How effective is cannabis for ulcerative colitis?

How effective is cannabis for ulcerative colitis?


With 5 years of cannabis journalism behind her after graduating from De Montfort University and writing for cannabis publications such as The Cannavist, Lucy is a dedicated journalist passionate about cannabis education and culture.

Ulcerative colitis is a persistent inflammatory bowel disease (IBD) characterised by inflammation in the inner lining of the colon and rectum. This chronic condition has a diverse range of symptoms, the severity of which can fluctuate significantly.

Traditionally, Ulcerative colitis has been managed through a combination of lifestyle practices and pharmaceutical medications. In recent years, medical cannabis has emerged as a potential bridge between these two options. The interest in medical cannabis as a treatment for Ulcerative colitis is mainly due to its potential anti-inflammatory and analgesic (pain-relieving) properties.

The symptoms of ulcerative colitis

Some of the most common symptoms experienced by individuals with ulcerative colitis include diarrhoea, rectal bleeding, abdominal pain and cramping, fatigue, weight loss and loss of appetite. More severe symptoms may include joint pain, malnutrition, and anaemia.

The persistent nature of these symptoms can have a profound impact on daily life, causing discomfort, disruption and emotional distress. Frequent and urgent trips to the bathroom can interfere with work, social activities and overall well-being. The chronic pain and cramping can further exacerbate the physical and emotional toll, leading to fatigue and decreased productivity.

How cannabis may help alleviate the symptoms of Ulcerative colitis

Research studies have indicated that cannabis may have anti-inflammatory properties that could be beneficial for individuals with ulcerative colitis. Specifically, it may reduce inflammation in the colon and rectum. This could help alleviate many of the common symptoms of the condition, such as diarrhoea, abdominal pain, and rectal bleeding.

Furthermore, cannabis may be able to influence the body's perception of pain. This means that it could provide effective relief from the discomfort and cramping experienced by individuals with ulcerative colitis.

But how does medical cannabis interact with the body, and offer these potential therapeutic benefits?

The endocannabinoid system

The endocannabinoid system (ECS) regulates a huge scope of various physiological processes, including inflammation, pain perception, and gastrointestinal function. It is composed of endocannabinoids (the signalling molecules of the ECS), cannabinoid receptors CB1 and CB2, and enzymes that produce the endocannabinoids, and also break them down once their function has been completed. 

Cannabis is a source of phytocannabinoids (cannabinoids produced by a plant). These interact with the body’s own endocannabinoid system. In particular, they can bind themselves with the ECS receptors in the gut.

This has the potential effect of easing inflammation, reducing pain perception, and promoting healthy gastrointestinal function. This, in turn, leads to relief from symptoms such as abdominal pain, rectal bleeding and diarrhoea.

The science of cannabis and Ulcerative colitis

Several studies have investigated the effectiveness of cannabis in treating inflammatory bowel conditions in general and Ulcerative colitis in particular.

A 2023 review of the literature on this topic highlighted that “the efficacy of cannabinoid use in IBD treatment was reported in most studies”. It also confirmed that “very few adverse effects were documented”.

Another recent paper looked into the therapeutic potential of cannabis for treating inflammatory bowel disease. They found that “There is accumulating evidence that enhancing signalling through cannabinoid receptors 1 and 2 has anti-inflammatory potential in the intestine in vivo.”

This 2018 paper researched the use of medical cannabis as a treatment for Ulcerative colitis specifically (as opposed to inflammatory bowel conditions in general). It noted that “Cannabis and some cannabinoids have been shown to decrease inflammation in animal and laboratory models which suggests it may help people with Ulcerative colitis.” 

How different forms of medicinal cannabis can be applied to ease the symptoms of ulcerative colitis

There are three main ways of administering cannabis to potentially offer symptomatic relief from ulcerative colitis. These are inhalation, ingestion and topical application.

Inhalation: Vaporising or vaping cannabis is among the more often prescribed options. Vaping delivers cannabinoids through the respiratory system. This means that results can be experienced very quickly, in some cases almost immediately.

Oral ingestion: There are two main forms of orally ingested medicinal cannabis.

Tinctures are delivered sublingually (under the tongues, meaning the cannabinoids can bypass the digestive system and go straight into the bloodstream. The effects of tinctures can bed felt almost as quickly as inhalation. 

Edibles, on the other hand, have to be processed by the digestive system and hence work more slowly. They can, however, provide long-lasting relief. 

Topical application: Topical application has limited relevance for ulcerative colitis. It can, however, be useful in severe cases when joint pain is an issue.

Cannabis and conventional treatment for ulcerative colitis

Conventional treatments for ulcerative colitis typically include medications such as anti-inflammatory drugs, immune system suppressors, and symptom-specific medications. These treatments aim to reduce inflammation, manage symptoms, and promote remission. Some individuals may, however, find that conventional treatments alone are not sufficient in providing relief or managing their symptoms effectively.

Medicinal cannabis has shown the potential to be used in conjunction with conventional treatments for ulcerative colitis to enhance therapeutic outcomes. It may offer additional benefits such as reducing inflammation, relieving pain, improving appetite, and promoting overall well-being. By targeting different pathways in the body, cannabis may complement the effects of conventional treatments and provide a more comprehensive approach to managing the disease.

With that said, it’s important to consider the potential drawbacks of taking medicinal cannabis for ulcerative colitis. Like any medication, cannabis can have side effects. These may include drowsiness, dry mouth, or changes in appetite. Additionally, cannabis has the potential to interact with prescription medications. These interactions can affect the effectiveness of the medications or lead to undesirable side effects. This highlights the necessity to always consult with a doctor that is experienced in and registered to prescribe medicinal cannabis before making any changes to your current treatment plan. 

Legal considerations

Since November 2018, specialist doctors in the UK have been allowed to prescribe cannabis-based products for medicinal purposes. This change was implemented following high-profile cases and growing evidence of the potential therapeutic benefits of cannabis for certain medical conditions.

Medical professionals will make individual assessments to decide whether to prescribe cannabis-based products. They will take into account the patient's medical history and the severity of their Ulcerative colitis. It’s important to note that simply having a diagnosis of ulcerative colitis does not guarantee eligibility for medical cannabis treatment. Thus, medical cannabis should be viewed as only one of several treatment options available to patients.

Cannabis and ulcerative colitis in brief

The nature of ulcerative colitis means that its treatment and management generally have to be adapted to reflect the fluctuations in its symptoms. The good news is that here at Releaf, we offer a highly personalised service created with flexibility in mind. We’re always happy to work with you to ensure that you always get the right product for your needs. Whenever your needs change, we’ll update your subscription to match them.

Releaf is committed to helping you access the benefits of a medical cannabis service. Our monthly packages are tailored to your cannabis prescription, and we offer specialist consultations for medical cannabis and a unique medical cannabis card for protection. 

It is important to seek medical advice before starting any new treatments. The patient advisors at Releaf are available to provide expert advice and support. Alternatively, click here to book a consultation with one of our specialist doctors.

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