Marijuana Use Patterns Among Patients With Inflammatory Bowel Disease

[zachw]

Haven't seen this new study from Brigham and Women's Hospital (Boston) linked to yet.

 

 

CONCLUSIONS:

A significant number of patients with IBD currently use marijuana. Most patients find it very helpful for symptom control, including patients with ulcerative colitis, who are currently excluded from medical marijuana laws. Clinical trials are needed to determine marijuana's potential as an IBD therapy and to guide prescribing decisions.

 

Abstract here.

[+washtenaut]

GW Pharmaceuticals also has trials ongoing using cannabinoids to treat ulcerative colitis.  Obviously something to this

[t-pain]

in my non medical opinion, its the marijuana's anti-inflammitory that helps.

non-toxic anti-inflammatory cannabis cannabinoids and terpenes, inflammatory bowel disease.

seems simple enough to figure out.

 

instead of doing a clinical study telling us that marijuanas anti-inflammatory properties works on inflammatory bowel disease,

i would like to see a study done to find out which cannabinoids work best for IBD.

is it CBD? CBDA? THC? THCA? CBN? CBG? 

 

that would be far far far more helpful to patients currently.

i mean, GW Pharma's 15%THC / 15%CBD tincture maybe useful for IBD, giving relief for 60% over placebo in trials.

but what if they figured out which cannabinoids did best? what if they got 70% relief? 80% ?

 

one can dream?

[Dr. Bob]

I would tend to agree with you T.  

 

Personally I would like to see some listed conditions as we have, but have the ability as a physician to make a judgement call on a case by case basis.  We do that in medicine.  For example we in many cases will use an antidepressant in chronic pain.  Or an anti-seizure medication.  I don't have the freedom to do that will MMJ. It is a serious limitation.

 

Dr. Bob

[trichcycler]

Many conditions can cause a qualifying condition to arise. Like IBS causing sever pain, or muscle spasms, or medications taken for an unapproved condition, and causing nausea?  Correct me if I'm wrong please

[bobandtorey]

It is my opinion that nausea covers a lot of people if you take just about any kind of medication one of the side effects is nausea 

[Norby]

Yes, it can be recommended for either pain, nausea or spasms associated with IBS(I get all 3 from time to time).  My Primary and my other doctor both said they'd have no problem with recommending esp. in place of the xanax.

. I'm currently beginning real research on strains for nausea and inducing the munchies.  I've found that kush' really help with the underlying problem of anxiety and the associated depression.  I'd like to find something that induces hunger and work with tailoring it into a good kush strain.  I had a lemon skunk x white widow cross that made you hungry as a bear but wasn't the greatest for anxiety and depression.  Back to the drawing board.  Any suggestions much appreciated.

 

On a side note, my doc in NY had to list anxiety as the reason for the alprazolam.  He couldn't prescribe it for IBS even though that was why I was taking it.  I have no problem handling the stress, just that my stomach doesn't agree.  On my health records it reads like a mental chart and doesn't deal with my IBS when mental health is not the problem.  Just something I noticed when getting my records to bring to Mi.

Edited November 19, 2013 by Norby

[zachw]

Yes, it can be recommended for either pain, nausea or spasms associated with IBS(I get all 3 from time to time).  My Primary and my other doctor both said they'd have no problem with recommending esp. in place of the xanax.

 

Psychiatrist friend tells me that xanax is more addicting and harder to get off of than heroin.

[Norby]

Glad I only take 1/2 of a .25MG a day on avg.  I had some MJ pills that I could easily substitute although it'd be about $70 - $80/month rather than $2/month for the xanax.

[+washtenaut]

This was from GW Pharmaceutical's earnings report and product pipeline.

 

 

GWP42003, which features CBD as the primary cannabinoid, for the treatment of ulcerative colitis (“UC”), for which a Phase 2 trial is ongoing, with data expected in the first half of 2014. This follows pre-clinical research that has shown GWP42003 to have anti-inflammatory properties in a number of accepted animal models of inflammation, notably of the gut and the joints. In particular, GW’s research has demonstrated potential in the treatment of UC in standard in vivo models.

