Over a third of IBD patients using medicinal cannabis, finds survey

A new survey finds that many patients with inflammatory bowel disease (IBD) are using cannabis medicinally – and reporting benefit from it – but less than half are talking to their doctor about it.  

Over a third of patients with inflammatory bowel disease, including ulcerative colitis or Crohn’s disease, report using medicinal cannabis, according to new data.

Almost all of those who did consume cannabis, said they had seen improvements in their symptoms and overall quality of life as a result.

IBD describes conditions which cause inflammation in the digestive tracts, most notably ulcerative colitis (UC) and Crohn’s disease. While UC affects the large intestine, Crohn’s can affect any part of the digestive system.  

Common symptoms include diarrhoea, abdominal pain, bloody stools, weight loss and fatigue, but knock-on effects of IBD can impact the whole body and cause a range of debilitating mental and physical symptoms. 

Factors such as how the disease affects the body’s absorption of nutrients, and the side-effects of common medications mean that many patients live with co-morbidities such as arthritis and joint pain, migraine, depression and anxiety. 

The new findings, published in the Journal of Environmental Research and Public Health, are taken from a survey of 162 patients being treated at the University of Puerto Rico Center for Inflammatory Bowel Diseases.

Sixty (37%) reported consuming cannabis, of which 38 (63%) said they used it to relieve their IBD. Over half had obtained medicinal cannabis via a prescription and almost all (94%) said they had been using it for more than a year.  

Among cannabis users, the majority were males with Crohn’s disease, and 39% were aged between 21 to 30-years-old. 

The most frequent symptoms for which cannabis was consumed were abdominal pain (65%) and weight loss (41%) followed by joint pain (38%), back pain (35%) and diarrhoea (17%). Other symptoms include anxiety, insomnia, depression, and headache. 

The most common methods of administration were inhalation and oral ingestion, followed by vaping and oil ingestion. Most used cannabis less than twice a week, with just over 30% using it once daily, and only 16% used it more than once a day.

Other evidence for cannabis and IBD

While clinical trials are yet to show any meaningful effects of cannabis on inflammation in IBD, increasingly observational data suggests many patients find it to be beneficial for symptom management. 

In 2020, a nationwide survey of IBD patients in Australia found that up to a quarter of them used cannabis to manage their condition. 

More than 90% of patients surveyed reported that medicinal cannabis use improved their symptoms – with greatest benefits reported for abdominal pain, stress, sleep, cramping and anxiety. However, there were fewer benefits to symptoms associated with disease pathology, such as rectal bleeding, obstructive symptoms and stool frequency, consistency and urgency.

A study, published in 2022, investigated patterns of use and adverse effects from medical cannabis in patients with IBD. Respondents reported fewer emergency room visits in the 12 months after versus before medical cannabis use and found that their symptoms had less impact on their daily life. 

More recently, data taken from the UK Medical Cannabis Registry observed significant benefits in IBD patients’ anxiety, sleep and health-related quality of life.

Education and communication around cannabis 

A number of previous studies have pointed to the need for better clinician education on cannabis and patient-doctor communication. A previous survey published last year by the same researchers, found that 78% of IBD patients did not discuss their cannabis use with their doctor and over half reported little to no knowledge of medicinal cannabis prior to consumption.

The latest data shows improvements, with 77% reporting low to moderate knowledge about cannabis, and only 15% reporting little to no knowledge.  

Just under half (48%) of cannabis consumers in the survey said they had spoken to their doctor about it, but a much larger proportion (88%) said they ‘would feel comfortable discussing medical cannabis for IBD’. 

“The use of medical cannabis to relieve symptoms is frequent in patients with IBD, although knowledge about cannabis among patients and physicians is limited,” the authors say. 

“Our study supports the need for more investigation in this area, as well as an increase in educational programs for patients and physicians.”

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