Colitis – Cannabis THC : CBD Ratios

Colitis Research Dashboard

31

Primary Studies

22

Related Studies

53

Total Studies

Clinical Studies

2

Double-blind human trials

0

Clinical human trials

Pre-Clinical Studies

11

Meta-analyses/Reviews

15

Animal studies

3

Laboratory studies

State of the Science

Clinical Guidance:
FDA Approval:
EU Approval:
Overall Positive Results: 87%
Positive Clinical Results: 100%

Studies by Country of Researcher

No data to display

Studies by Chemotype (THC:CBD Ratio)

No data to display

Clinical Dosing Summary

Data available for 2 studies.

Synopsis of Cannabis Research for Colitis

With nearly 2 dozen of trials (including one double-blind placebo-controlled experiment) that directly examined the treatment potential of cannabinoid-based therapeutics to address signs and symptoms of colitis such as gut inflammation, motility and visceral pains for example, new insights are emerging: Various components of the endocannabinoid system (ECS) such as anandamide (AEA) 2-arachidonoylglycerol (2-AG) and their respective degrading enzyme FAAH (via the use of inhibitors) and MAGL acting on CB1, CB2, PPARs, TRPs play a significant role in protecting, restoring and/or maintaining gut health and well-being in both acute and chronic forms of colitis; cannabinoids produce anti-inflammatory effects in the gut; more specifically, CB1 and CB2 receptor agonism is largely considered anti-inflammatory while CB1 and CB2 receptor antagonism is posited to be pro-inflammatory in nature; CBD was the most investigated cannabinoid followed by other cannabis constituents such as THC, THCA, CBG, cannabis common terpenes shown to proceed therapeutic effects for this patient population include Beta-Caryophyllene (a CB2 agonist), borneol, and geraniol; synthetic cannabinoids such as HU-210 display protective effects in animal models of colitis. To provide the reader with some context, HU210 is a full agonist at CB1 and CB2 (meaning that HU-210 is about 100 x more potent than THC at CB1 and about 86 x more potent than THC at CB2); synergies were reported for the co-adminsitration cannabis and turmeric in IBD and IBS.

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31 PRIMARY STUDIES | 53 TOTAL STUDIES

Efficacy of combined therapy with fish oil and phytocannabinoids in murine intestinal inflammation

Type of Study: Animal Study

Year of Pub: 2021

Novel selective agonist of GPR18, PSB-KK-1415 exerts potent anti-inflammatory and anti-nociceptive activities in animal models of intestinal inflammation and inflammatory pain

Type of Study: Animal Study

Year of Pub: 2021

Olorinab (APD371), a peripherally acting, highly selective, full agonist of the cannabinoid receptor 2, reduces colitis-induced acute and chronic visceral hypersensitivity in rodents

Type of Study: Animal Study

Year of Pub: 2021

Symptoms and Extraintestinal Manifestations in Active Cannabis Users with Inflammatory Bowel Disease

Type of Study: Meta-analysis

Year of Pub: 2021

Attitudes towards and use of cannabis in New Zealand patients with inflammatory bowel disease: an exploratory study

Type of Study: Meta-analysis

Year of Pub: 2021

Cannabis and Canabidinoids on the Inflammatory Bowel Diseases: Going Beyond Misuse

Type of Study: Meta-analysis

Year of Pub: 2020

Cannabinoid receptor activation on hematopoietic cells and enterocytes protects against colitis

Type of Study: Animal Study

Year of Pub: 2020

Activation of Cannabinoid Receptor 2 Prevents Colitis-Associated Colon Cancer through Myeloid Cell De-activation Upstream of IL-22 Production

Type of Study: Animal Study

Year of Pub: 2020

Cannabidiol, a safe and non-psychotropic ingredient of the marijuana plant Cannabis sativa, is protective in a murine model of colitis.

Type of Study: Animal Study

Year of Pub: 2019

Cannabis and Turmeric as Complementary Treatments for IBD and Other Digestive Diseases.

