Inflammatory bowel disease

Inflammatory bowel disease is an umbrella term for chronic immune-mediated intestinal disorders, principally Crohn's disease and ulcerative colitis, characterized by relapsing-remitting mucosal inflammation, abdominal pain, diarrhea, bleeding, and increased colorectal cancer risk. The mucosal endocannabinoid system—CB1 and CB2 receptors on epithelial cells, enteric neurons, and leukocytes—regulates motility, secretion, and inflammation, and is upregulated in inflamed tissue. The Kafil et al. Cochrane reviews (2018) on cannabis for Crohn's disease and for ulcerative colitis both concluded that available evidence was of very low quality and insufficient to draw conclusions about efficacy or safety, with no trials demonstrating induction or maintenance of clinical remission by objective endoscopic criteria ⚠️. NASEM (2017) likewise rated evidence as insufficient. Patient-reported symptomatic benefits (pain, appetite, sleep) are reported in observational studies but may not reflect underlying inflammatory activity. → See also: Crohn's disease, Ulcerative colitis, CB1 receptor, CB2 receptor, Endocannabinoid system.