studies have been conducted in the setting of Crohn’s disease and ulcerative colitis.

G&H What is the rationale for using medical cannabis to help manage inflammatory bowel disease?

JK There is currently a large unmet need in the treatment of inflammatory bowel disease (IBD) with conventional medical therapy. Despite improvement in disease activity, many patients have persistent clinical symptoms that have significant impact on their quality of life. Patients have been seeking out alternative therapies (including cannabis) to help manage persistent symptoms associated with IBD.

Cannabis, which comes from the plant Cannabis sativa, is composed of hundreds of compounds and over a hundred cannabinoids (including THC and CBD, which are the most well known). Cannabinoids interact with the endocannabinoid system through endocannabinoid receptors. The most-studied receptors, CB1 and CB2, are expressed in the gastrointestinal tract, enteric nervous system, brain, and immune cells, which are areas of interest in patients with IBD. Activation of these receptors may result in gastrointestinal effects. A 2009 study in a mouse model of colitis found that when the CB1/CB2 receptors were activated, there was a decrease in inflammation. This provides a potential rationale as to the role of cannabis in the management of IBD and IBD-related symptoms.

G&H Currently, how common is medical cannabis use in IBD patients?

JK Surveys of cannabis use in IBD patients in the United States and Canada have found that approximately 15% to 20% of patients currently use cannabis, and up to 40% have tried cannabis to relieve IBD symptoms. These retrospective studies have shown that patients are using cannabis for improvement in pain, appetite, and diarrhea. In these studies, patients have used cannabis by both oral and inhalation routes.

G&H What have studies reported regarding symptom improvement with the use of medical cannabis in patients with Crohn’s disease and ulcerative colitis?

JK There have been a few small retrospective, prospective, and randomized, controlled studies that have looked at the effects of medical cannabis use in both Crohn’s disease and ulcerative colitis. A survey-based study in cannabis users with IBD in the United States noted that cannabis use was associated with an improvement in abdominal pain, appetite, nausea, and diarrhea. In a prospective pilot study, IBD patients who were using medical cannabis as needed for pain control experienced improvements in pain, general health perception, social functioning, ability to work, and symptoms associated with IBD. Although patients in this study reported weight gain, there was no change in C-reactive protein (CRP) measurements. Further studies have assessed both symptom improvement as well as efficacy of treatment in IBD.

G&H Have any studies shown that medical cannabis use can improve Crohn’s disease activity?

JK Several small studies have attempted to address this question. The first small observational study in Crohn’s disease (N=30) was conducted by Naftali and colleagues in Israel in 2011. The researchers found that medical cannabis use was associated with a decrease in subjective disease activity scores and a reduced need for corticosteroid therapy. However, concerningly, the majority of patients discontinued conventional medical therapy while using medical cannabis.

This study led to further investigation by Naftali and colleagues in the form of the first randomized, controlled trial of medical cannabis in Crohn’s disease (N=21), the results of which were published in Clinical Gastroenterology & Hepatology in 2013. The study found that smoking 2 cannabis cigarettes per day for 8 weeks was associated with significant improvement in Crohn’s Disease Activity Index (CDAI) scores compared to patients who were on placebo. Clinical remission was seen in 45% of patients on daily cannabis, and 25% were able to stop corticosteroid therapy. However, despite overall improvement in clinical symptoms in the cannabis group, the study failed to meet its primary endpoint of clinical remission (ie, a CDAI <150). Cannabis use was not associated with an improvement in objective disease markers (hemoglobin and CRP). Similar to previous retrospective research, cannabis use in this study was associated with improved overall satisfaction, quality-of-life scores, pain scores, and appetite.

In their most recent follow-up research, Naftali and colleagues performed a placebo-controlled study to examine low-dose oral CBD in patients with medically refractory Crohn’s disease (N=19). This study was the first to look at a single-compound oral formulation in IBD patients. The study had negative findings, as there was no improvement in CDAI or laboratory parameters when compared to placebo. However, there were no adverse effects in the treatment group when compared to placebo. This study highlighted the possible differences in cannabis formulations and routes and their impact on clinical improvement.

