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Crohn's Disease Forum » Books, Multimedia, Research & News » Cannabis use provides symptom relief in patients with IBD but is associated with worse disease prognosis in patients with Crohn's disease


 
02-26-2014, 06:01 PM   #1
kiny
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Cannabis use provides symptom relief in patients with IBD but is associated with worse disease prognosis in patients with Crohn's disease

http://www.ncbi.nlm.nih.gov/pubmed/24407485

2014 Mar

Cannabis use provides symptom relief in patients with inflammatory bowel disease but is associated with worse disease prognosis in patients with Crohn's disease.

Storr M1, Devlin S, Kaplan GG, Panaccione R, Andrews CN.

Department of Medicine, University of Munich.

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.
02-26-2014, 11:24 PM   #2
wildbill_52280
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so these conclusions were based on a questionaire? and no actual examinations or measurements of the patients were done? id say this isn't enough info to come to any conclusions at all, but its great they tried to get some information. I'd say, not very good science here.
02-27-2014, 09:05 AM   #3
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Without doctor examination, I would say this study is bunk. With a questionaire and no "control", how can you be sure the patients were being completely honest? And one person's idea of normal is not necessarily what is considered medically normal
02-27-2014, 01:47 PM   #4
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I am starting to notice a trend...legit cannabis studies show very positive results while studies based on crap science/gov funded studies tend to show mixed or negative results
02-27-2014, 03:15 PM   #5
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I thought Crohns disease is considered IBD? Are they saying IBD is the term for only Ulcerative colitis? My daughter has been using a strain of marajuana with only CBD and her inflammation has improved considerably as seen in her latest scopes. She is taking the oil by mouth and has no negative side effects.
02-27-2014, 03:56 PM   #6
kiny
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I thought Crohns disease is considered IBD? Are they saying IBD is the term for only Ulcerative colitis?
they distinguish symptom relief with clinical outcomes, while it improved abdominal pain, abdominal cramping, joint pain, and diarrhea, the cannabis using crohn's disease demographic had more surgeries.

so, the title, symptom relief but worse prognosis for those ppl iin the study
02-27-2014, 04:32 PM   #7
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When you consider that there is portion of people who start using marijuana because the disease is progressing to the point of needing surgery the idea behind the study is intrinsically flawed. Correlation is not causation.

I didn't start smoking pot until after diagnosis, it wasn't until my disease started getting progressively worse and I was heading towards needing surgery that I started smoking pot. My Doctor within the first 6 months of diagnosis was already advocating surgery, and had given me an estimate of how long he thought I would last with a colon.
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02-28-2014, 08:23 AM   #8
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I heard somewhere that smoking Cannabis lower your immune's system response so maybe and its just maybe its got something to do with the hypothesis that Crohns actually is caused by immunodeficiency?
02-28-2014, 08:45 AM   #9
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I am starting to notice a trend...legit cannabis studies show very positive results while studies based on crap science/gov funded studies tend to show mixed or negative results
Where are the legit studies?

The one i see most often is a double-blind which had the control group with Crohn's smoke regular cigarettes (a known trigger for worsening Crohn's symptoms). Not exactly an honest study.

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02-28-2014, 08:45 AM   #10
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When you consider that there is portion of people who start using marijuana because the disease is progressing to the point of needing surgery the idea behind the study is intrinsically flawed. Correlation is not causation.



I didn't start smoking pot until after diagnosis, it wasn't until my disease started getting progressively worse and I was heading towards needing surgery that I started smoking pot. My Doctor within the first 6 months of diagnosis was already advocating surgery, and had given me an estimate of how long he thought I would last with a colon.

