The Potential of Cannabis in Managing Inflammatory Bowel Disease and Its Future Perspective

Inflammatory bowel disease (IBD) is an inflammation of the gastrointestinal tract mainly categorized as Crohn's disease and ulcerative colitis. The current management of IBD includes pharmacological, surgical, psychological, and complementary treatments, but cannabis effects are also becoming more popular as complementary therapies. Cannabinoids act on two G-protein coupled receptors, CB1 and CB2 located in the brain, enteric nervous system, gastrointestinal cells (epithelial cells), and immune cells. Interaction with these two receptors results in the potential symptomatic and therapeutic effects of cannabis such as decreased gut motility, secretions, and reduced inflammatory edema. Many observational and placebo control trials have been done in the past decades to validate the potential benefits of cannabis in IBD. However, the small sample size of these studies makes it difficult to draw firm conclusions regarding its efficacy and safety. There is a need for large randomized placebo-controlled trials using standardized compositions of cannabinoids with long-term follow-up as cannabis is now an emerging drug to be used for IBD. Future research should emphasize cannabis derivatives and endocannabinoids in order to maximize analgesia and minimize psychotropic side effects.