G&H Have there been similar studies looking at the efficacy of medical cannabis in patients with ulcerative colitis?

JK The initial studies were done in Crohn’s disease, and, since then, there has only been 1 published study examining the effects of medical cannabis in patients with ulcerative colitis. Irving and colleagues assessed the efficacy, safety, and tolerability of once-daily oral CBD-4% THC (CBD-rich extract) for 10 weeks in patients with active ulcerative colitis (N=60) as an adjuvant therapy while on stable dosing of mesalamine therapy. Patients were less tolerant to the CBD-rich extract than placebo, and there were significant protocol deviations in the study. Both groups failed to reach the primary endpoint of clinical remission, and there were no differences in the rates of remission between the groups (28% for the CBD-rich extract and 26% for placebo). Per-protocol analysis showed improvement in patient’s global impression of change and a trend toward improved quality-of-life scores with CBD-rich extract use.

More recently, unpublished data were presented by Naftali and colleagues at this year’s Digestive Disease Week. They evaluated the effects of smoking 2 cannabis (THC-rich) cigarettes daily or placebo for 8 weeks in patients with moderate to severe ulcerative colitis (N=28). The authors assessed both clinical outcomes and objective outcomes (laboratory evaluation and endoscopic evaluation). In this study, medical cannabis use was associated with improved clinical disease activity scores and endoscopic improvement (reduction of Mayo endoscopic subscore from 2 to 1; P<.01). However, there was no significant change in CRP or fecal calprotectin in either group. No serious side effects were observed during the treatment period, but the authors reported a higher rate of memory decline in the cannabis group.

G&H Are there any concerns with the short- or long-term use of medical cannabis?

JK The long-term effects have not been well studied in an IBD population. However, a 2014 study published in The New England Journal of Medicine identified several long-term risks associated with cannabis use in the general population. These include risk of addiction to other substances, diminished life achievement, increase in motor vehicle accidents, symptoms of chronic bronchitis, abnormal brain development in a younger population, psychiatric disturbances, depression, and anxiety. Studies in the general population have also shown an increased risk for cannabis hyperemesis syndrome in frequent cannabis users. Although this has not been described in the limited studies in IBD patients, I have seen it as one of the more common side effects associated with daily cannabis use in my IBD patients. Cannabis use may also have effects on fertility (both male and female), which can have implications in this often young, childbearing-age population. Overall, the small studies performed in both Crohn’s disease and ulcerative colitis have failed to show serious adverse events. However, the recent study in ulcerative colitis by Irving and colleagues had significant protocol deviations, which were thought to be related to the THC content in the preparation. In addition, Naftali and colleagues’ study in patients with ulcerative colitis showed an increase in memory decline in the cannabis group. These are important considerations when talking about the efficacy and tolerability of this potential adjuvant therapy.

In addition, these studies have raised some concerns about the use of cannabis specifically in the IBD population. The study by Naftali and colleagues in 30 Crohn’s disease patients showed improvement in clinical symptoms; however, the majority of patients stopped conventional medical therapy. It is important to note that the studies that have been conducted have not suggested a role for cannabis as primary therapy but have studied cannabis as adjuvant therapy for patients with IBD and ongoing clinical symptoms. We know that medication noncompliance is associated with clinical relapse of disease and could have implications on disease outcomes. In addition, a large retrospective study in Canada of 300 patients with Crohn’s disease found that self-reported medical cannabis use was associated with an increased risk for surgery (odds ratio, 5.30; 95% CI, 1.45-17.46). This finding comes from uncontrolled retrospective data, and it should be noted that patients using medical cannabis could have been more symptomatic, possibly due to greater disease severity, which is a known risk factor for surgery.

G&H Are there any limitations to the research that has been conducted to date?

JK Due to the federal status of cannabis as a Controlled Substance Act Schedule I drug, there have been no randomized, controlled trials evaluating the effects of cannabis in IBD patients in the United States. In addition, most of the studies in this area have looked at the administration of medical cannabis via the inhalation route, with only more recent studies looking at an oral formulation. Larger studies are needed to look at efficacy in IBD patients as well as evaluate the optimal route of administration, formulation, dosing frequency, and duration. Other limitations of the research to date include selection bias, lack of control groups, and recall bias (as patients who use cannabis and continue to use it are more likely to have subjective benefit).

