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People with inflammatory bowel disease may be considering using cannabis for a variety of reasons. There is a desire for an alternative or complementary treatment to existing traditional therapies. Many people living with IBD have reported relief of symptoms like pain, nausea, diarrhea, low appetite, and an improvement in overall mood when using cannabis. Cannabis products are available in many different forms. Cannabis can be smoked, inhaled, ingested or made into oils, capsules, and edibles. Most people using cannabis for medicinal purposes consume it as an oil or vapor. The method of consumption can influence the effects of cannabis, which is explained in more detail below under The Effects of Cannabis. Traditionally, cannabis has been smoked as a joint. Smoking carries with it many of the risks of smoking tobacco, so health professionals have advised against smoking cannabis. Cannabis smoke is filled with many of the same chemicals as tobacco and can be harmful to the lungs. Cannabis contains a variety of compounds called cannabinoids which are the active ingredients in the plant there are over 70 cannabinoids reported so far. The human body has an Endocannabinoid System ECS which regulates different functions such as pain, appetite, mood, and stress response. The ECS is comprised of endocannabinoids natural cannabinoids produced by our bodies that stimulate our cannabinoid receptors. They are found in different parts of the body including the brain, liver, nervous system, and especially, the gastrointestinal tract. When people consume cannabis, the cannabinoids THC, CBD and others mimic those found in the body and activate the same receptors. In the gut, these receptors trigger certain responses such as regulating inflammation, pain, nausea, satiety, vomiting, and possibly, altering gut barrier function the leakiness of the gut. To take effect, the cannabinoids bind to endocannabinoid receptors on the surface of different cells. Once locked in, some of the effects that can take place have been reported to improve symptoms in patients with inflammatory bowel disease. Different strains of cannabis have different combinations of cannabinoids. CBD and THC are the major active ingredients in the cannabis plant, but when cannabis is consumed, users get the effect of a number of products in the plant. The two most common strains of cannabis are called indica and sativa. Indica is said to have a more relaxing effect while sativa has a more energizing effect. There are also hybrid strains that combine both. Different methods of consumption will alter how long the effects of cannabis will last. Intensity how strong the effects are is highest with inhalation smoking or vaporizing but the duration is shorter. If you smoke or vaporize cannabis, the effects are very rapid and can usually be felt within a few minutes, usually peaking within 30 minutes to an hour. Effects can last between two and four hours. Note that edible cannabis products are only legal and available in some Canadian provinces. Cannabis is relatively harmless in low to moderate amounts. But using cannabis can cause some short-term side effects including:. Physical impairments such as short-term memory or concentration loss, dizziness, drowsiness, fatigue, headache, disorientation, confusion, and feeling faint. There is little data available on the long-term dangers of cannabis use so we advise to use caution. Increased risk of mental health problems such as the development of depression, anxiety, psychosis, and schizophrenia. Physical problems that can affect the respiratory system like symptoms of chronic bronchitis when smoking. Potential risk of dependency or addiction. A small percentage of cannabis users develop a dependence, which is much lower than other substance use such as alcohol, tobacco, and other drugs. Can lead to withdrawal symptoms if stopped, such as anger, aggression, nightmares, insomnia, headaches, anxiety, irritability, depression, cravings, decreased appetite, stomach pain, chills, and sweating. Unlike most other drugs, there have been no deaths attributed to cannabis alone. Someone would have to consume an impossibly high amount of cannabis in order to overdose. A limited number of studies have reported improvement with smoked cannabis. Heavy cannabis use is associated with more severe GI disease, but it is relatively harmless in low to moderate amounts. Heavy cannabis use is associated with cannabis hyperemesis syndrome, a condition involving nausea, low appetite, vomiting and abdominal pain. Symptoms resolve when people stop using cannabis. It is advised that those under 21 years old do not use cannabis since their brain is not fully developed. Cannabis use can impact brain development, specifically the pre-frontal cortex, which is the area of the brain that is last to develop. This area is responsible for skills like thinking ahead and weighing risks and harms about decisions we make. Certain mental health issues are also at an increased risk with cannabis consumption during this time. There are some suggestions that long term cannabis use may affect sperm quality by decreasing the sperm count, concentration and motility. Early research suggests cannabis may delay or inhibit ovulation and lower sperm counts but is based on self-reported use. On the other hand, a recent study suggests cannabis may not interfere with trying to conceive. Cannabis use during pregnancy can negatively impact the behavioural and cognitive development of the baby including resulting in low birth weight, preterm labour, and stillbirth. The Society of Obstetricians and Gynecologists of Canada recommends to avoid cannabis during pregnancy. Can cannabis improve the quality of life for people suffering from gastrointestinal disorders? Research is in its early stages, but patients have reported some therapeutic effects in the management