Inflammatory Bowel Disease (IBD) affects around 1 in 123 people in the UK. It includes conditions like Crohn’s disease and ulcerative colitis. If you have IBD, you might experience abdominal pain, diarrhoea, and bloody stools.
Current treatments, like medications and surgery, can help many people, but they don’t work for everyone. That’s why many IBD patients are turning to alternative therapies, including medical cannabis.
Medical Cannabis and IBD
Cannabis-based medicines can now be prescribed in the UK for many conditions, including IBD, if first-line treatments have not been successful. It is important to note that medical cannabis is only prescribed to address troublesome symptoms and not to treat underlying inflammation in the gut.
Our bodies have cannabinoid receptors (CB1 and CB2) throughout the gut. Cannabinoids like CBD and THC interact with these receptors, and scientists believe this may help regulate digestion. However, clinical research in this area remains limited.
Previous Findings from the UK Medical Cannabis Registry
Researchers have previously analysed patient-reported outcome measures (PROMs) in IBD patients prescribed cannabis-based medicinal products (CBMPs) using data from the UK Medical Cannabis Registry (UKMCR). This data demonstrated a change in IBD-specific, anxiety-related, and general health-related quality of life (HRQoL) outcomes up to three months.
An updated analysis of these outcomes aimed to evaluate differences in PROMs for patients prescribed CBMPs for IBD over 18 months.
Key Findings from the UKMCR
The current study analysed self-reported PROMs from baseline and at 1-, 3-, 6-, 12-, and 18 months. PROMs included Short Inflammatory Bowel Disease Questionnaire alongside three GRQoL PROMs: the EQ-5D-5L, Generalised Anxiety Disorder-7 (GAD-7), and Single-Item Sleep Quality Scale (SQS). Patient Global Impression of Change (PGIC) values and adverse events were also recorded. A total of 116 IBD patients were included in the present analysis.
Key findings from this most recent analysis include:
- Changes in IBD-specific PROMs: Sub-group analysis based on primary diagnosis showed changes in IBD-specific measures in both Crohn’s disease and ulcerative colitis patient groups; however, improvements in anxiety and general HRQoL were only seen in the Crohn’s disease group.
- Other improvements in PROMs: There were also changes in the mobility, self-care, and usual activities domains of the EQ-5D-5L at various time points.
- CBMP dosing: Patients treated with above median doses of THC and with severe baseline anxiety were more likely to achieve minimal clinically important difference in the SIBDQ.
- Adverse Events: Twenty patients (17.24%) reported 155 adverse events which were largely mild; the most common were fatigue (n = 15, 12.93%) and dry mouth (n = 11, 9.48%).
These findings suggest that medical cannabis treatment was associated with changes in HRQoL and IBD-specific PROMs; however, as a case series without placebo control or operator arm, there are limitations to this study. Furthermore, while these findings are promising, causation cannot be proven.
Nonetheless, this study had a relatively large sample size and is the longest-known longitudinal assessment of the effects of CBMPs in IBD patients. This study adds to previous research in this area, providing valuable real-world evidence of medical cannabis in the treatment of IBD. Yet, double-blinded randomised controlled studies are needed to fully understand this potential in a clinical setting.