G&H Do you have any advice for gastroenterologists who are managing IBD patients interested in trying medical cannabis?

JK It is important for health care providers to be informed about medical cannabis, including the limited data on efficacy and adverse events, so that they can counsel their patients appropriately. Studies have shown that many patients are using cannabis, but the majority do not discuss it with their health care provider. In a recent study, up to 50% of IBD patients stated that they would use medical cannabis if it became legal, which means that many patients are coming into their health care provider’s office thinking about this therapeutic approach but may not be discussing it at their office visit. Gastroenterologists should incorporate this discussion into their routine clinical evaluation of IBD patients. It is routine in my practice to ask all patients about both recreational and medical cannabis use to ensure that we can have an open discussion about the implications of this therapy in their management strategy.

It is also important for health care providers to know that each state has its own medical cannabis laws. Although many states list Crohn’s disease and/or ulcerative colitis as qualifying medical conditions, some states do not but do list symptoms associated with IBD (eg, severe pain, cachexia or wasting syndrome, severe nausea, arthritis). Most importantly, health care providers should know that under the federal law, they are protected from prosecution for recommending or suggesting that a patient use medical cannabis. Many providers are not aware of this and might avoid discussing medical cannabis because they think there may be legal or licensing implications. It is important for both patients and providers to be informed about medical cannabis to ensure its proper use and to prevent potential risks associated with the therapy. A useful guide regarding the laws associated with medical cannabis use can be found at www.safeaccessnow.org.

G&H What are the next steps in research in this area?

JK Unless there is a change in the current federal status of cannabis, we will not be able to conduct larger prospective, randomized, controlled trials in the United States to assess its effects in IBD patients. (The few randomized, controlled trials to date have been conducted in other countries.) The current US data are observational, and, although helpful to establish the potential effects, are significantly prone to bias. To better understand the therapeutic benefits of cannabis in IBD, larger prospective, controlled studies are needed. Along with several other gastroenterologists, I had the opportunity to work with the Crohn’s and Colitis Foundation to release a position statement in May 2018 calling for a policy change to help facilitate further clinical research in the development of possible cannabinoid-based therapies and potentially revise cannabis’ status as a Schedule I controlled substance. The full position paper will be published in Inflammatory Bowel Diseases by the end of 2018.

G&H Do you know of any ongoing studies in this area?

JK Naftali and colleagues are completing another randomized, controlled trial looking at moderate to severe Crohn’s disease patients using CBD-THC oil for 8 weeks, and both clinical and endoscopic outcomes will be assessed. They are also looking at short- and long-term safety of medical cannabis in an IBD population. These are important studies that will help add to the current paucity of literature in this area.

Dr Kinnucan has no relevant conflicts of interest to disclose.

Suggested Reading

Lahat A, Lang A, Ben-Horin S. 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.

Naftali T, Bar-Lev Schleider L, Dotan I, Lansky EP, Sklerovsky Benjaminov F, Konikoff FM. Cannabis induces a clinical response in patients with Crohn’s disease: a prospective placebo-controlled study. Clin Gastroenterol Hepatol. 2013;11(10):1276-1280.e1.

Naftali T, Bar-Lev Schleider L, Sklerovsky Benjaminov F, Lish I, Konikoff FM. Cannabis induces clinical and endoscopic improvement in moderately active ulcerative colitis. Presented at Digestive Disease Week 2018; June 2-5, 2018; Washington, DC. Abstract Sa1744.

Volkow ND, Baler RD, Compton WM, Weiss SR. Adverse health effects of marijuana use. N Engl J Med. 2014;370(23):2219-2227.

Cannabis Showing Promise for IBD

This article is a collaboration between MedPage Today and:

WASHINGTON — Cannabis could be considered to treat inflammatory bowel disease (IBD), investigators said here over the weekend, but the limited evidence on the plant’s efficacy and potential adverse effects necessitates much more research before cannabis becomes a mainstream medicine got IBD.