of abdominal pain, nausea, diarrhea, and improvements in sleep, appetite and quality of life. Observational studies suggest patients use cannabis to relieve symptoms associated with IBD. In observational studies, the investigator simply observes participants and records what happens without intervening. Clinical studies, on the other hand, are controlled and randomized to achieve unbiased results. This type of research aims to answer a specific question. There are some flaws in human studies that examine cannabis and the management of IBD including:. Recall bias is present. Observational studies in patients with IBD are still limited, but early research suggests patients use cannabis to relieve symptoms associated with IBD. The number one reason patients use cannabis is to control abdominal pain. Patients with IBD also reported improvements in joint pain, abdominal pain and cramping after using cannabis. Improvements in sleep, reduced diarrhea, nausea and appetite were also reported after using cannabis. It is not yet known what the best type or strain of cannabis is for symptom management in IBD. There are some suggestions that the indica strain is more effective at reducing pain, controlling nausea, and helping with sleep but there is little evidence on the different benefits of different strains. Cannabis may mask inflammation because the symptoms have improved, but there is little evidence to support that cannabis plays an anti-inflammatory role. There is no evidence that cannabis positively alters the disease course. There is also no evidence to demonstrate any benefit of cannabis in gut motility disorders. Gut motility is related to the movement of the digestive system. It is the expansion and contraction of the muscles in the GI tract. There is little evidence to support the use of cannabis for treatment in GI disease but some suggestion that it improves quality of life and relieve some symptoms. Cannabis cannot cure IBD. If you are using cannabis in combination with other medications, discuss this directly with your health care provider. To find out more about research studies that investigates the effectiveness of cannabis for IBD management, click on the articles below:. Dosing for medical cannabis is highly individualized. There are no defined doses of cannabis for specific medical conditions, though current information suggests up to 3 grams daily is common for experienced users. When used individually, THC was more effective. If you have never used cannabis before, do so with someone you trust close by in case you experience adverse effects. Start slow and gradual for example 1 mg of THC and wait 30 minutes before taking more puffs or inhalations to gauge the strength and effects taking place. Increasing your dose should be done slowly and as needed. There is not a lot of data on the best dose or optimal timing. Start with a low amount of cannabis with a small quantity of active ingredients especially low amounts of THC to avoid major psychiatric effects. Remember to keep your health care providers informed of your dosing patterns. Since cannabis has no effect on inflammation, it does not replace conventional medical therapy. Be open and upfront with your healthcare provider. It also helpful to log or note your dosing and symptoms and report this information to the health care provider. When discussing your cannabis use with family, be prepared to answer questions honestly and keep the conversation open and ongoing. Explain the benefits of cannabis for managing your symptoms and explain that you are consulting with your healthcare provider throughout the process. With children, you may want to gauge how much they know about cannabis and how they feel about it. Explain the facts, focusing on medical benefits, physical side effects, safety, legal implications like cannabis and driving and any risks to be aware of. Remember to reflect on your substance use and coping strategies so you can better address these conversations with your children. Build trust so they are able to come to you with questions and encourage them to share their own experiences. Medical cannabis became legal in Canada in Recreational cannabis, on the other hand, recently became legal in October under the Cannabis Act. The Act helps set rules around production, distribution, sale and possession of cannabis. It outlines safety and quality requirements, including restricting access to youth and specifying criminal penalties for those who break the law. Cannabis is legal for adults 18 or 19 years old, depending on the province or territory. Here are some important things to note under this Act:. It is legal to consume in authorized locations only. Authorized locations differ between provinces and territories. As a general rule, smoking in your home is okay if you rent, check with your landlord. Smoking in most public greenspaces is okay. There are criminal penalties for offences such as driving impaired or crossing international borders with cannabis. Edible cannabis products and cannabis extracts are still illegal to purchase in some provinces, though you can make your own. The side effects of cannabis use can impair driving. Driving while impaired by drugs including cannabis is illegal. Law enforcement are trained to detect drug-impaired drivers. Repercussions of driving impaired can include fines, confiscations and charges. Talk with your health care provider about the timing of your cannabis use to ensure safety on the road. Rules regarding driving with cannabis differ between provinces. Here are some general recommendations:. Do not cross international borders with cannabis - no exceptions. It is illegal to travel outside of Canada with cannabis, even to and from countries where cannabis is legal. In rare circumstances, Health Canada may authorize a person to bring cannabis across international borders for medical purposes. Learn more about cannabis and