[trichcycler]

Unfortunately we're comparing lab isolated cbd's with home grown plants, that will differ in each garden with each feeding program, every different type of light, harvest habits, flowering duration,humidity, temperatures, and other variables. Every plant acts differently for every patient, sometimes varying from use to use in the same person even. "kush" is afghan kush, covering hundreds of hybrid strains, many with one off names made up on the fly.  One plant makes me sleep while it gives another patient insomnia, and the next time it relaxes him, while it causes me anxiety, for example. growers have the optional advantage of total control in the garden, and a vast sampling spree daily sometimes. We're able to find whats good for us fairly easily, but patients may find repeatability difficult, especially changing out caregivers often while seeking it. I've grown requests so many times, like "Querkle" for one, and the response was "this is so totally different than that one I tried at the club..........hmmmmm, go figure. I 've personally witnessed dispensary "naming" techniques in the past, and its disgusting, and problematic for serious patients. 

 

when a patient finds a "strain" that offers them the relief they seek, they should clone it, and grow it, rather than wait for it to turn up again somewhere else.

I have found "the best" for me, but some with the same issues as I may find them useless maybe.

 

I seek to accept patients who find me, based on my personal experience and posts, as a good start to a great match. example; I grow to treat my migraines. I interview patients who suffer similar migraines, for similar reasons, with shared expectations. (not true at all, I don't get migraines btw). It might not always work out, but its a good start to a positive patient outcome in my experience.

 

some folks simply enjoy the side effects offered while treating their condition, and these are easy to please, however some are very much more specific with their expectations, and deserve solid information and repeatability if possible, and as you see, not many find it in a consistent supply. Some gardens are managed with a "see what happens in this batch" or "hopefully the next batch will be better" as the grow reigns are tossed to chance.

 

We all have different grow bibles it seems, so no surprises 3  different growers produce three different Querkles, if indeed it was querkle in the beginning, even mine. so when a patient tells me "querkle" cures my "X", a grain of salt is to be taken.

 

If someone will teach me to upload an app, I have an interactive one that lists all terpenes and each correspondence of treatments, using checkboxes of ailments and a list of the needed terpenes, not a chart.

Yes, it can be recommended for either pain, nausea or spasms associated with IBS(I get all 3 from time to time).  My Primary and my other doctor both said they'd have no problem with recommending esp. in place of the xanax.

. I'm currently beginning real research on strains for nausea and inducing the munchies.  I've found that kush' really help with the underlying problem of anxiety and the associated depression.  I'd like to find something that induces hunger and work with tailoring it into a good kush strain.  I had a lemon skunk x white widow cross that made you hungry as a bear but wasn't the greatest for anxiety and depression.  Back to the drawing board.  Any suggestions much appreciated.

 

On a side note, my doc in NY had to list anxiety as the reason for the alprazolam.  He couldn't prescribe it for IBS even though that was why I was taking it.  I have no problem handling the stress, just that my stomach doesn't agree.  On my health records it reads like a mental chart and doesn't deal with my IBS when mental health is not the problem.  Just something I noticed when getting my records to bring to Mi.

[trichcycler]

while my confusion was being assessed, I learned the differences between IBS and IBD. I also learned that treating this disorder with cannabis offers relief, it does nothing to heal the issue, being too much of some things, or not enough of others. Sufferers share many commonalities in their lifestyle, which cant be ignored. The best relief is found in fixing the problem, rather than masking its symptoms. Inflammation is not something that just happens to some of us, its caused. Physicians rarely aim to find and eliminate dis-ease causes, so we learn to live with these awful conditions. Health Care should be aptly named Sick Care,  here's what I found

 

Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD)

 

 

Article Body

Irritable bowel syndrome (IBS) is often referred to inaccurately as “colitis” and “mucous colitis.” But the suffix “itis” in a medical condition’s name denotes inflammation, which is not a hallmark of IBS. Rather than inflaming the colon, IBS sensitizes the nerves responsible for the contractions (called peristalsis) that propel partially digested food through the organ. As a result, the muscular inner wall overreacts to mild stimuli like milk products and emotional stress, and goes into spasm. Irritable bowel syndrome produces cramplike pains and bouts of diarrhea and/or constipation.

The more serious disorders, Crohn’s disease and ulcerative colitis, are both forms of inflammatory bowel disease. IBD damages the tissue of the small bowel and the large bowel, respectively, through the process of inflammation. As the body’s response to injury, inflammation is characterized by blood-carrying, infection-fighting white blood cells that rush to the site of the injury. Their presence accounts for the painful swelling, warmth and redness associated with an inflammatory reaction.