In addition, a preliminary study showed that consuming cannabis for 8 weeks helped ulcerative colitis (UC) patients.

Speaking at Digestive Disease Week, Mark Silverberg, MD, PhD, of Sinai Health System in Toronto, led a review of evidence on cannabis and IBD, concluding that “when you have exhausted other treatments, it isn’t unreasonable” to try cannabis.

But cannabis can yield adverse effects, he cautioned, especially when consumed by children and adolescents: “It’s not a completely harmless substance.

“It is not clear if cannabis can be used to induce remission in IBD. Further research is warranted to determine if cannabis can be used as an adjunctive therapy to treat symptoms such as nausea, pain, and anorexia,” and to examine the long-term effects.

Right now “we don’t fully understand the endocannabinoid system,” Silverberg said, so it is difficult to manipulate the system with cannabis.

Regarding available evidence, he noted that only three studies have been published to date about cannabis and Crohn’s disease (CD), and one on cannabis and UC. Researchers conducting the CD studies found a higher clinical response rate in the cannabis group, compared with a placebo group, after 8 weeks. There was no difference in clinical remission rates and there was a higher rate of adverse events among cannabis patients. He added that regarding the UC study, the researchers did not divulge any clinical differences after 10 weeks and also recorded more adverse events among cannabis patients.

Silverberg said that cannabis could be an alternative to narcotic medications for IBD patients. In addition, panelists noted after Silverberg’s presentation, cannabis has not caused some of the caustic side effects that narcotics have.

Silverberg said that practitioners should ask themselves if they are aiding their patients: “Are we providing patients what they want? If not, that’s the reason they are seeking out” cannabis independently.

He also cited the following as reasons justifying the use of cannabis to treat IBD:

  • There is significant morbidity in young patients with systemic and local symptoms
  • Current therapies are effective, but require immune suppression and are often accompanied by adverse events
  • A “substantial number” of patients have a desire for complementary and alternative treatments
  • There is “ubiquitous” use of cannabis — about one-half of IBD patients use it in some areas, he said
  • Cannabis is often applied to reduce abdominal pain, diarrhea, nausea, and anorexia symptoms

Also at DDW, Timna Naftali, MD, of Meir General Hospital and Tel Aviv University in Israel, presented preliminary results of her group’s randomized placebo-controlled trial on cannabis and patients with “moderately active” UC. The researchers divided 28 UC patients who did not respond to conventional medical treatment into placebo and control groups (receiving twice-daily “cigarettes” featuring 0.5 g of cannabis, or about 11.5 mg of THC), and assessed the Disease Activity Index (DAI), Mayo endoscopic scores, and laboratory parameters before and after 8 weeks of treatment.

The control group reported significantly better changes in DAI and Mayo endoscopic scores than the placebo group did. Control patients also reported significantly better improvements in appetite, behavioral change, pain relief, and general satisfaction; placebo respondents reported significantly better improvement in sleep. The laboratory parameters, however, did not improve.

There were no “serious” side effects, the researchers reported, although they did observe statistically insignificant differences in memory decline and dizziness.

The study included 17 males, with a mean age of 33. Patients did not change other medication regimens during the study period.

“Tetrahydrocannabinol-rich cannabis is safe and can induce clinical as well as endoscopic improvement in moderately active UC,” the team concluded.

The study launched in 2010 and just finished, Naftali told MedPage Today, which demonstrates the amount of time it can take to perform the human studies needed to examine cannabis’ potential as a treatment for digestive diseases. She pointed out that numerous animal studies have been conducted, but human studies have been severely lacking.

The results “didn’t surprise me,” she said, explaining that she started the study because she had several patients who were already self-medicating with cannabis and figured she may as well examine it.

She said she hopes the results will fuel future research into medical cannabis for IBD. “It’s not a magic bullet, but it certainly does have an effect, and I think should be explored further.”