international travel. Flying with cannabis within Canada is legal. Carrying cannabis oil in a carry-on luggage must follow the liquid restriction of ml or less. Under the Canadian Human Rights Act, employers are obligated to accommodate those with medical cannabis authorizations, to the point of undue hardship. Medical cannabis must be treated like any other prescription medication. To learn more about cannabis in Canadian workplaces, click here. Although now legal, consuming cannabis is prohibited at schools, on school grounds, in public areas within 20 metres of these grounds, and in child care centres including home care, in accordance with the Smoke-Free Ontario Act. This Act also applies to tobacco and electronic cigarettes. Those who require cannabis for medical purposes are permitted to carry it on school property. Students and staff can use medical cannabis on school property in non-smoking and non-vaping form for example, cannabis oils and capsules. School boards are responsible for developing policies pertaining to the administration and storage of medications in schools. Cannabis can be purchased directly from a federally licensed seller or authorized provincial outlet, or you may grow your own. If you would like to access cannabis for medical use, speak with your health care provider to discuss if cannabis is right for you. With this document, you can register with a licensed producer of your choice by contacting them directly or visiting their website to fill out a registration form. You can also register to purchase the materials to produce your own cannabis or have another person produce it on your behalf. Personal storage limits under the Cannabis Act indicate you are allowed to possess either a a day supply of what your healthcare provider has prescribed or b grams -- whichever comes first. Be prepared to show law enforcement, if requested, that you are authorized to carry more than the 30 grams of cannabis for recreational use. You can switch licensed producers at any time by cancelling your registration with your current producer and obtaining another medical document from your healthcare provider to register with your new producer. The packaging would also include the standardized cannabis symbol and mandatory health warnings. There is currently no public insurance coverage for medical cannabis. Since medical cannabis does not yet have a drug identification number DIN , provincial health insurance programs, such as OHIP in Ontario, do not cover it. It is not included on the drug formularies and did not go through the formal Health Canada process to become an approved drug. Your workplace benefits plan may cover medical cannabis for certain health conditions through a private insurance plan. Health spending accounts typically consider medical cannabis as an eligible expense. Contact your Human Resources department to find out if your workplace benefits covers medical cannabis. Veterans Affairs Canada has a reimbursement policy for medical cannabis purchased from a licensed producer, up to three grams per day. Watch the video below to learn from a gastroenterologist about cannabis use to manage symptoms of Crohn's and colitis. Speaker: Dr. Watch the video below to learn more from a gastroenterologist and expert about cannabinoids and the effects of cannabis on the mind and body. Keith Sharkey Ph. Yasmin Nasser MD Ph. We use cookies on this site to improve your browsing experience, as further explained in our Privacy Policy. Please click OK to signify your consent to our use of cookies. You can reject cookies by changing your browser settings. Medical Cannabis. What is cannabis? The cannabis plant is said to be one of the oldest agricultural crops. One strain of the plant, called hemp, has been used for industrial purposes to make food hemp seeds , paper, clothing, rope, insulation, biofuel and more over the ages. Using cannabis as a medicine dates back to the ancient world, where it was used to heal wounds and soothe pain. Recently, the medical potential of cannabis has been gaining interest for its effects on different symptoms. Medical cannabis became legal in Canada in to treat a number of conditions. Cannabis has also been used recreationally for its psychoactive properties. There is no real difference between medical and recreational cannabis. It is the intent that is different, but the drug is the same. Sometimes there is an overlap. If you intend to use cannabis for its medicinal properties, you may look for features of the plant that make you feel better and give your body relief. Typically, medical cannabis contains a higher concentration of CBD. If you are using cannabis for recreational purposes, you may be concerned with the amount of THC in the plant and focus on the method of consumption and the timing of consumption to suit your activities. Medical cannabis is prescribed by a healthcare provider. The patient would get a medical authorization to purchase from a licensed seller. More about accessing cannabis is explained later in this section under How to Access Cannabis. The legalization of cannabis may increase opportunities for clinical research on the role of cannabis in the management of inflammatory bowel disease. There is a perception of cannabis as natural and harmless. There is a possible benefit as an alternative to opioids and other drugs. Smoking Traditionally, cannabis has been smoked as a joint. Vapourization vape Vaporization has become a popular way to consume cannabis, both medically and recreationally. Vaping involves heating cannabis into a vapour and inhaling it through a mouthpiece. Oil and edibles Edibles such as a brownie or gummy bear can also be consumed, though these are only legal in some provinces across Canada. Edibles are more risky for a number of reasons. If the ingredients are not measured correctly, homemade edibles can more potent than anticipated. In addition, when cannabis is