title: Treatment of Crohn's disease with cannabis: an observational study.
abstract: BACKGROUND
  The marijuana plant cannabis is known to have therapeutic effects, including improvement of inflammatory processes. However, no report of patients using cannabis for Crohn's disease (CD) was ever published.
  
  
  OBJECTIVE
  To describe the effects of cannabis use in patients suffering from CD.
  
  
  METHODS
  In this retrospective observational study we examined disease activity, use of medication, need for surgery, and hospitalization before and after cannabis use in 30 patients (26 males) with CD. Disease activity was assessed by the Harvey Bradshaw index for Crohn's disease.
  
  
  RESULTS
  Of the 30 patients 21 improved significantly after treatment with cannabis. The average Harvey Bradshaw index improved from 14 +/- 6.7 to 7 +/- 4.7 (P < 0.001). The need for other medication was significantly reduced. Fifteen of the patients had 19 surgeries during an average period of 9 years before cannabis use, but only 2 required surgery during an average period of 3 years of cannabis use.
  
  
  CONCLUSIONS
  This is the first report of cannabis use in Crohn's disease in humans. The results indicate that cannabis may have a positive effect on disease activity, as reflected by reduction in disease activity index and in the need for other drugs and surgery. Prospective placebo-controlled studies are warranted to fully evaluate the efficacy and side effects of cannabis in CD.
authors.affiliation: Institute of Gastroenterology and Hepatology, Meir Medical Center, Kfar Saba affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel. naftali@post.tau.ac.il
authors.forename: Timna
authors.initials: T
authors.lastname: Naftali
authors.forename: Lihi Bar
authors.initials: LB
authors.lastname: Lev
authors.forename: Doron
authors.initials: D
authors.lastname: Yablecovitch
authors.forename: Doron
authors.initials: D
authors.lastname: Yablekovitz
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Half
authors.forename: Fred M
authors.initials: FM
authors.lastname: Konikoff
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002188:Cannabis; D003424:Crohn Disease / Q000188:drug therapy*; D013505:Digestive System Surgical Procedures / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D008517:Phytotherapy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D019804:Mesalamine; D008727:Methotrexate