I think you make a very valid point. The reason some with CD may have more surgery is because these are people with more aggressive disease who are desperate for solutions. Maybe it's not the cannabis but rather their aggressive flare? I agree that while I'm happy to see new studies it can't be taken too seriously.
02-28-2014, 01:26 PM   #11
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I heard somewhere that smoking Cannabis lower your immune's system response so maybe and its just maybe its got something to do with the hypothesis that Crohns actually is caused by immunodeficiency?
Actually CB1 & CB2 receptors are activated by cannabinoids, which causes a mild TNF inhibition, reducing inflammation and acting in a similar way to Remicade, Humira etc.
02-28-2014, 03:33 PM   #12
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I thought Crohns disease is considered IBD? Are they saying IBD is the term for only Ulcerative colitis? My daughter has been using a strain of marajuana with only CBD and her inflammation has improved considerably as seen in her latest scopes. She is taking the oil by mouth and has no negative side effects.
Hi Searchingforhealth.Glad to year the CBD is helping your daughter. I am trying to find high CBD/low or no THC for my son who has Crohn's. Can you tell which collective in the Bay Area your daughter found this?
02-28-2014, 07:59 PM   #13
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junk food munchies connection?
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02-28-2014, 08:47 PM   #14
wildbill_52280
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junk food munchies connection?
i was thinking the same thing.

those pot heads would likely be eating more junk.
02-28-2014, 08:49 PM   #15
wildbill_52280
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Where are the legit studies?

The one i see most often is a double-blind which had the control group with Crohn's smoke regular cigarettes (a known trigger for worsening Crohn's symptoms). Not exactly an honest study.
i think they smoked marijuana cigarettes not tobacco cigarettes.

either way the study found benefits but i really dont like the way this study was designed because they seemed to be altering the plants natural composition.

http://www.ncbi.nlm.nih.gov/pubmed/23648372
02-28-2014, 08:56 PM   #16
VeganOstomy
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they smoked marijuana cigarettes not tobacco cigarettes.
There's another study which I've seen others promote and it's a double-blind with controls smoking regular tobacco that's had the active component to cannabis removed (so they think they're smoking real cannabis). The study group used marijuana. So it's no wonder the controls had worse results (in that study).
02-28-2014, 09:17 PM   #17
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"Studies" like this mean very little to me. Get in there with your damn colonoscopy in a double blind placebo controlled and tell me if there is reduced inflammation and mucosal healing or not. And throw in a heap of blood tests as well.

Regardless, thanks for posting this Kiny
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02-28-2014, 09:26 PM   #18
VeganOstomy
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"Studies" like this mean very little to me. Get in there with your damn colonoscopy in a double blind placebo controlled and tell me if there is reduced inflammation and mucosal healing or not. And throw in a heap of blood tests as well.

Regardless, thanks for posting this Kiny
Exactly.
03-01-2014, 01:34 PM   #19
wildbill_52280
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"Studies" like this mean very little to me. Get in there with your damn colonoscopy in a double blind placebo controlled and tell me if there is reduced inflammation and mucosal healing or not. And throw in a heap of blood tests as well.

Regardless, thanks for posting this Kiny
excellent point!! otherwise it seems like a waste of funding. why generate multiple substandard studies when you could just do one excellent designed study and get it over with to answer a question almost conclusively?

assuming you can find patients that have the willingness to do all of this that is!!it takes time to recruit people for these studies, who wants to go through a colonoscopy just for the sake of science?
03-01-2014, 01:38 PM   #20
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"Studies" like this mean very little to me. Get in there with your damn colonoscopy in a double blind placebo controlled and tell me if there is reduced inflammation and mucosal healing or not. And throw in a heap of blood tests as well.



Regardless, thanks for posting this Kiny

This is exactly what I've been reading up to find. Doesn't exist, huh? Dangit!


03-01-2014, 04:11 PM   #21
VeganOstomy
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assuming you can find patients that have the willingness to do all of this that is!!it takes time to recruit people for these studies, who wants to go through a colonoscopy just for the sake of science?
I've been in a clinical trial and would do it again if I had the chance. Trials are FAR more thorough than a regular dr's visit... regular blood tests, urine tests, stool samples, free meds and often monetary compensation. If it's a stage 2/3 test, then there's less to worry about when it comes to safety. A cannabis trial would be in high demand as it touts "safety" (debatable) and little side effects, however, you always run the risk of worsening your illness with experimental trials.