Among children, Crohn’s is two times more prevalent than ulcerative colitis. Whereas ulcerative colitis affects only the inner lining of the intestine and is confined to one section, “Crohn’s disease can penetrate the full thickness of the bowel and tends to occur in more than one area,” explains Dr. Alan Lake, a pediatrician and pediatric gastroenterologist at Baltimore’s Johns Hopkins University School of Medicine. In colitis, however, ulcers form where inflammation has destroyed the tissue. The open sores ooze blood, mucus and pus.

The cause of inflammatory bowel disease has yet to be discovered, although theories abound. Heredity is a factor: 15 to 30 percent of IBD sufferers have a relative with either disorder.

Symptoms that Suggest Irritable Bowel Syndrome may include:

• Cramplike pain and spasms in the lower abdomen
• Nausea
• Bloating and gas
• Headache
• Rectal pain
• Backache
• Appetite loss
• Alternating bouts of diarrhea and constipation
• Fatigue
• Depression
• Anxiety
• Difficulty concentrating

Symptoms that Suggest Inflammatory Bowel Disease may include: Crohn’s Disease

• Cramping abdominal pain and tenderness, particularly after meals
• Nausea
• Diarrhea
• General ill feeling
• Fever
• Appetite loss possibly leading to weight loss
• Bloody stool
• Swelling, pain, stiffness in the knees and ankles
• Cankerlike sores in the mouth
• Eye inflammation
• Irritation or swelling around the rectum
• Fatigue
• Depression
• Anxiety
• Difficulty concentrating
• Delayed growth and sexual development in younger teens, due to lack of nutrition

Ulcerative Colitis

• Pain and cramping in the left side of the abdomen
• Intermittent episodes of bloody, mucus-like stool
• Swelling, pain, stiffness in the knees and ankles
• Canker-like sores in the mouth
• Fatigue
• Depression
• Anxiety
• Difficulty concentrating
• Growth retardation in younger teens, due to lack of nutrition

Acute attacks may include:

• Up to twenty bloody, loose bowel movements a day
• Urgent need to move bowels
• Severe cramps and rectal pain
• Profuse sweating
• Dehydration
• Nausea
• Appetite loss
• Weight loss
• Abdominal bloating
• Fever up to 104 degrees F

You can see that many of the symptoms overlap, making diagnosis complicated at times. In general, says Dr. Lake, “the patient with ulcerative colitis has more bloody bowel movements, and the patient with Crohn’s disease experiences more pain.” He goes on to say that while ulcerative colitis is usually picked up quickly, “with Crohn’s disease, many months can pass between the onset of symptoms and the time of diagnosis. Not only are the symptoms subtle, but they can be minimized by cutting back on eating. So it can be difficult for parents to recognize that something is the matter.

“Frequently, kids are diagnosed because they develop inflammation elsewhere, like the eyes, the mouth and the rectum. If your child has irritation or swelling around the rectum,” he advises, “never assume that it is hemorrhoids, which is all but unheard of in children. The concern should be that he or she has Crohn’s disease.”

How Irritable Bowel Syndrome is Diagnosed:

Physical examination and thorough medical history, plus one or more of the following procedures:

• Urinalysis
• Urine culture
• Complete blood count
• Erythrocyte sedimentation rate (sed rate) blood test
• Stool blood test
• Sigmoidoscopy

How Inflammatory Bowel Disease is Diagnosed:

Physical examination and thorough medical history, plus one or more of the following procedures:

• Complete blood count
• Prothrombin time blood test
• Erythrocyte sedimentation rate (sed rate) blood test
• Stool blood test
• Urinalysis
• Sigmoidoscopy or colonoscopy
• Upper gastrointestinal (GI) series (also known as a barium swallow)

Still other laboratory tests may be ordered.

How Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) are Treated

All of these chronic conditions are incurable but treatable, meaning that steps can be taken on several fronts to reduce the frequency and severity of symptoms.