swallowed, the effects take longer to onset. This can cause people to consume more cannabis than needed to get the desired effects and can lead to an overdose. Ingested cannabis also takes longer to clear from the body. Cannabinoids THC vs CBD Cannabis contains a variety of compounds called cannabinoids which are the active ingredients in the plant there are over 70 cannabinoids reported so far. THC may be the most recognized cannabinoid. It is also associated with some negative effects such as anxiety and irritability. It may also counter some of the negative symptoms associated with THC. The endocannabinoid system The human body has an Endocannabinoid System ECS which regulates different functions such as pain, appetite, mood, and stress response. Strains of cannabis Sativa vs Indica Different strains of cannabis have different combinations of cannabinoids. How long will the effects last? Short-term side effects Cannabis is relatively harmless in low to moderate amounts. But using cannabis can cause some short-term side effects including: Physical impairments such as short-term memory or concentration loss, dizziness, drowsiness, fatigue, headache, disorientation, confusion, and feeling faint Impaired motor skills and perception Increased anxiety, paranoia, suspiciousness, hallucinations Dry mouth and coughing Skin reactions Nausea, vomiting Fast heartbeat Adverse effects of long-term cannabis There is little data available on the long-term dangers of cannabis use so we advise to use caution. Impact on brain functions like memory, concentration, decision-making, and judgement Increased risk of mental health problems such as the development of depression, anxiety, psychosis, and schizophrenia Physical problems that can affect the respiratory system like symptoms of chronic bronchitis when smoking Potential risk of dependency or addiction. Can lead to withdrawal symptoms if stopped, such as anger, aggression, nightmares, insomnia, headaches, anxiety, irritability, depression, cravings, decreased appetite, stomach pain, chills, and sweating Unlike most other drugs, there have been no deaths attributed to cannabis alone. Cannabis Hyperemesis Syndrome Heavy cannabis use is associated with cannabis hyperemesis syndrome, a condition involving nausea, low appetite, vomiting and abdominal pain. Cannabis and young people teens It is advised that those under 21 years old do not use cannabis since their brain is not fully developed. Fertility and pregnancy There are some suggestions that long term cannabis use may affect sperm quality by decreasing the sperm count, concentration and motility. There are some flaws in human studies that examine cannabis and the management of IBD including: Cannabis use is often underreported. There are no objective parameters or measurements to show symptom improvements. Small sample sizes, short research timeframes, and little or no follow up can affect results. Symptom relief and quality of life Observational studies in patients with IBD are still limited, but early research suggests patients use cannabis to relieve symptoms associated with IBD. Best strain for symptom relief It is not yet known what the best type or strain of cannabis is for symptom management in IBD. Cannabis and gut inflammation Cannabis may mask inflammation because the symptoms have improved, but there is little evidence to support that cannabis plays an anti-inflammatory role. Talking with health care providers Since cannabis has no effect on inflammation, it does not replace conventional medical therapy. Come prepared to answer these questions: Which symptoms does cannabis help you manage? How much are you consuming in grams, if possible? How are you consuming it smoking, vaping, oil, etc. What type of strain are you using? What has your experience been like? Talking with family and kids When discussing your cannabis use with family, be prepared to answer questions honestly and keep the conversation open and ongoing. The Cannabis Act Medical cannabis became legal in Canada in Here are some important things to note under this Act: It is legal to possess up to 30 grams of cannabis at a time. It is legal to grow up to four cannabis plants per household for personal use. Legal cannabis includes fresh or dried cannabis, cannabis oil, and seeds and plants. Cannabis and driving The side effects of cannabis use can impair driving. Here are some general recommendations: Keep receipts to show cannabis was purchased at an authorized outlet. Keep cannabis in its original, sealed packages. Travel with cannabis in the trunk, out of reach. Transport it from point A to point B. Travelling with cannabis Do not cross international borders with cannabis - no exceptions. Cannabis use in the workplace Under the Canadian Human Rights Act, employers are obligated to accommodate those with medical cannabis authorizations, to the point of undue hardship. Cannabis in post-secondary school Although now legal, consuming cannabis is prohibited at schools, on school grounds, in public areas within 20 metres of these grounds, and in child care centres including home care, in accordance with the Smoke-Free Ontario Act. Recreational and medical cannabis Cannabis can be purchased directly from a federally licensed seller or authorized provincial outlet, or you may grow your own. Insurance Coverage There is currently no public insurance coverage for medical cannabis. Video: Cannabis and Inflammatory Bowel Disease Watch the video below to learn more from a gastroenterologist and expert about cannabinoids and the effects of cannabis on the mind and body. Speakers: Dr. Next Drug Coverage and Financial Support. Goals of Therapy. Sulfasalazine and 5-Aminosalicylates 5-ASA. JAK inhibitors. S1P receptor modulators. Enteral Nutrition EEN. Drug Coverage and Financial Support. Additional Resources. Join us at Gutsy Walk! MyGut App. Volunteer With Us. Create A Fundraiser. Advocate For Change.