Primary Source

Digestive Disease Week

Source Reference: Naftali T, et al “Cannabis induces clinical and endoscopic improvement in moderately active ulcerative colitis” DDW 2018; Abstract Sa1744.

Comment

How Medicinal Marijuana Helps My UC

Recently, my home state of Ohio granted access to medicinal marijuana for patients who have a qualifying condition, such as an IBD like ulcerative colitis (UC). I immediately researched the steps to get a medical marijuana card because I’ve heard how beneficial cannabis can be when it comes to symptoms of UC.

Before I had my colon removed in July 2013, my UC flares and intense symptoms were prominent and made life difficult. I was constantly in pain, could not sleep, was going to the bathroom more than 40 times per day, and had no appetite. I experienced symptoms at least three to five days a week. Some days, I was bowled over in pain all day long.

My father, who is a physician, tried a lot of clinically researched methods to ease my symptoms. At first, he suggested nicotine after reading about its benefits in a medical journal. While using nicotine products didn’t help reduce my ulcerative colitis symptoms, my dad (determined to help me find any kind of extended relief from symptoms) decided to have me try medicinal marijuana.

The first time I used medicinal marijuana to help with UC was in 2012 when my family and a group of our friends were heading to a concert. Everyone was able to have drinks and eat whatever they wanted without having to worry about being close to a bathroom. I was the only exception. We were riding to the concert in a limo, which obviously doesn’t have bathrooms. My dad knew that I would be anxious about my symptoms, so he pulled me aside and handed me a marijuana cigarette, or a joint. I smoked a little bit of it and felt better within minutes. My anxiety about having to run to a bathroom suddenly diminished. I could relax and enjoy the limo ride.

When we arrived at the House of Blues in downtown Cleveland, I realized how much better I felt and that I hadn’t run to the bathroom in over an hour. I was able to enjoy dinner without pain or discomfort — plus I had an appetite. Before Third Eye Blind came on stage that night, I smoked a little more. I didn’t have to miss any songs during the concert because of an emergency bathroom break. I danced and sang along and was sincerely able to enjoy myself for the first time in over a year without having to worry about symptoms popping up.

Five months after the concert in May of 2013, my UC was at its worst. I was in and out of the hospital on a consistent basis. The prescription pain and anti-nausea medication only worked for a few hours. When I was out of the hospital I regularly smoked cannabis to help alleviate multiple symptoms. Unfortunately, as much as cannabis helped ease my symptoms, it did not stop the rapid progression of my disease. In early July, I needed a total colectomy.

I used medicinal marijuana during my recovery from each surgery and continue to use it today.

Waiting for medicinal marijuana to become legal in Ohio has been a lengthy process. Luckily, my dad has a friend who would provide us with medicinal grade marijuana for the interim. If marijuana had never ended up medicinally legal in Ohio, I’d probably still use it, but I wouldn’t have access to strains and recommended methods of ingestion that help specifically with UC. Legislation to allow the sale, cultivation, and possession of medical marijuana was finally enacted in Ohio in 2016, which changed everything for me.

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Legalization of Marijuana Helps Me Get the Medicine I Need

I saw a licensed doctor in November of 2018 to receive my medical marijuana card. The process was smooth and simple, and the doctor was able to provide me with great advice on what forms of cannabis would be best for ulcerative colitis and IBD. She let me know that smoking marijuana is effective, but the relief was only temporary (up to two hours).

The effects of tinctures, or alcohol-based cannabis extracts that are taken by putting a few drops under your tongue so that the THC can be absorbed quickly, can last a bit longer. My doctor recommended that I use tinctures and dabs (concentrated doses of cannabis that are made by extracting THC), These methods provide me with an average of three to five hours of symptom relief. Oil vape pens also help relieve my symptoms.

From my experience, the people working at marijuana dispensaries, known as budtenders, are extremely knowledgeable and helpful. I’m able to walk in and tell them what my main symptoms are, and they recommend which strains and methods of ingestion are best.

It’s typically advised for UC patients to steer clear of edibles, simply because we are going to the bathroom a lot. Our digestive tracts don’t function well, therefore we may not be able to absorb the medication into our systems via chewing and swallowing.

