Purpose of Review
Complementary therapies for inflammatory bowel disease (IBD) have earned growing interest from patients and investigators alike, with a dynamic landscape of research in this area. In this article, we review results of the most recent studies evaluating the role of cannabis and turmeric for the treatment of IBD and other intestinal illnesses.
Cannabinoids are well-established modulators of gut motility and visceral pain and have demonstrated anti-inflammatory properties. Clinical trials suggest that there may be a therapeutic role for cannabinoid therapy in the treatment of IBD, irritable bowel syndrome (IBS), nausea and vomiting, and GI motility disorders. Recent reports of serious adverse effects from synthetic cannabinoids highlight the need for additional investigation of cannabinoids to establish their efficacy and safety. Turmeric trials have demonstrated some promise as adjuvant treatment for IBD, though not in other GI disease processes.
Evidence suggests that the use of cannabis and turmeric is potentially beneficial in IBD and IBS; however, neither has been compared to standard therapy in IBD, and thus should not be recommended as alternative treatment for IBD. For cannabis in particular, additional investigation regarding appropriate dosing and timing, given known adverse effects of its chronic use, and careful monitoring of potential bleeding complications with synthetic cannabinoids are imperative.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
de Groof EJ, Rossen NGM, van Rhijn BD, Karregat EPM, Boonstra K, Hageman I, et al. Burden of disease and increasing prevalence of inflammatory bowel disease in a population-based cohort in the Netherlands. Eur J Gastroenterol Hepatol. 2016;28(9):1065–72.
McLean LP, Cross RK. Adverse events in IBD: to stop or continue immune suppressant and biologic treatment. Expert Rev Gastroenterol Hepatol. 2014;8(3):223–40.
Peyrin-Biroulet L, Lemann M. Review article: remission rates achievable by current therapies for inflammatory bowel disease. Aliment Pharmacol Ther. 2011;33(8):870–9.
Roda G, Jharap B, Neeraj N, Colombel JF. Loss of response to anti-TNFs: definition, epidemiology, and management. Clin Transl Gastroenterol. 2016;7:e135.
Kelak JA, Cheah WL, Safii R. Patient’s decision to disclose the use of traditional and complementary medicine to medical doctor: a descriptive phenomenology study. Evid Based Complement Alternat Med. 2018;2018:4735234.
Goyal H, Singla U, Gupta U, May E. Role of cannabis in digestive disorders. Eur J Gastroenterol Hepatol. 2017;29(2):135–43.
Coutts AA, Irving AJ, Mackie K, Pertwee RG, Anavi-Goffer S. Localisation of cannabinoid CB(1) receptor immunoreactivity in the guinea pig and rat myenteric plexus. J Comp Neurol. 2002;448(4):410–22.
Sumariwalla PF, Gallily R, Tchilibon S, Fride E, Mechoulam R, Feldmann M. A novel synthetic, nonpsychoactive cannabinoid acid (HU-320) with antiinflammatory properties in murine collagen-induced arthritis. Arthritis Rheum. 2004;50(3):985–98.
Costa B, Trovato AE, Comelli F, Giagnoni G, Colleoni M. The non-psychoactive cannabis constituent cannabidiol is an orally effective therapeutic agent in rat chronic inflammatory and neuropathic pain. Eur J Pharmacol. 2007;556(1–3):75–83.
Burstein SH, Zurier RB. Cannabinoids, endocannabinoids, and related analogs in inflammation. AAPS J. 2009;11(1):109–19.
Naftali T, et al. Cannabis induces a clinical response in patients with Crohn’s disease: a prospective placebo-controlled study. Clin Gastroenterol Hepatol. 2013;11(10):1276–1280 e1. This was the first randomized, placebo-controlled trial studying the effect of cannabis in Crohn's disease.
Hoffenberg EJ, et al. Marijuana use by adolescents and young adults with inflammatory bowel disease. J Pediatr. 2018;16(18):30388–3.
Capasso R, Borrelli F, Aviello G, Romano B, Scalisi C, Capasso F, et al. Cannabidiol, extracted from Cannabis sativa, selectively inhibits inflammatory hypermotility in mice. Br J Pharmacol. 2008;154(5):1001–8.
Naftali T, Lev LB, Yablecovitch D, Half E, Konikoff FM. Treatment of Crohn’s disease with cannabis: an observational study. Isr Med Assoc J. 2011;13(8):455–8.
Naftali T, et al. Low-dose cannabidiol is safe but not effective in the treatment for Crohn’s disease, a randomized controlled trial. Dig Dis Sci. 2017;62(6):1615–20. This is a randomized, placebo-controlled study assessing the effect of low dose cannabidiol in moderate to severely active Crohn's disease.
Naftali T, Bar Lev Schlieder L, Sklerovsky Benjaminov F, Lish I, Hirsch J, Konikoff FM. Cannabis induces clinical and endoscopic improvement in moderately active ulcerative colitis (UC). J Crohns Colitis. 2018;12:S306.
Sooklal S, Parikh M, Ahmad AS. 45 - Chronic cannabis use and gastrointestinal symptomatology, endoscopic and high-resolution manometry findings: a retrospective case-control study. Gastroenterology. 2018;154(6, Supplement 1):S-15–6.
Solowij N, Battisti R. The chronic effects of cannabis on memory in humans: a review. Curr Drug Abuse Rev. 2008;1(1):81–98.
Thames AD, Arbid N, Sayegh P. Cannabis use and neurocognitive functioning in a non-clinical sample of users. Addict Behav. 2014;39(5):994–9.
