The effects of cannabis on physical symptoms in adults with inflammatory bowel disease

Abstract

Overview of the Topic: Medical cannabis has been legal in Malta since 2018 and in December 2021, the use of recreational cannabis was also legalized. Despite this, the use of cannabis as an alternative treatment is still an emerging area that needs to be investigated. The purpose of this dissertation is to evaluate the effects of cannabis on IBD-related physical symptoms. The Research Question: “In individuals with Inflammatory Bowel Disease, is cannabis effective in relieving physical symptoms?” PICOT Elements: The population (P) consisted of adults suffering from Inflammatory Bowel Disease. The intervention (I) was cannabis use while the comparison (C) was no cannabis use. Outcome (O) was an improvement in physical symptoms. Inclusion and Exclusion Criteria: The inclusion criteria incorporated studies that were in the English language, were conducted in the last ten years and had been peer-reviewed. Studies found in level VI or higher in the Hierarchy of Evidence were included whereas those found lower than level VI were excluded. All studies included involved only adults with a diagnosis of IBD. Studies involving children or murine models and adults with other chronic conditions apart from IBD were excluded. The intervention included cannabis use but excluded any other herbal or alternative interventions. This dissertation also took into consideration the outcome of evaluating the effects of cannabis on physical symptoms and excluded other outcomes such as clinical remission and legal use or attitudes towards cannabis. Search Outcome: The search was completed by utilizing the Hybrid Discovery (HyDi) platform of the University of Malta, EBSCO, Pubmed and Google Scholar. As a result, two randomized controlled trials, one cohort study, two cross sectional studies and two survey studies were retrieved. Methods of Appraisal: The CASP, JBI and CEBMa tools were used according to the study designs. Results and Conclusions: The overall results showed that cannabis has beneficial effects on IBD related physical symptoms. However, due to the general poor quality of the studies retrieved, a definite conclusion could not be reached. Implications and recommendations: Further robust studies with larger sample sizes are recommended. Since most retrieved experimental studies had consisted of patients with IBD refractory to conventional therapies, studies more representative of the target population should be organized. This could help guide the effective use of medical cannabis. Educational incentives aimed at both the community and healthcare professionals are also recommended.