Type of Study: Meta-analysis

Year of Pub: 2019

Cannabis for the Treatment of Crohn's Disease and Ulcerative Colitis: Evidence From Cochrane Reviews

Type of Study: Meta-analysis

Year of Pub: 2019

Association between cannabis use and complications related to ulcerative colitis in hospitalized patients

Type of Study: Meta-analysis

Year of Pub: 2019

Cannabis for the treatment of ulcerative colitis

Type of Study: Meta-analysis

Year of Pub: 2019

A Randomized, Double-blind, Placebo-controlled, Parallel-group, Pilot Study of Cannabidiol-rich Botanical Extract in the Symptomatic Treatment of Ulcerative Colitis

Type of Study: Double Blind Human Trial

Year of Pub: 2019

The Anti-Inflammatory Effect and Intestinal Barrier Protection of HU210 Differentially Depend on TLR4 Signaling in Dextran Sulfate Sodium-Induced Murine Colitis

Type of Study: Animal Study

Year of Pub: 2019

Cannabis is associated with clinical but not endoscopic remission in ulcerative colitis: A randomized controlled trial

Type of Study: Double Blind Human Trial

Year of Pub: 2019

Profiles of Patients Who Use Marijuana for Inflammatory Bowel Disease.

Type of Study: Meta-analysis

Year of Pub: 2018

The Use of Cannabinoids in Colitis: A Systematic Review and Meta-Analysis.

Type of Study: Meta-analysis

Year of Pub: 2018

The Role of Cannabis in the Management of Inflammatory Bowel Disease: A Review of Clinical, Scientific, and Regulatory Information: Commissioned by the Crohn's and Colitis Foundation.

Type of Study: Meta-analysis

Year of Pub: 2018

Fatty acid amide hydrolase (FAAH) blockade ameliorates experimental colitis by altering microRNA expression and suppressing inflammation.

Type of Study: Animal Study

Year of Pub: 2018

Anti-Inflammatory Activity in Colon Models Is Derived from Δ9-Tetrahydrocannabinolic Acid That Interacts with Additional Compounds in Cannabis Extracts.

Type of Study: Laboratory Study

Year of Pub: 2017

Cannabidiol and palmitoylethanolamide are anti-inflammatory in the acutely inflamed human colon.

Type of Study: Laboratory Study

Year of Pub: 2017

Manipulation of the Endocannabinoid System in Colitis: A Comprehensive Review.

Type of Study: Meta-analysis

Year of Pub: 2017

(+)-Borneol Improves the Efficacy of Edaravone Against DSS-induced Colitis by Promoting M2 Macrophages Polarization via JAK2-STAT3 Signaling Pathway

Type of Study: Laboratory Study

Year of Pub: 2017

Geraniol Ameliorates TNBS-induced Colitis: Involvement of Wnt/β-catenin, p38MAPK, NFκB, and PPARγ Signaling Pathways

Type of Study: Animal Study

Year of Pub: 2015

Experimental colitis in mice is attenuated by changes in the levels of endocannabinoid metabolites induced by selective inhibition of fatty acid amide hydrolase (FAAH)

Type of Study: Animal Study

Year of Pub: 2014

Pro-resolution, protective and anti-nociceptive effects of a cannabis extract in the rat gastrointestinal tract

Type of Study: Animal Study

Year of Pub: 2013

Topical and systemic cannabidiol improves trinitrobenzene sulfonic acid colitis in mice

Type of Study: Animal Study

Year of Pub: 2012

β-Caryophyllene Inhibits Dextran Sulfate Sodium-Induced Colitis in Mice through CB2 Receptor Activation and PPARγ Pathway.

Type of Study: Animal Study

Year of Pub: 2011

Targeting endocannabinoid degradation protects against experimental colitis in mice: involvement of CB1 and CB2 receptors.

Type of Study: Animal Study

Year of Pub: 2008

Cannabidiol, extracted from Cannabis sativa, selectively inhibits inflammatory hypermotility in mice.