Rubino T, Zamberletti E, Parolaro D. Adolescent exposure to cannabis as a risk factor for psychiatric disorders. J Psychopharmacol. 2012;26(1):177–88.
Hall W. The respiratory risks of cannabis smoking. Addiction. 1998;93(10):1461–3.
Hall W. The adverse health effects of cannabis use: what are they, and what are their implications for policy? Int J Drug Policy. 2009;20(6):458–66.
Cooper ZD. Adverse effects of synthetic cannabinoids: management of acute toxicity and withdrawal. Curr Psychiatry Rep. 2016;18(5):52.
Volkow ND, Baler RD, Compton WM, Weiss SRB. Adverse health effects of marijuana use. N Engl J Med. 2014;370(23):2219–27.
Pattathan MB, Hejazi RA, McCallum RW. Association of marijuana use and cyclic vomiting syndrome. Pharmaceuticals (Basel). 2012;5(7):719–26.
Hejazi RA, McCallum RW. Review article: cyclic vomiting syndrome in adults--rediscovering and redefining an old entity. Aliment Pharmacol Ther. 2011;34(3):263–73.
Pinto L, Izzo AA, Mascolo N, Capasso F, Cascio MG, Bisogno T, et al. Endocannabinoids as physiological regulators of colonic propulsion in mice. Gastroenterology. 2002;123(1):227–34.
Xue XC, Qi XX, Wan XY. Randomized controlled study of efficacy and safety of drotaverine hydrochloride in patients with irritable bowel syndrome. Medicine. 2017;96(51):0000000000009235.
Rice AS, Farquhar-Smith WP, Nagy I. Endocannabinoids and pain: spinal and peripheral analgesia in inflammation and neuropathy. Prostaglandins Leukot Essent Fatty Acids. 2002;66(2–3):243–56.
Malik Z, Baik D, Schey R. The role of cannabinoids in regulation of nausea and vomiting, and visceral pain. Curr Gastroenterol Rep. 2015;17(2):429.
Kano M, Ohno-Shosaku T, Hashimotodani Y, Uchigashima M, Watanabe M. Endocannabinoid-mediated control of synaptic transmission. Physiol Rev. 2009;89(1):309–80.
McCallum RW, et al. Delta-9-tetrahydrocannabinol delays the gastric emptying of solid food in humans: a double-blind, randomized study. Aliment Pharmacol Ther. 1999;13(1):77–80.
Holt PR, Katz S, Kirshoff R. Curcumin therapy in inflammatory bowel disease: a pilot study. Dig Dis Sci. 2005;50(11):2191–3. Open label study evaluating pure curcumin preparation in patients with UC proctitis or Crohn’s disease.
Hanai H, et al. Curcumin maintenance therapy for ulcerative colitis: randomized, multicenter, double-blind, placebo-controlled trial. Clin Gastroenterol Hepatol. 2006;4(12):1502–6. Double-blind placebo controlled trial evaluating curcumin in patients with ulcerative colitis.
Gupta SC, Patchva S, Aggarwal BB. Therapeutic roles of curcumin: lessons learned from clinical trials. AAPS J. 2013;15(1):195–218.
Epstein J, Docena G, MacDonald TT, Sanderson IR. Curcumin suppresses p38 mitogen-activated protein kinase activation, reduces IL-1beta and matrix metalloproteinase-3 and enhances IL-10 in the mucosa of children and adults with inflammatory bowel disease. Br J Nutr. 2010;103(6):824–32.
Bundy R, Walker AF, Middleton RW, Booth J. Turmeric extract may improve irritable bowel syndrome symptomology in otherwise healthy adults: a pilot study. J Altern Complement Med. 2004;10(6):1015–8.
Lauche R, Kumar S, Hallmann J, Lüdtke R, Rampp T, Dobos G, et al. Efficacy and safety of Ayurvedic herbs in diarrhoea-predominant irritable bowel syndrome: a randomised controlled crossover trial. Complement Ther Med. 2016;26:171–7.
Zhu Y, Bu S. Curcumin induces autophagy, apoptosis, and cell cycle arrest in human pancreatic cancer cells. Evid Based Complement Alternat Med. 2017;2017:5787218.
Zhang Y et al. Inhibition of cell survival by curcumin is associated with downregulation of cell division cycle 20 (Cdc20) in pancreatic cancer cells. Nutrients. 2017;9(2).
Yoshida K, Toden S, Ravindranathan P, Han H, Goel A. Curcumin sensitizes pancreatic cancer cells to gemcitabine by attenuating PRC2 subunit EZH2, and the lncRNA PVT1 expression. Carcinogenesis. 2017;38(10):1036–46.
Lee YH, et al. Curcumin suppresses oncogenicity of human colon cancer cells by covalently modifying the cysteine 67 residue of SIRT1. Cancer Lett. 2018;25(18):30369.
Wang J, Li XM, Bai Z, Chi BX, Wei Y, Chen X. Curcumol induces cell cycle arrest in colon cancer cells via reactive oxygen species and Akt/ GSK3beta/cyclin D1 pathway. J Ethnopharmacol. 2018;210:1–9.
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This article is part of the Topical Collection on Small Intestine
About this article
Cite this article
Quezada, S.M., Cross, R.K. Cannabis and Turmeric as Complementary Treatments for IBD and Other Digestive Diseases. Curr Gastroenterol Rep 21, 2 (2019). https://doi.org/10.1007/s11894-019-0670-0
- Inflammatory bowel disease
- Complementary therapy