Cannabis helped provide an outlet of relief for me when I was close to losing my life. When prescription medication doesn’t help my ulcerative colitis symptoms, I turn to cannabis. I’m so happy that medicinal marijuana is finally becoming more accessible to chronically ill patients. I became so interested in the topic that I started working with two marijuana business-based publications to learn more about the industry and how this alternative therapy can help me heal.

If you are interested in trying medicinal marijuana to help with UC symptoms, I highly recommend doing some research and learning as much as you can about cannabis and its availability where you live.

Ulcerative colitis is an inflammatory Bowel Disease (IBD) disease that causes inflammation and sore (ulcers) in the lining of the large intestine (colon).

It usually affects the lower section (sigmoid colon) and the rectum although it can affect the entire colon. The more of the colon that’s affected, the worse the symptoms will be.

The disease can affect people of any age. But most people who have it are diagnosed before the age of 30.

Experts aren’t sure what causes it. They think it might be caused by the immune system overreacting to normal bacteria in the digestive tract. Or other kinds of bacteria and viruses may cause it. Colitis may be acute and self-limited or chronic, i.e. persistent, and broadly fits into the category of digestive diseases.

Finding optimal treatment for Inflammatory Bowel Disease is imperative, as these conditions can be intensely painful, and often cause abdominal discomfort, appetite loss, nausea/vomiting, and other related symptoms. They are therefore likely to cause a decreased quality of life for patients.

Symptoms of Colitis

The signs and symptoms of colitis are quite variable and dependent on the cause of the given colitis and factors that modify its course and severity.

Symptoms of colitis may include: mild to severe abdominal pain, recurring bloody diarrhea, fecal incontinence, flatulence, and fatigue, loss of appetite and unexplained weight loss. More severe symptoms may include: shortness of breath, a fast or irregular heartbeat and fever. The disease can also cause other problems such as; joint pain, eye problems, or liver disease.

In most people, the symptoms come and go. Some people go for months or years without symptoms (remission). They will have a flare-up. About 5 to 10 out of 100 people with ulcerative colitis have symptoms all the time.

Cannabis for Colitis

For people with colitis, life can mean always wondering when the condition will flare-up and how bad the symptoms will be. Until now, there have been limited treatments for these painful, life-altering conditions. The available conventional treatment for the symptoms is accompanied with a number of side effects which are harmful to the patients’ health.

As is true with many disorders, cannabis has been used for centuries to treat the symptoms of Colitis including a reduction in pain sensation, nausea relief and reduce the feeling of unpleasantness.

According to a statement issued by The Crohn’s & Colitis Foundation of America in 2012, compounds found in the marijuana plant closely mimic endocannabinoids (molecules that occur naturally in the body) and have been shown to play an important part in decreasing gastrointestinal inflammation.

A 2011 study found that 51% of ulcerative colitis patients are lifetime cannabis users. Users having utilized medical marijuana for treatment of symptoms with no side effects.

There is evidence that THC may be helpful in reducing permeability of the epithelial lining thus helping to reduce damage and decrease inflammation. Both Ulcerative Colitis and Crohn’s Disease have recently qualified for treatment by medical marijuana treatment in more states.

Conclusion

As it stands now, there are dozens of high quality studies that illustrate the fact that medical marijuana serves an important purpose in treating and alleviating the symptoms of painful IBD disorders. In addition to relieving pain, muscle cramps, anxiety, insomnia and inflammation, certain strains of cannabis also promote appetite, produce weight gain and enhance the mood of affected patients.

Colitis and Crohn’s disease are both incredibly disruptive conditions that affect people’s ability to hold a job, maintain social relationships or even plan everyday events. Because the symptoms of these conditions are so unpredictable and painful, they often rob affected individuals of their ability to lead a normal life.

Fortunately, the soothing effects of medical cannabis have the potential to treat some of these symptoms and help people with Colitis and Crohn’s disease do everything, from maintain a job and social relationships to helping them live a healthier life despite their condition.

Source: Medical Marijuana Blog
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