Randomized controlled trials (RCTs) comparing any form or dose of cannabis or its cannabinoid derivatives (natural or synthetic) to placebo or an active therapy for adults (> 18 years) with UC were included.
The second study comparing two cannabis cigarettes (23 mg THC/day) to placebo cigarettes showed lower disease activity index scores in the cannabis group compared to the placebo group. C-reactive protein and fecal calprotectin levels (both measures of inflammation in the body) were similar in both groups. No serious side effects were reported. This study did not report on remission rates.
The effects of cannabis and cannabis oil on ulcerative colitis are uncertain, thus no firm conclusions regarding the effectiveness and safety of cannabis or cannabis oil in adults with active ulcerative colitis can be drawn. There is no evidence for cannabis or cannabis oil use for maintenance of remission in ulcerative colitis. Further studies with a larger number of participants are required to assess the effects of cannabis in people with active and inactive ulcerative colitis. Different doses of cannabis and routes of administration should be investigated. Lastly, follow-up is needed to assess the long term safety outcomes of frequent cannabis use.
What did the researchers find?
The study comparing cannabis oil capsules to placebo found no difference in remission rates at 10 weeks. Twenty four (7/29) percent of cannabidiol participants achieved clinical remission compared to 26% (8/31) of placebo participants. The study also showed higher self reported quality of life scores in cannabis oil participants compared to placebo participants. More side-effects were observed in the cannabis oil participants compared to the placebo participants. These side effects were considered to be mild or moderate in severity. Common reported side effects include dizziness, disturbance in attention, headache, nausea and fatigue. No patients in the cannabis oil group had any serious side effects. Ten per cent (3/31) of the placebo group had a serious side effect. Serious side effects in the placebo group included worsening ulcerative colitis and one complicated pregnancy.
What did the researchers investigate?
While Crohn’s disease may show up in any part of the digestive gut, ulcerative colitis is exclusively referred to as inflammation of the colon. Another name for this condition is the ‘large intestine.’ Unlike Crohn’s Disease, ulcerative colitis causes inflammation only in the inner lining of the gut.
As mentioned, CBD has remarkable anti-inflammatory and painkilling effects. On top of that, it can modulate the inflammatory response of the immune system by improving communication between its cells. Numerous studies have mentioned these qualities in relation to a wide range of health conditions, including IBD and its symptoms.
What Is Ulcerative Colitis?
In more severe cases of ulcerative colitis, surgery may be required to remove the parts of the large intestine that are most damaged. Sometimes, the disease can be cured with surgical removal of the colon, but it may seriously compromise a person’s daily functioning, not to mention the risks of such surgery, especially among elderly sufferers.
Several studies have suggested that CBD and cannabis in general are possible medical treatment options for ulcerative colitis, Crohn’s disease, and other inflammatory bowel conditions. Researchers found that CBD could prevent injury in the colon’s lining as well as inflammation, which is the underlying cause of all IBD’s.
The results of the study were encouraging, with 78% of participants reporting no harmful side effects. Some patients experienced very mild side effects, such as dry mouth and short-term memory decline. However, these patients also noted that the improvements in their symptoms outweighed these minor reactions.