Marijuana and colorectal cancer: Does weed help?

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Official websites use. Share sensitive information only on official, secure websites. Our objective is to assess the benefits and harms of cannabis for the treatment of patients with ulcerative colitis. Cannabis or marijuana is often promoted as a treatment for various illnesses including cancer and autoimmune disorders Hill It is a common recreational drug that alters sensory perception and elicits feelings of euphoria Tibirica Cannabis is known to affect pain and discomfort via psychotropic effects Tibirica However, cannabis also modulates the endocannabinoid system which acts on the nervous system and immune cell function Klein It is hypothesized that cannabis and its derivatives may work through this pathway to exert a therapeutic effect on ulcerative colitis Schicho ; Tibirica There is a higher prevalence of cannabis use among patients with IBD compared to the general population Weiss Cannabis may relieve symptoms of ulcerative colitis such as abdominal pain, reduced appetite, and diarrhea Lal ; Weiss Studies looking at UC in animal and laboratory models have found benefit in attenuating inflammation Borrelli i; Leinwand However, in humans, there is evidence that cannabis may be associated with harm and adverse effects such as dizziness and diarrhea Whiting This study posed important questions regarding whether cannabis and its derivatives can ameliorate symptoms of ulcerative colitis. For example, can cannabis objectively reduce inflammation in UC? If so, is this benefit clinically significant in the absence of psychotropic effects? UC is associated with significant morbidity and a decreased quality of life Lahat In Europe, the prevalence of ulcerative colitis ranges from Mortality in ulcerative colitis is highest during the initial years of disease activity Friedman Patients with UC may have a genetic predisposition to this disease and the pathophysiology of this condition is multifactorial Friedman The pathophysiology involves a dysregulated immune response towards commensal microbiota and dietary contents in the gastrointestinal tract Friedman UC is a relapsing remitting disorder and symptoms may include diarrhea, rectal bleeding, tenesmus, passage of mucus, and abdominal pain Friedman Cannabis is derived from the leaves and flowering tops of the plant and is prepared in various forms such as cigarettes, hash oil and edible formulations Mello Cannabis contains over compounds and has numerous derivatives called cannabinoids Mello Cannabis is rapidly absorbed into the body due to its lipophilic nature, but then it is sequestered into tissues and very slowly cleared from the body through feces Mello Cannabis is hypothesized to affect disease activity in ulcerative colitis via the endocannabinoid system Hasenoehrl The endocannabinoid system affects the nervous system, peripheral tissues, and the immune system Tibirica It is composed of cannabinoid CB receptors 1 and 2, endogenous endocannabinoids, and associated enzymes Hasenoehrl ; Klein It is hypothesized that modulating this system may therapeutically decrease inflammation in the gut Hasenoehrl CB1 receptors are found in the central nervous system, peripheral tissues and gastrointestinal system Hasenoehrl ; Klein Activation of these receptors may help reduce intestinal transit time and reduce colon propulsion, and enhance epithelial wound closure in the colon Pinto ; Wright There is evidence that these receptors play a physiologic role in protecting the colon during excessive inflammation Massa In the central nervous system, CB1 receptors are associated with effects such as reduction in pain and nausea Klein ; Tibirica CB2 receptors are found in the myenteric plexus, immune cells and in epithelial cells in ulcerative colitis Hasenoehrl ; Klein ; Marquez Cannabis is thought to influence immune cells through various pathways. The endocannabinoid system also has other pathways that may be activated by cannabis and cannabinoids. This review will help evaluate the evidence supporting the use of cannabis and cannabinoids for the treatment of ulcerative colitis. We intend to assess the efficacy and safety of cannabis and its derivatives for the treatment of ulcerative colitis. This systematic review will help distinguish objective markers of improvement e. Randomized controlled trials will be considered for inclusion. Studies published as abstracts will only be included if the authors can be reached for further information to allow for evaluation of quality and main outcomes. Any study duration will be included. Patients with clinically active or quiescent ulcerative colitis will be considered for inclusion. Patients with active e. We will include patients on