Cannabinoids for Inflammatory Bowel Disease: A Scoping Review

Area of Science:

• Gastroenterology
• Pharmacology
• Public Health

Background:

• Inflammatory bowel disease (IBD), encompassing ulcerative colitis (UC) and Crohn's disease (CD), is marked by chronic inflammation and cyclical disease activity.
• Cannabis and cannabinoids are increasingly explored for therapeutic potential in various conditions, including IBD.

Purpose of the Study:

• To conduct a scoping review of unprescribed and prescribed cannabis use in IBD patients.
• To investigate the objective clinical benefits and patient-reported outcomes associated with cannabis use in IBD.

Main Methods:

• A comprehensive literature search was conducted across major databases (Medline, Embase, Scopus, Cochrane Library).
• Included studies comprised 14 abstracts/letters, 7 randomized controlled trials (RCTs), 6 cohort studies, 10 cross-sectional surveys, and 3 meta-analyses.

Main Results:

• Cannabis use for symptom control ranged from 11% to 17.6% in surveyed IBD patients, with high lifetime prevalence (39.8-78.2%).
• Patients reported improvements in abdominal pain, emotional distress, stool frequency, and anorexia.
• Prescribed cannabis users showed higher rates of prior surgery, need for future surgery, lower quality of life, and current use of corticosteroids and opioids. RCTs indicated mild reductions in disease activity and variable endoscopic improvements.

Conclusions:

• IBD patients using cannabis often have refractory disease and report symptom management benefits, but with a lower quality of life.
• The impact of cannabis on underlying IBD disease activity appears modest.
• Further research with refined cannabinoid formulations is needed to clarify their role in IBD management.