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Cannabis Use Provides Symptom Relief in Patients with Inflammatory Bowel Disease but Is Associated with Worse Disease Prognosis in Patients with Crohn's Disease

INFLAMMATORY BOWEL DISEASES (2014)

期刊

INFLAMMATORY BOWEL DISEASES

卷 20, 期 3, 页码 472-480

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OXFORD UNIV PRESS INC

DOI: 10.1097/01.MIB.0000440982.79036.d6

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Crohn's disease; Cannabis; hospitalization; inflammatory bowel disease; marijuana; ulcerative colitis; surgery

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Gastroenterology & Hepatology

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Background: Cannabinoids are used by patients with inflammatory bowel disease (IBD) to alleviate their symptoms. Little is known on patient motivation, benefit, or risks of this practice. Our aim was to assess the extent and motives for Cannabis use in patients with IBD and the beneficial and adverse effects associated with self-administration of Cannabis. Methods: Consecutive patients with IBD (n = 313) seen in the University of Calgary from July 2008 to March 2009 completed a structured anonymous questionnaire covering motives, pattern of use, and subjective beneficial and adverse effects associated with self-administration of Cannabis. Subjects who had used Cannabis specifically for the treatment of IBD or its symptoms were compared with those who had not. Logistic regression analysis was used to identify variables predictive of poor IBD outcomes, specifically surgery or hospitalization for IBD. Results: Cannabis had been used by 17.6% of respondents specifically to relieve symptoms associated with their IBD, the majority by inhalational route (96.4%). Patients with IBD reported that Cannabis improved abdominal pain (83.9%), abdominal cramping (76.8%), joint pain (48.2%), and diarrhea (28.6%), although side effects were frequent. The use of Cannabis for more than 6 months at any time for IBD symptoms was a strong predictor of requiring surgery in patients with Crohn's disease (odds ratio = 5.03, 95% confidence interval = 1.45-17.46) after correcting for demographic factors, tobacco smoking status, time since IBD diagnosis, and biological use. Cannabis was not a predictor for hospitalization for IBD in the previous year. Conclusions: Cannabis use is common in patients with IBD and subjectively improved pain and diarrheal symptoms. However, Cannabis use was associated with higher risk of surgery in patients with Crohn's disease. Patients using Cannabis should be cautioned about potential harm, until clinical trials evaluate efficacy and safety.

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The use of, and outcomes for, inflammatory bowel disease services during the Covid-19 pandemic: a nationwide observational study

Mohammed Deputy, Kapil Sahnan, Guy Worley, Komal Patel, Violeta Balinskaite, Alex Bottle, Paul Aylin, Elaine M. Burns, Ailsa Hart, Omar Faiz

Summary: The Covid-19 pandemic has had a detrimental effect on inflammatory bowel disease (IBD) services, leading to delays in emergency care and access to investigations and surgeries. A study in England found significant decreases in hospital attendances for acute ulcerative colitis (UC) and acute Crohn's disease (CD), as well as a decrease in the volume of IBD procedures and investigations. The study also highlighted the importance of prioritizing care for patients with IBD to prevent clinical harm and a decrease in quality of life.

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