• Changes in diet: Boys and girls with IBS or IBD are able to eat relatively normally when the disease is in remission, which is much of the time. During flareups, though, they need to be conscientious about avoiding certain foods. Your pediatrician will work with a nutritionist or a GI specialist to tailor an eating plan for your youngster.
  In irritable bowel syndrome, adding roughage to the diet may be all that’s necessary to ease cramping and soften hardened stool or eliminate diarrhea. However, high-fiber foods induce the opposite effect in a teen with Crohn’s disease or ulcerative colitis, who should stick to easy-to-digest low-residue items like broth, gelatin, skinless poultry, fish, rice, eggs and pasta. Fried foods and dairy are also taboo when the disease is active.
  Memo to Mom and Dad: Help spare your son or daughter some of the unwelcome consequences of IBD by serving five or six small meals a day instead of the customary big three.
• Drug therapy: If diet alone doesn’t bring relief from an irritable bowel, occasionally a pediatrician will prescribe an antispasmodic agent to slow down its activity. Medication is usually indicated in Crohn’s disease or ulcerative colitis, where the favored drugs include corticosteroids such as prednisone (“the cornerstone of treatment,” according to Dr. Lake), and the 5-ASA agents sulfasalazine, olsalazine and mesalamine. Should these fail to stem the inflammation, your pediatrician might prescribe one of the following immunomodulators: azathioprine, cyclosporine, methotrexate or 6-mercaptopurine. They work by altering the body’s immune response. An IBD patient’s medicine cabinet often contains antibiotics and antidiarrheal medicines as well.
• Dietary supplements: From a child's perspective, one of the most upsetting effects of inflammatory bowel disease is its suppression of growth and sexual maturity. Large doses of prednisone can decelerate physical development; accordingly, pediatricians lower the dose or gradually take young people off the drug once it has controlled the inflammation.
  The main cause of poor growth, however, is insufficient nutrition. Adolescents with IBD sometimes fall into the habit of skimping on breakfast and lunch in order to avoid repeated trips to the bathroom while at school. As a result, they may be lacking in calories, nutrients, vitamins and minerals. Protein is especially crucial for growth.
  Your pediatrician will monitor your child’s eating patterns. Most nutritional deficiencies can be corrected by tinkering with the diet. If necessary, though, she can prescribe oral supplements and/or high-calorie liquid formulas.
• Surgery: Cases of inflammatory bowel disease that resist drug therapy or develop complications may require an operation to remove part or all of the colon. This route is rarely taken during the teen years.
• Mental health care: Emotional stress does not cause IBS or IBD, but it can aggravate either condition. Therefore, patients may benefit a great deal from seeing a mental health professional who can teach them stress-reduction techniques such as progressive muscle relaxation and progressive guided imagery. As with other chronic ailments, inflammatory bowel disease can be frustrating for teenagers. Flareups often leave them more dependent on their parents than they want to be and make them feel different from their friends. They may feel as though their body has betrayed them. If you suspect that your son or daughter is having a hard time coping, ask your pediatrician for a referral to a suitable counselor.

[Norby]

I should have qualified real research as not being "real" research.

I have IBS and  a friend has IBD so I am somewhat familiar with both.  From what I remember MJ is the only medicine which has shown to repair the lesions caused by IBD.  While IBS is a syndrome, which isn't curable and is only "cured" when managed as to not have symptoms arise.

While there are differences in the way certain strains affect people and kush' do have differing effects, most of the couple kush' I've tried all have had a relaxing to sedative effect on me and many of my friends.  I have also saw strains that generally give most people the munchies.  I am working on this for myself but i hope to have it work more in general for IBD's anxiety and nausea side affects and things like cancer treatment and the like for a majority of people.  There are some people where opiates don't generally work for them.  I don't process caffeine well while some people can sleep after a cup of coffee.  We just hope for the best.

[trichcycler]

I was unaware of the lesion healing, that is promising!  Where can I research this ? Is this considered muscle spasms in the qualifying conditions section?  I hope so.

I wish you well Norby, I know this is a trying situation for you. I think you're on to the right path though. Can you tell me of some wacky pills docs might prescribe for the dis-ease?   (rx--yuck!)

[Norby]

I think I read about the healing in the pot book by julie holland.  I'm terrible at remembering sources.  I qualified under spasms, nausea and chronic pain for the cramps associated.

  The only meds I've been prescribed were alprazolam(xanax).  The fx labs co2 capsules are what would substitute well for the xanax.

 

Thanks.

[trichcycler]

thanks for the reference !