Type of Study: Animal Study

Year of Pub: 2008

22 RELATED STUDIES | 53 TOTAL STUDIES

An Overview of Cannabis Based Treatment in Crohn's Disease

Type of Study: Meta-analysis

Year of Pub: 2020

The pharmacological case for cannabigerol (CBG)

Type of Study: Meta-analysis

Year of Pub: 2020

Cannabis use disorders may protect against certain disorders of the digestive organs in people with schizophrenia but not in healthy controls

Type of Study: Meta-analysis

Year of Pub: 2019

Insights into the role of cannabis in the management of inflammatory bowel disease

Type of Study: Meta-analysis

Year of Pub: 2019

Cannabinoid Attenuation of Intestinal Inflammation in Chronic SIV-Infected Rhesus Macaques Involves T Cell Modulation and Differential Expression of Micro-RNAs and Pro-inflammatory Genes

Type of Study: Animal Study

Year of Pub: 2019

Cannabidiol As A Novel Therapeutic Strategy For Oral Inflammatory Diseases: A Review Of Current Knowledge And Future Perspectives

Type of Study: Meta-analysis

Year of Pub: 2019

Priority Considerations for Medicinal Cannabis-Related Research

Type of Study: Meta-analysis

Year of Pub: 2019

Cannabis and pediatric inflammatory bowel disease: change blossoms a mile high.

Type of Study: Meta-analysis

Year of Pub: 2018

Low-Dose Cannabidiol Is Safe but Not Effective in the Treatment for Crohn's Disease, a Randomized Controlled Trial.

Type of Study: Double Blind Human Trial

Year of Pub: 2017

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

Type of Study: Meta-analysis

Year of Pub: 2017

Prevalence and Patterns of Marijuana Use in Young Adults With Inflammatory Bowel Disease.

Type of Study: Meta-analysis

Year of Pub: 2017

Therapeutic Use of Cannabis in Inflammatory Bowel Disease.

Type of Study: Meta-analysis

Year of Pub: 2016

An Orally Active Cannabis Extract with High Content in Cannabidiol attenuates Chemically-induced Intestinal Inflammation and Hypermotility in the Mouse.

Type of Study: Animal Study

Year of Pub: 2016

The gastrointestinal tract – a central organ of cannabinoid signaling in health and disease.

Type of Study: Meta-analysis

Year of Pub: 2016

Efficacy, tolerability, and safety of cannabinoids in gastroenterology: A systematic review.

Type of Study: Meta-analysis

Year of Pub: 2016

Comparison of Antispasmodic Effects of Dracocephalum Kotschyi Essential Oil, Limonene and α-Terpineol

Type of Study: Animal Study

Year of Pub: 2015

Cannabis for inflammatory bowel disease.

Type of Study: Meta-analysis

Year of Pub: 2014

Geraniol-a Flavoring Agent With Multifunctional Effects in Protecting the Gastric and Duodenal Mucosa

Type of Study: Animal Study

Year of Pub: 2014

Cannabis induces a clinical response in patients with Crohn's disease: a prospective placebo-controlled study.

Type of Study: Double Blind Human Trial

Year of Pub: 2013

Cannabidiol in inflammatory bowel diseases: a brief overview.

Type of Study: Meta-analysis

Year of Pub: 2013

Oral administration of d-limonene controls inflammation in rat colitis and displays anti-inflammatory properties as diet supplementation in humans.

Type of Study: Animal Study

Year of Pub: 2013

Treatment of Crohn's Disease With Cannabis: An Observational Study

Type of Study: Meta-analysis

Year of Pub: 2011

Overview - Colitis

Description of Colitis

Colitis simply mean inflammation of the large colon. There are a number of types which are generally identified by its underlying causes such as in autoimmune colitis, ischemic colitis, allergic colitis, microscopic colitis (i.e. collagenous colitis, lymphocytic colitis), ulcerative colitis, chemotherapy-induced colitis, infectious colitis (e.g. salmonella), or idiopathic colitis (of unknown origins). To-date there is no cure within the model of modern medicine for the chronic type and treatment is limited to supportive therapies such as hydration via IV-fluids, pharmaceutical intervention (e.g. steroids to depress the immune system), iron supplements to balance anemia, or surgery for example. Some progress has been reported with certain dietary regimes and microbiome supportive supplements.

