Cannabis-Using IBD Patients Had Longer Procedures and More Inflammation on Endoscopy | Research

The takeaway

Among inflammatory bowel disease patients undergoing endoscopy for acute symptoms, cannabis users had significantly longer procedures and were more likely to show inflammation compared to matched non-users.

IBD patients using or considering cannabis and gastroenterologists treating IBD.

Cannabis-using IBD patients were significantly more likely to show endoscopic inflammation (p=0.044)

What the researchers found

IBD patients who used cannabis had significantly longer endoscopy durations (p<0.001) and were more likely to have endoscopic inflammation (p=0.044) than matched non-users. There was no significant difference in recovery time, propofol dose per procedure duration, or IBD treatment at the time of endoscopy.

Why it matters

Many IBD patients use cannabis for symptom relief, but this study found cannabis users actually had more inflammation on endoscopy. This raises the question of whether cannabis masks symptoms while inflammation continues, or whether people with worse disease are more likely to turn to cannabis.

The numbers in context

124 patients total (62 cannabis users, 62 matched controls). Significant differences: endoscopy duration (p<0.001) and endoscopic inflammation (p=0.044). No significant differences: recovery time (p=0.15), IBD treatment (p=0.84), stricture (p=0.53), adjusted propofol dose (p=0.082).

How the study worked

Retrospective case-control study at a tertiary academic medical center (2018-2022). 62 IBD patients reporting cannabis use were matched by age, sex, and BMI with 62 non-using IBD patients. All underwent endoscopy for acute IBD complaints.

What this study cannot tell us

Retrospective case-control design cannot determine causation. Cannabis use was self-reported. Selection bias: patients undergoing endoscopy for acute complaints represent a sicker subset. Cannot determine whether cannabis use preceded or followed disease worsening.

How to read the evidence

Preliminary: retrospective case-control at a single center with self-reported cannabis use and potential selection bias.

When this study was published

2025 study using 2018-2022 data.

The bigger picture

Cannabis is widely used by IBD patients despite limited evidence. This study suggests cannabis use may be a marker for more severe disease or may provide symptomatic relief without addressing underlying inflammation, both concerning possibilities.

Questions still open

Does cannabis mask IBD symptoms while inflammation progresses? Are cannabis-using IBD patients delaying medical treatment because they feel symptom relief? Would prospective studies show different results?

Common questions

Does cannabis help inflammatory bowel disease?

This study found cannabis users actually had more inflammation on endoscopy. While cannabis may provide symptom relief, it may not address the underlying inflammation, though this study cannot prove cannabis caused the worse outcomes.

Why did cannabis users have longer procedures?

Possibly due to more extensive inflammation requiring more thorough examination. The longer duration was not explained by cannabis users needing more sedation.

Read the original research

Cannabis use in Patients With Inflammatory Bowel Disease is Associated With Longer Endoscopic Duration and Endoscopic Inflammation.

Crohn's & colitis 360, 7(3), otaf034

View on PubMed ↗Publisher’s paper ↗

Citation

Loeb, Lauren; Hochwald, Alexander; Picco, Michael F; Chan, Johanna L; Hashash, Jana G; Chadha, Ryan; Farraye, Francis A; Kinnucan, Jami A. (2025). Cannabis use in Patients With Inflammatory Bowel Disease is Associated With Longer Endoscopic Duration and Endoscopic Inflammation.. Crohn's & colitis 360, 7(3), otaf034. https://doi.org/10.1093/crocol/otaf034