Currently, there's anecdotal evidence that people with nausea, poor appetite, weight loss, trouble sleeping, could benefit from cannabis if nothing else. As an adjudicative therapy, I think there's promise, but I don't believe it heals moderate/severe Crohn's like some other drugs can.
03-31-2014, 09:08 PM   #22
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Yea, a lot of correlation causation here. It seems likely to me that higher marijuana usage would be associated with more severe disease process, thus making it look like the marijuana usage itself is the culprit. Double blind placebo controlled trial is definitely needed before any conclusions can be drawn.
03-31-2014, 11:33 PM   #23
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When you consider that there is portion of people who start using marijuana because the disease is progressing to the point of needing surgery the idea behind the study is intrinsically flawed. Correlation is not causation.

I didn't start smoking pot until after diagnosis, it wasn't until my disease started getting progressively worse and I was heading towards needing surgery that I started smoking pot. My Doctor within the first 6 months of diagnosis was already advocating surgery, and had given me an estimate of how long he thought I would last with a colon.
This is exactly it. Of the entire population of people with Crohns:

1 - How many are predisposed to use it right away as soon as they are diagnosed

vs

2 - The much larger majority that are

a) not comfortable with using it (fear, legality, social pressure).

b) cannot get access to for legal reasons, or

c) any other reason that prevents them from immediately starting use until they are at the point of literal desperation.

Category #2 is much, much greater part of the overall population than category one. We don't even need to see hard data to deductively see that this is true. But it has to be over 80% (probably more).

Therefore the study is bunk. This is obvious to anyone with common sense and clear thinking.

I also wholeheartedly agree with a comment made earlier re: the following truism:

If its funded by corporate government (but I repeat myself) entities - we can be very sure that there is high probability that there is huge bias, hidden agendas, and often outright deliberate fraud at the core of it.

News on this is coming out every day from every angle. Studies like this have 0 credibility if you are following current events (real ones - not propoganda ones) concerning everything about modern 'evidence based' medicine.

These types of studies are propaganda and should be treated as such. Wait for the real studies to come - we will know them when we see them.
04-01-2014, 10:33 AM   #24
ce1210
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I've been in a clinical trial and would do it again if I had the chance. Trials are FAR more thorough than a regular dr's visit... regular blood tests, urine tests, stool samples, free meds and often monetary compensation. If it's a stage 2/3 test, then there's less to worry about when it comes to safety. A cannabis trial would be in high demand as it touts "safety" (debatable) and little side effects, however, you always run the risk of worsening your illness with experimental trials.

Currently, there's anecdotal evidence that people with nausea, poor appetite, weight loss, trouble sleeping, could benefit from cannabis if nothing else. As an adjudicative therapy, I think there's promise, but I don't believe it heals moderate/severe Crohn's like some other drugs can.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2451037/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931570/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3165957/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664885/

most of these studies are done on mice so obviously far from proving safe therapeutic benefits but they do show that cannabis could help decrease bowel motility and inflammation which would most def promote mucosal healing...and they need to be testing cannabis concentrates as thats where the most med benefits are I believe I was being told with 6-mp and humira I'd be in and out of the doc/er and would def need surgery. Been on cannabis concentrates and organic high probiotic diet with no pharma besides prilosec for months now and feel the best that I have in years...
04-01-2014, 10:42 AM   #25
ce1210
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another good one.....

http://www.ncbi.nlm.nih.gov/pubmed/20117132
04-01-2014, 10:44 AM   #26
VeganOstomy
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most of these studies are done on mice so obviously far from proving safe therapeutic benefits but they do show that cannabis could help decrease bowel motility and inflammation which would most def promote mucosal healing...
Unfortunately, mice are not people - especially mice that were purposely given colitis in order to test and dissect them.

Second, two of the four studies listed were funded by a pharmaceutical company that profits from selling medicinal cannabis, so there's a bias already.

