Medical marijuana and CBD are of great interest to help manage various conditions and symptoms such as pain, nausea and sleep problems. If you or a loved one is struggling with ulcerative colitis (UC) and its symptoms, you may be wondering if marijuana or CBD might help.
It is helpful to understand the difference between marijuana and CBD. Marijuana comes from a plant that people sometimes use for recreational or therapeutic purposes Cannabis sativa. It contains two main active ingredients: THC (short for delta-9 tetrahydrocannabinol) and CBD (short for cannabidiol).
It’s THC in marijuana that makes you feel. If you buy CBD products, they come from a cannabis cousin of marijuana called cannabis. There shouldn’t be too much, if any, too much THC in your CBD. So CBD can cause fatigue or dry mouth, but you won’t be able to use it.
Does he help with either UC? Some researchers and doctors are investigating the possibility that cannabis in one form or another helps people with inflammatory bowel diseases, including UC. Based on the evidence to date, the answer is no simple yes or no.
“There is a percentage of patients who use cannabis and feel better,” said Jami Kinnucan, MD, a gastroenterologist at the University of Michigan. “Their symptoms – most commonly abdominal or body pain, diarrhea, appetite and nausea – are improving.”
But Kinnucan says it doesn’t mean that cannabis use is a good way to treat UC. This is because people with UC have inflammation in the digestive tract. This inflammation as well as ulcers is associated with UC symptoms, including diarrhea, pain, cramps, bleeding and fatigue. The primary goal of treatment is to stop inflammation.
There is some evidence in mice that suggests that cannabis may help with inflammation. This is related to certain receptors that respond to other cannabinoids that our body makes naturally. Cannabis can also slow the digestive tract. However, it is not clear that smoking cannabis or using it in a capsule fights underlying inflammation in people with UC.
In one small clinical study, people with UC who took CBD capsules containing small amounts of THC for 10 weeks were no more likely to go into remission than those who took placebo. Even smoking two marijuana cigarettes a day did not reduce the signs of inflammation.
“If you perform blood tests, imaging or stool samples, the numbers of patients do not change,” says Kinnucan. “While they may feel better, their inflammatory burden is not improving.”
The CBD study found that 10 weeks of treatment improved quality of life. But study participants also reported side effects, including dizziness, attention problems, headaches, nausea, and fatigue. Dizziness was the most common reason people dropped out in the CBD study. The marijuana study did not report side effects or quality of life.
A recent review of two clinical trials concluded that the effects of cannabis and CBD in people with UC remain uncertain. There is no evidence that it can help get people with UC into remission.
But it is too early to say whether it ever helps in other ways and how safe it is.
Kinnucan says it is possible that cannabis could help some patients with UC and others do not. For those who have a UC that is drug controlled, he says there is no reason to think that adding cannabis would help. It is never a good idea to replace approved medicines with cannabis. There is a risk that cannabis could hide the symptoms and encourage people to stop the treatment they need.
“At the end of the day, if there is hope to control inflammation, there is no data to support it,” says Kinnucan.
Consider the risks
For people with UC, the most important thing is to continue treatment that doctors know works. If symptoms persist, Kinnucan says your doctor should evaluate your illness to make sure the treatment you are taking is adequate. But if you or a loved one is taking prescription medications to control UC, there is a chance that cannabis may help with persistent symptoms such as pain or nausea. He recommends taking cannabis orally and not smoking it due to the risks of smoking and starting with the lowest levels of THC.
Kinnucan says more doctors and patients should talk about cannabis, including how and why patients can use it themselves. However, it is now difficult for doctors to know how to advise people with UC on how they can safely use cannabis. Cannabis studies for inflammatory bowel disease, including UC, are ongoing, so more data are being added.
In addition to whether it works, doctors and cannabis patients also need to consider legal issues. CBD is federally legal if it contains only very low levels of THC, although national rules may change.
It’s more complicated with marijuana. In Michigan, for example, recreational marijuana is legal, but medical marijuana requires a confirmed diagnosis from two doctors. UC is on the list of qualifying conditions for medical marijuana. Marijuana can be classified as medicinal or recreational. Both are legal in some states. Other states have legalized only medical marijuana. And in some, no form is legal. The Federal Drug Administration (DEA) also recognizes marijuana, including medical marijuana, as a controlled substance.
“We have patients who live in one state and travel across state borders to get cannabis, but then bring them back illegally,” says Kinnucan. “You should refer to the laws of your state. Crossing borders can be a criminal offense. “