title: Cannabis use amongst patients with inflammatory bowel disease.
abstract: BACKGROUND
  Experimental evidence suggests the endogenous cannabinoid system may protect against colonic inflammation, leading to the possibility that activation of this system may have a therapeutic role in inflammatory bowel disease (IBD). Medicinal use of cannabis for chronic pain and other symptoms has been reported in a number of medical conditions. We aimed to evaluate cannabis use in patients with IBD.
  
  
  METHODS
  One hundred patients with ulcerative colitis (UC) and 191 patients with Crohn's disease (CD) attending a tertiary-care outpatient clinic completed a questionnaire regarding current and previous cannabis use, socioeconomic factors, disease history and medication use, including complimentary alternative medicines. Quality of life was assessed using the short-inflammatory bowel disease questionnaire.
  
  
  RESULTS
  A comparable proportion of UC and CD patients reported lifetime [48/95 (51%) UC vs. 91/189 (48%) CD] or current [11/95 (12%) UC vs. 30/189 (16%) CD] cannabis use. Of lifetime users, 14/43 (33%) UC and 40/80 (50%) CD patients have used it to relieve IBD-related symptoms, including abdominal pain, diarrhoea and reduced appetite. Patients were more likely to use cannabis for symptom relief if they had a history of abdominal surgery [29/48 (60%) vs. 24/74 (32%); P=0.002], chronic analgesic use [29/41 (71%) vs. 25/81 (31%); P<0.001], complimentary alternative medicine use [36/66 (55%) vs. 18/56 (32%); P=0.01] and a lower short inflammatory bowel disease questionnaire score (45.1±2.1 vs. 50.3±1.5; P=0.03). Patients who had used cannabis [60/139 (43%)] were more likely than nonusers [13/133 (10%); P<0.001 vs. users] to express an interest in participating in a hypothetical therapeutic trial of cannabis for IBD.
  
  
  CONCLUSIONS
  Cannabis use is common amongst patients with IBD for symptom relief, particularly amongst those with a history of abdominal surgery, chronic abdominal pain and/or a low quality of life index. The therapeutic benefits of cannabinoid derivatives in IBD may warrant further exploration.
authors.affiliation: The IBD Clinic, Mount Sinai Hospital, Toronto, Ontario, Canada. simon.lal@srft.nhs.uk
authors.forename: Simon
authors.initials: S
authors.lastname: Lal
authors.forename: Neeraj
authors.initials: N
authors.lastname: Prasad
authors.forename: Manijeh
authors.initials: M
authors.lastname: Ryan
authors.forename: Sabrena
authors.initials: S
authors.lastname: Tangri
authors.forename: Mark S
authors.initials: MS
authors.lastname: Silverberg
authors.forename: Allan
authors.initials: A
authors.lastname: Gordon
authors.forename: Hillary
authors.initials: H
authors.lastname: Steinhart
mesh_terms: D000328:Adult; D002188:Cannabis / Q000009:adverse effects; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000523:psychology; D000529:Complementary Therapies / Q000706:statistics & numerical data; D003424:Crohn Disease / Q000188:drug therapy / Q000523:psychology; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000523:psychology; D008297:Male; D009864:Ontario; D008517:Phytotherapy / Q000379:methods / Q000706:statistics & numerical data*; D010936:Plant Extracts / Q000627:therapeutic use; D011788:Quality of Life; D012651:Self Medication / Q000706:statistics & numerical data
chemical_list: D010936:Plant Extracts