I have no doubts that there may be medicinal properties to cannabis (we already use it medically for a reason), but it should be easy enough to test the theory on consenting humans so we can put the case to rest and move forward with providing help to those who need it.

My doc refused to prescribe cannabis, even though the Canadian government already indicates that Crohn's disease qualifies for eligibility. Instead, I was put on Prednisone, which if didn't help some people, I'd assume it was a chemical used to torture prisoners.

I do hope that more funding goes into researching medicinal cannabis, since it's use, even as an adjunct, could help a lot of people.
04-01-2014, 12:24 PM   #27
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I didn't try cannabis until a couple of years ago. I had 6 resections and a illiostomy before I was desperate enough to try it. I have used remicade, humira, and Cimzia in the past and they did help the crohn's but I had so many severe infections the doctors took me off the biologicals for good. I won't even mention steroids. Since I have been using cannabis brownies I have not even been to the GI clinic once. I don't know about the clinical trials and don't really care. All I know is what is. I can truly have a life now and I am pretty happy most of the time. I don't know why the cannabis works so well for me.

When I see the commercials for humira I am amazed that anyone would take a chance using it. Behind the beautiful music and scenes of people having a wonderful life the possible side effects are quickly mentioned. I sometimes wonder what a commercial for cannabis would be like.

I feel awful for anyone that has this disease. I would do or try just about anything to help someone that has crohn's disease. It does take over almost every aspect of your life when it is active. I had many psychological issues that I would not have had otherwise. Getting help for that was very important for me. I tried to hide the symptoms from others for some reason.

Just realized I am babbling. Sorry.
04-01-2014, 02:53 PM   #28
ce1210
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I didn't try cannabis until a couple of years ago. I had 6 resections and a illiostomy before I was desperate enough to try it. I have used remicade, humira, and Cimzia in the past and they did help the crohn's but I had so many severe infections the doctors took me off the biologicals for good. I won't even mention steroids. Since I have been using cannabis brownies I have not even been to the GI clinic once. I don't know about the clinical trials and don't really care. All I know is what is. I can truly have a life now and I am pretty happy most of the time. I don't know why the cannabis works so well for me.

When I see the commercials for humira I am amazed that anyone would take a chance using it. Behind the beautiful music and scenes of people having a wonderful life the possible side effects are quickly mentioned. I sometimes wonder what a commercial for cannabis would be like.

I feel awful for anyone that has this disease. I would do or try just about anything to help someone that has crohn's disease. It does take over almost every aspect of your life when it is active. I had many psychological issues that I would not have had otherwise. Getting help for that was very important for me. I tried to hide the symptoms from others for some reason.

Just realized I am babbling. Sorry.
Hahaha the funny thing is they do have "cannabis commercials" but they are the ones where the kid smokes weed and never leaves the couch, eventually actually physically melting into the couch, insinuating weed makes you lazy. If it wasn't for cannabis, I wouldn't be able to work the 60 hours a week that I work between the crohn's an the arthritis...

Yet, humira is all clouds, happy music, and kids running around...then you listen to the "fast talking man" come in w/ the side effects ie, lymphoma, hepatitis, pancreatitis, liver problems, skin problems, eye problems, etc. I'm sure it helps people, but I feel like it should always be a last resort.

Cannabis completely changed my life after my diagnosis, and it has allowed me to get off all the crohn's meds (entocort,LDN,6-mp,asacol hd) and eat things that I'd had to give up too...
04-01-2014, 03:37 PM   #29
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First I want to say that I appreciate this forum even more for the fact that you all know and share which research articles are crap and which are solid. So many people put faith in anything published!

I'm so intrigued by the use of cannibis. We are moving to Nebraska. I'm not familiar with the relevant legislation there. Medical marijuana isn't an option there is it?
04-01-2014, 03:54 PM   #30
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I used it for several years for help with Crohn's and it was very helpful. The implication that such use may be a cause for surgery is laughable. Of course sicker people who are trying everything are more likely to be sicker, you might as well say more frequent visits to the doctor is a likely cause.
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