Disease Classification

Condition: Colitis
Disease Family: Inflammatory Condition
Organ System: Digestive System
ICD-10 Chapter: Diseases of the Digestive System
ICD-10 Code: K51

Colitis Symptoms:

Abdonial pain/cramps, chronic diarrhea (blood, mucus, pus), generalized weakness, weight loss, difficult BM despite urge, anemia, inflammation

Also known as:

Ulcerative pancolitis, ulcerative colitis, ulcerative rectosigmoiditis, inflammatory polyps of colon, autoimmune colitis, ischemic colitis, allergic colitis, microscopic colitis (i.e. collagenous colitis, lymphocytic colitis), chemotherapy-induced colitis, infectious colitis (e.g. salmonella), or idiopathic colitis

Drug Interactions

THC Interaction with Pharmaceutical Drugs

  • THC can enhance the effects of drugs that cause sedation and depress the central nervous system, such as benzodiazepines, barbiturates, and alcohol, for example. 
  • THC is metabolized by and an inhibitor of a number of enzymatic liver pathways referred to as cytochrome P450. There are more than 50 enzymes belonging to this enzyme family, a number of which are responsible for the breakdown of common drugs such as antidepressants (e.g. amitriptyline, doxepine, fluvoxamine), antipsychotics (haloperidol, clozapine, stelazine), or beta-blockers (propranolol, theophylline, warfarin).  Thus patients taking these classes of medication may find that THC increases the concentration and effects of these drugs as well as the duration of their effects.
  • Clinical observation suggests no likely interactions with other pharmaceuticals at a total daily dose of up to 20mg THC.

CBD Interaction with Pharmaceutical Drugs

  • CBD may alter action on metabolic enzymes (certain drug-transport mechanisms), and as such may alter interactions with other drugs, some of which may produce therapeutic or adverse effects. For instance, CBD interacts with the enzyme cytochrome P450 3A4 and cytochrome P450 2C19, increasing the bioavailability of anti-epileptic drugs such as clobazam (a benzodiazepine). This makes it possible to achieve the same results at significantly lower dosages, reducing treatment costs and risks of adverse effects. 
  • Groups of drugs affected include: anti-epileptic drugs, psychiatric drugs, and drugs affecting metabolic enzymes, for example.
  • Clinical observations suggest no likely interactions with other pharmaceuticals at a total daily dose of up to 100mg CBD

Dosing Considerations

THC Dosage Considerations

  • THC micro dose:  0.1 mg to 0.4 mg (0.001mg/kg to 0.005mg/kg)
  • THC low dose:  0.5 mg to 5 mg (0.006mg/kg to 0.06mg/kg)
  • THC medium dose:  6 mg to 20 mg (0.08mg/kg to 0.27mg/kg)
  • THC high dose:  21 mg to 50+ mg (0.28mg/kg to 0.67mg/kg)
Formula for converting a set dose into mg/kg considerations: mg ÷ kg = mg/kg
(sample conversion calculated on a person weighing 75kg)

CBD Dosage Considerations

  • CBD low dose:  0.4 mg to 19 mg (0.005mg/kg to 0.25mg/kg)
  • CBD medium dose: 20 mg to 99 mg (0.26mg/kg to 1.32mg/kg)
  • CBD high dose:  100 mg to 800+ mg (1.33mg/kg to 10.7mg/kg)
  • (upper limits tested ~1,500mg)
Formula for converting a set dose into mg/kg considerations: mg ÷ kg = mg/kg
(sample conversion calculated on a person weighing 75kg)
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Information on this site is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your physician, nutritionally oriented health care practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.