Cannabinoids for treating inflammatory bowel diseases: where are we and where do we go?

Expert Rev Gastroenterol Hepatol. 2017 Apr;11(4):329-337. doi: 10.1080/17474124.2017.1292851. Epub 2017 Feb 16.

Abstract

Fifty years after the discovery of Δ9-tetrahydrocannabinol (THC) as the psychoactive component of Cannabis, we are assessing the possibility of translating this herb into clinical treatment of inflammatory bowel diseases (IBDs). Here, a discussion on the problems associated with a potential treatment is given. From first surveys and small clinical studies in patients with IBD we have learned that Cannabis is frequently used to alleviate diarrhea, abdominal pain, and loss of appetite. Single ingredients from Cannabis, such as THC and cannabidiol, commonly described as cannabinoids, are responsible for these effects. Synthetic cannabinoid receptor agonists are also termed cannabinoids, some of which, like dronabinol and nabilone, are already available with a narcotic prescription. Areas covered: Recent data on the effects of Cannabis/cannabinoids in experimental models of IBD and in clinical trials with IBD patients have been reviewed using a PubMed database search. A short background on the endocannabinoid system is also provided. Expert commentary: Cannabinoids could be helpful for certain symptoms of IBD, but there is still a lack of clinical studies to prove efficacy, tolerability and safety of cannabinoid-based medication for IBD patients, leaving medical professionals without evidence and guidelines.

Keywords: Cannabinoids; Cannabis; Crohn’s disease; dronabinol; inflammatory bowel disease; medical marijuana; nabilone; nabiximols; ulcerative colitis.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / therapeutic use*
  • Cannabinoid Receptor Agonists / adverse effects
  • Cannabinoid Receptor Agonists / therapeutic use*
  • Cannabinoids / adverse effects
  • Cannabinoids / therapeutic use*
  • Colitis, Ulcerative / drug therapy*
  • Colitis, Ulcerative / metabolism
  • Colitis, Ulcerative / physiopathology
  • Crohn Disease / drug therapy*
  • Crohn Disease / metabolism
  • Crohn Disease / physiopathology
  • Endocannabinoids / metabolism
  • Gastrointestinal Agents / adverse effects
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Intestinal Mucosa / metabolism
  • Intestines / drug effects*
  • Intestines / physiopathology
  • Receptors, Cannabinoid / drug effects*
  • Receptors, Cannabinoid / metabolism
  • Signal Transduction / drug effects
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Cannabinoid Receptor Agonists
  • Cannabinoids
  • Endocannabinoids
  • Gastrointestinal Agents
  • Receptors, Cannabinoid