Inflammatory Bowel Disease

Inflammatory Bowel Disease

Inflammatory Bowel Disease

Last week, WCM’s monthly webinar focused on the use of medical cannabis to treat Inflammatory Bowel Disease (IBD).

IBD is an umbrella term which encompasses Crohn’s disease, ulcerative colitis, and other chronic gastrointestinal diseases which damage the tissues of the digestive tract.

Our guest expert was “David”*, a WCM member whose 15-year struggle with ulcerative colitis ended literally the moment that he tried cannabis.

Like many of today’s 65-and-up medical cannabis patients, David’s first access to the plant was via illicit use in college. As an adult, his cannabis use slowed, then stopped.

Then came the onset of ulcerative colitis and its parade of negative side effects: inflamed open sores in his colon caused chronic visceral pain, bleeding, and a related litany of social and interpersonal challenges.

David tried many of the standard treatments for Inflammatory Bowel Disease, particularly steroid medicines that left him bloated and his moods swinging wildly. Despite these side effects, pharmaceutical interventions provided him with brief, blessedly symptom-free interludes, but never for more than a few months.

After more than a decade trying to manage his UC via pharmaceuticals, over the counter remedies, and dietary changes, David was at a holiday party when he overheard a similarly-afflicted friend talking about using medical cannabis to wean off of Humira (an anti-inflammatory drug originally approved to treat rheumatoid arthritis and psoriasis, but now commonly used to treat inflammation in IBD patients). As he left the gathering, David tucked his friend’s words away.

He knew his regimen of pharmaceuticals was providing only intermittent, temporary relief. And he knew that his now-adult children sometimes left cannabis in the basement after their visits to him. Long story short: on December 28, 2014, David found and raided his adult offspring’s stash.

As his fingers recalled the long-disused motions of rolling himself a joint, he felt a cramping twinge in his stomach—not a twinge of guilt for ransacking his grown kids’ green, but one of those deep visceral twinges that starts a countdown clock in an Inflammatory Bowel Disease patient’s head, signaling them to start looking for the nearest bathroom.

Instead, David finished his roll, then took a quick puff or two.

The twinge in his gut swiftly dwindled, dissipated. Within minutes, it disappeared.

More than 18 months later, it has not returned.

He did not realize it, in the moment, but after living with this chronic illness for more than a decade, David’s ulcerative colitis went into remission on December 28, 2014.

Shortly after realizing that cannabis gave him real relief, David talked to his primary care doctor and his GI specialist about becoming certified to use medical cannabis in Maine. One doctor was opposed to the idea and would not certify; the other thought it would be a good avenue to pursue, but could not certify. David ended up consulting with a cannabis specialist doctor, and ever since has controlled his UC with a mix of therapeutic cannabis capsules, edibles, and vaporizing.

He still has the pharma pills, just in case. But again, 18+ months later, David’s ulcerative colitis is in full remission. No gut twinges. No bleeding. No weird stools. No pills, and no mental calculations about the swiftest route to the nearest bathroom or the best excuse to use when suddenly ducking out of a social gathering.

In preparing for our webinar, I was unprepared for the relative dearth of scientific research into the capacity of plant-based cannabinoids to help control IBD. One of the more promising studies occurred in 2013, and involved 21 human subjects with Crohn’s disease which had not responded to traditional treatments. These were divided into a group of 11 who received whole-plant cannabis joints, and 10 who received “placebo containing cannabis flowers from which the THC had been extracted.”

10 of the 11 participants in the cannabis group achieved a clinically significant decrease in symptoms, while 5 of the 11 achieved “complete remission” of symptoms, as did David. Three of them were also weaned off of steroids after this short-course (8-week) study. “Further, subjects receiving cannabis reported improved appetite and sleep, with no significant side effects.”

A few other studies were promising, but they were for the most part in non-human subjects. This dearth of research was not the only surprise. Another came when I asked David if his most recent colonoscopy showed that his colon had healed of the ulcers, a result that one might expect given the lasting, 100% remission of even his worst symptoms.

Despite living with UC for so long, David does not qualify for an insurance-covered colonoscopy in the near future, and would have to pay out-of-pocket for the procedure.

So do we have current medical “proof” that his ulcerative colitis is in remission; that his lower GI tract is no longer inflamed by ulcerative sores? No, we don’t. And based on David’s current insurance situation, we won’t have that evidence for several years.

And that leads me to perhaps the strangest words I have ever written for publication:

I really want to see David’s current colonoscopy results.

Based on his experience of 18+ months of complete symptom remission, we could expect that a current colonoscopy would show an absence of inflamed ulcers. It should show a healthy, well-functioning colon.

And if we have the patience to wait for insurance to cover it, we’ll have the evidence in another 5 years or so.

Ask almost anyone working in the medical cannabis movement what motivates them, and you are likely to hear a personal story—that cannabis either helped them with a health issue, or that they witnessed it helping someone they care about. (SO to Senate Minority Leader Harry Reid.)

So, “David,” thank you for sharing your personal story. May it help others find a path toward healing, with or without pharmaceutical intervention. (And do keep us posted when you do have that next ‘scope…)

*Like many of our members, David was not comfortable sharing his real name. Despite the fact that medical cannabis appears to have put his ulcerative colitis into remission; despite the support of his family and his close friends; despite the fact that he no longer relies on pharmaceuticals as he once did, he fears negative repercussions should his workplace discover that he is a medical cannabis patient. WCM respects his and all patients’ privacy, and is committed to working toward a day when cannabis use carries no such stigma.