A review of herbal medicine use in elderly IBD patients highlights that cannabis is among many supplements that can interact with standard IBD medications, making provider awareness of drug-herb interactions critical.
Older adults with IBD who use cannabis or herbal supplements alongside prescription medications.
Nearly 50% of IBD patients have used complementary or alternative medicine
What the researchers found
Nearly half of patients with inflammatory bowel disease (IBD) have used complementary and alternative medicine at some point, and elderly IBD patients face particular risks because they often take multiple medications for comorbid conditions.
The review covers over 20 herbs commonly used by IBD patients, including cannabis, and details their potential interactions with standard IBD drugs like immunomodulators, biologics, and corticosteroids. Cannabis was included alongside turmeric, boswellia, wormwood, and others.
For older patients, the combination of polypharmacy, altered drug metabolism, and herbal supplement use creates a complex landscape of potential interactions that providers may not be asking about or even aware of.
Why it matters
Many IBD patients use herbal supplements without telling their doctors, and many doctors do not ask. In elderly patients who are already on multiple medications, adding cannabis or other herbs without awareness of potential interactions could lead to unexpected drug levels, side effects, or reduced treatment efficacy.
The numbers in context
Nearly 50% of IBD patients have used complementary/alternative medicine. The elderly are the fastest-growing IBD demographic. Over 20 herbs reviewed for interaction potential.
How the study worked
Narrative review covering common herbal supplements used by IBD patients, including background, suggested use, evidence in IBD, and potential drug-herb interactions with IBD medications, with focus on the elderly population.
What this study cannot tell us
Narrative review without systematic search methodology. Cannabis was one of many herbs discussed, and the depth of cannabis-specific interaction data was limited. Much of the interaction evidence is theoretical or based on pharmacological principles rather than documented clinical cases.
How to read the evidence
Moderate evidence from a narrative review synthesizing known pharmacological interactions.
When this study was published
Published in 2017. Drug interaction awareness continues to evolve.
The bigger picture
As both cannabis use and IBD prevalence increase in older populations, the intersection of herbal medicine and conventional treatment becomes more clinically important. This review serves as a reminder that cannabis does not exist in pharmacological isolation and that its interactions with other medications deserve the same scrutiny as any other drug.
Questions still open
- What specific interactions between cannabis and IBD medications have been documented clinically? Do elderly IBD patients who use cannabis have different treatment outcomes? Should providers routinely screen for cannabis and supplement use in IBD patients?
Common questions
Can cannabis interact with IBD medications?
Should I tell my doctor if I use cannabis for IBD symptoms?
Read the original research
Drug-Herb Interactions in the Elderly Patient with IBD: a Growing Concern.
Current treatment options in gastroenterology, 15(4), 618-636
Citation
Rahman, Haider; Kim, Marina; Leung, Galen; Green, Jesse A; Katz, Seymour. (2017). Drug-Herb Interactions in the Elderly Patient with IBD: a Growing Concern.. Current treatment options in gastroenterology, 15(4), 618-636. https://doi.org/10.1007/s11938-017-0154-y
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