Using Cannabis Compounds to Treat Inflammatory Bowel Disease: Where the Science Stands | Research

The takeaway

Cannabis compounds show promise for relieving IBD symptoms like pain, diarrhea, and appetite loss, but clinical evidence proving efficacy and safety remains insufficient.

Read this if you have IBD and are curious whether cannabis or CBD products might help manage your symptoms.

Clinical evidence proving cannabinoid safety and efficacy for IBD remains insufficient

What the researchers found

Fifty years after THC was identified, this expert review assessed the clinical translation of cannabinoids for inflammatory bowel diseases (IBD) including Crohn's disease and ulcerative colitis.

Surveys and small clinical studies confirmed that IBD patients frequently use cannabis to manage diarrhea, abdominal pain, and appetite loss. Both plant-derived cannabinoids (THC and CBD) and synthetic versions (dronabinol, nabilone) showed potential for symptom relief in experimental models.

However, the reviewers concluded there is still insufficient clinical evidence to prove efficacy, tolerability, and safety of cannabinoid-based medications for IBD patients, leaving clinicians without evidence-based guidelines for recommending these treatments.

Why it matters

IBD affects millions worldwide and many patients self-medicate with cannabis despite limited clinical evidence. This review identifies a significant gap between patient behavior and medical evidence, highlighting the urgent need for rigorous clinical trials.

The numbers in context

Synthetic cannabinoids dronabinol and nabilone are already available by prescription. The review covers 50 years of cannabinoid research since THC's discovery.

How the study worked

The researchers reviewed recent data on cannabis and cannabinoid effects in experimental IBD models and clinical trials with IBD patients using a PubMed database search. They also provided background on the endocannabinoid system and its relevance to gastrointestinal inflammation.

What this study cannot tell us

This is a narrative expert commentary rather than a systematic review with formal quality assessment. Most evidence comes from preclinical models and small clinical studies, with very few randomized controlled trials available for analysis.

How to read the evidence

Expert narrative review drawing on experimental and clinical data, rated moderate because it synthesizes meaningful evidence but lacks systematic methodology.

When this study was published

Published in 2017, covering cannabinoid-IBD research through early 2017.

The bigger picture

The endocannabinoid system plays a documented role in gut inflammation and motility, providing biological plausibility for cannabinoid therapy in IBD. But biological plausibility alone does not equal clinical proof, and this review makes clear that the field has not yet bridged that gap.

Questions still open

Could CBD-dominant preparations offer anti-inflammatory benefits without THC side effects for IBD patients? What dosing protocols would be needed for clinical trials? Could cannabinoids complement existing IBD therapies rather than replace them?

Common questions

Can cannabis treat Crohn's disease or ulcerative colitis?

Small studies and patient surveys suggest cannabis can relieve symptoms like pain, diarrhea, and appetite loss, but there is not yet enough clinical evidence to establish it as a proven treatment for either condition.

Are there approved cannabinoid medications for IBD?

While synthetic cannabinoids like dronabinol and nabilone are available by prescription for other conditions, none are specifically approved for IBD. Clinical trials are needed before cannabinoid therapies can be recommended for bowel diseases.

Read the original research

Cannabinoids for treating inflammatory bowel diseases: where are we and where do we go?

Expert review of gastroenterology & hepatology, 11(4), 329-337

View on PubMed ↗Publisher’s paper ↗

Citation

Hasenoehrl, Carina; Storr, Martin; Schicho, Rudolf. (2017). Cannabinoids for treating inflammatory bowel diseases: where are we and where do we go?. Expert review of gastroenterology & hepatology, 11(4), 329-337. https://doi.org/10.1080/17474124.2017.1292851