all therapies for ulcerative colitis including those with a history of biologic therapy. Studies comparing any form of cannabis or cannabinoid derivatives to placebo or an active therapy for ulcerative colitis will be included. We will include studies that utilize any dosage and method of consumption such as oral supplementation or smoking. We will include any validated scoring system such as the DAI. Quality of life as defined by validated instrument or primary study, e. Adverse events i. Psychotropic adverse events including mental health effects such as psychosis and schizophrenia ; and. We will search conference proceedings to identify studies only published in abstract form. We will search ClinicalTrials. We will also search the references sections of applicable studies and systematic reviews to identify additional studies that may meet the inclusion criteria. We will review studies and abstracts identified by the literature search. Two authors TK and NC will independently screen the search results to identify potentially relevant studies for full text evaluation. The studies selected for full text review will be independently assessed by two authors TK and NC and consensus for study inclusion and exclusion will be reached through discussion. Any conflicts regarding inclusion or exclusion will be resolved by consultation with a third author JKM. Studies published in abstract form will only be included if the authors can be reached for further information. Two authors TK and NC will independently extract the outcome data of interest from each study. Any conflicts will be resolved by discussion and consensus or by consultation with a third author JKM as necessary. If data are missing or unclear, the study authors will be contacted for clarification. Two authors TK and NC will independently assess methodological quality using the Cochrane risk of bias tool Higgins Any conflicts will be resolved by discussion and consensus or by consultation with a third author JKM as required. Items to be assessed will include: 1. Random sequence generation;. Each category will be evaluated as low, high or unclear risk of bias and justification for judgement will be provided in the characteristics of included studies section of the review. Using this approach outcome data will be rated as high, moderate, low or very low quality. Outcome data from randomized controlled trials begins as high quality, but can be downgraded based on several criteria. These criteria include:. When there are repeated observations on participants, we will use the primary endpoint defined by the study. It is unlikely that we will find study designs applicable to cannabis in ulcerative colitis where multiple treatment attempts are used. We will count treatment failures as a relapse for maintenance studies and as a failure to enter remission for induction studies. We will conduct a sensitivity analysis to assess the impact of this assumption on the effect estimate. If possible, we will impute missing standard deviations. We will conduct an available case analysis for missing continuous outcomes. We will use the Chi 2 test and the I 2 statistic to assess heterogeneity. For the Chi 2 test, we will consider a P value of 0. We will use the I 2 statistic to quantify the proportion of variation that is due to heterogeneity rather than to chance. We will visually inspect the forest plots to identify any outliers. If outliers are identified, a sensitivity analysis will be conducted to explore potential explanations for the heterogeneity. However, if the protocols are not available, we will assess reporting bias by comparing the outcomes specified in the methods section of the manuscript to those reported in the results section. If a sufficient number of studies are included in the pooled analysis i. However, if the continuous outcomes utilize different scales to measure the same underlying construct e. Subgroup analysis based on dose of cannabis or cannabinoid will be performed if the data allow for such comparisons. Other subgroup analyses of interest may include the form of cannabis consumed, UC disease location, cigarette smoking status, history of prior biologic therapy and failure of biologic therapy. We will attempt to perform a sensitivity analysis of study quality by excluding studies with a high risk of bias to see if there is an impact on the effect estimate. As a library, NLM provides access to scientific literature. Cochrane Database Syst Rev. Find articles by Tahir S Kafil. Find articles by Tran M Nguyen. Find articles by John K MacDonald. Find articles by Nilesh Chande. Collection date This article has been updated. See ' Cannabis for the treatment of ulcerative colitis ', CD Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.

Colon buying hash