scholarly journals Medicinal Cannabis for Inflammatory Bowel Disease: A Survey of Perspectives, Experiences, and Current Use in Australian Patients

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Melissa J Benson ◽  
Sarah V Abelev ◽  
Susan J Connor ◽  
Crispin J Corte ◽  
Lewis J Martin ◽  
...  

Abstract Background Medicinal cannabis (MC) is an increasingly utilized treatment option for various refractory diseases. While robust clinical evidence supporting MC efficacy in inflammatory bowel disease (IBD) is lacking, many IBD patients report using MC to obtain symptomatic relief. Understanding this use and associated outcomes may help inform future clinical trials. Methods A cross-sectional anonymous online survey was conducted involving Australians with IBD. It examined attitudes and experiences with MC in relation to IBD management. The survey included validated sub-questionnaires assessing quality of life, medication adherence, IBD severity, and functional impairment. Results A total of 838 responses were obtained. Results showed 25.3% (n = 212) of respondents were current or previous users of MC (18.1% current, 7.2% previous). Half of the current users also consumed cannabis recreationally although less frequently than for medicinal purposes. Cannabis consumption was via smoking (joints 34.2%; water pipe/bongs 14.5%) or as an oral liquid (19.7%) with products obtained from recreational dealers (44.6%), friends/family (26.1%), or self-grown (9.8%). Only 3 respondents reported using legally accessed products. Clinical ratings of IBD severity did not differ according to cannabis use although users reported more hospitalizations, less engagement with specialist services, and lower medication adherence. IBD symptoms reported as positively affected by cannabis included abdominal pain, stress, sleep, cramping, and anxiety. Most users (92.7%) endorsed cannabis as effective in symptom management. Cannabis-using ulcerative colitis patients reported better quality of life than nonusers on some measures. Conclusion Many patients in Australia are using illicit MC to manage their IBD. Further clinical trials are required to validate, or refute, patient claims around MC efficacy for symptom control in IBD.

1997 ◽  
Vol 11 (3) ◽  
pp. 261-264 ◽  
Author(s):  
Lloyd R Sutherland

The propensity of inflammatory bowel disease sufferers to experience recurrent episodes or disease flares is well documented. Until a cure can be found, strategies to lengthen the period of remission offer the greatest opportunity to reduce morbidity and enhance patient quality of life. Therapies that have been shown in randomized, controlled, double-blind clinical trials to either lengthen the time of remission or improve the odds of staying in remission during a set time interval are required.


2021 ◽  
Author(s):  
Nils Karl Josef Ecker ◽  
Ann-Christin Woywod ◽  
Karl-Wilhelm Ecker

Abstract Background Ileal pouch–anal anastomosis (IPAA) is the gold standard for proctocolectomy. The present study evaluates surgical outcomes of the authors’ operations over a 30-year period, including pouch survival and quality of life (QOL). Methods Records of patients undergoing IPAA between 1986 and 2015 were retrospectively analyzed regarding early and late complications and pouch survival. An online survey assessed QOL. Results Of 119 patients, 84 had chronic inflammatory bowel disease (IBD) and 35 non-inflammatory bowel disease (non-IBD). Pouch construction was simultaneous with proctocolectomy in 69% and metachronous in 31%. Double-stapler anastomosis with purse string suture was performed in 100 patients. With temporary transanal decompression by catheter insertion in all patients, loop ileostomy (LIS) was selectively omitted in 68%. Three anastomotic insufficiencies occurred both without (4.4%) and with LIS (9.4%). Perioperative morbidity for LIS closure was substantial (33.3%). In the long-term course, 36 patients (30.5%) required revision (cumulative probability after 15 years: 59.1%). IPAA was discontinued in 16 patients (13.6%), reducing cumulative continence preservation to 72.9% after 15 years. By converting the pouch to a continent ileostomy (CI) in 6 patients with uncorrectable functional complications, cumulative pouch survival reached 81.8% after 27 years. The online survey revealed significant improvements in occupation, sports, and travel vs. before proctocolectomy, but no change in sexual life. Physical, psychological, and social scores were still below the age-matched norm values. Whereas >90% were satisfied with the surgical outcome, only 3/25 had no functional improvement requests. Conclusion IPAA in double-stapler technique is safe, even without protective LIS. However, short- and long-term morbidity is considerable, with a non-negligible risk of continence loss. Conversion to CI for purely functional complications can significantly reduce definite pouch failure. Despite patients’ high subjective satisfaction, QOL remains objectively compromised.


2015 ◽  
Vol 37 (3) ◽  
pp. 219-227 ◽  
Author(s):  
Thiago H. Freitas ◽  
Thomas N. Hyphantis ◽  
Elias Andreoulakis ◽  
João Quevedo ◽  
Hesley L. Miranda ◽  
...  

2006 ◽  
Author(s):  
Carmen E. Curtis ◽  
Gary W. Harper ◽  
Leonard A. Jason ◽  
Brigida Hernandez

2021 ◽  
Vol 44 (3) ◽  
pp. 206-213
Author(s):  
Mario García-Alanís ◽  
Lizette Quiroz-Casian ◽  
Héctor Castañeda-González ◽  
Perla Arguelles-Castro ◽  
Liz Toapanta-Yanchapaxi ◽  
...  

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 56-57
Author(s):  
M Painchaud ◽  
S Singh ◽  
R M Penner

Abstract Background Due to the COVID-19 pandemic, clinics were forced to implement telehealth into clinical practice. Inflammatory bowel disease (IBD) patients are a unique population that require long-term care to achieve and maintain deep remission of disease. Thus, they require stable and continuous contact with healthcare providers, often with multiple appointments. We examined an IBD predominant practice, also providing care for general gastrointestinal (GI) conditions in Kelowna, British Columbia. As telehealth has the potential to become a standard of care for clinics, patient satisfaction must be considered. We hypothesize that with the efficacy and ease of remote appointments, there will be an increase in patient satisfaction, quality of care, and quality of communication. Aims We aim to compare the level of patient satisfaction between in-person appointments pre-pandemic, and current remote appointment telehealth practices. Methods An online survey was sent to the 608 patients who had participated in one or more remote appointment between March 15-June 15, 2020. The survey compared the level of patient satisfaction, quality of care, and quality of communication between patient and doctor before and during the pandemic. It was also determined if patients would elect to continue with remote appointments in the future due to ease of use, and time/financial resources saved. Results Of the 273 participants, 80% were IBD patients while 20% were treated for other GI conditions. A total of 78% reported that they would elect to continue with remote appointments as their primary point of care with their doctor. The remaining 22% reported that they prefer in-person visits due to the necessity of a physical exam, yet specified that communication by these remote means was still of good quality. Levels of patient satisfaction before and during the pandemic remained consistent, where 59% of patients assigned a satisfaction rating of 10 (highest) to their pre-pandemic in-person appointments, and 54% of patients assigned a rating of 10 to their remote appointments during the pandemic. Similar consistent results were found for quality of care and quality of communication. A total of 70% of patients reported that if this service had not been available, they would have sought out other forms of care; 18% of the total responses considering emergency care. Conclusions IBD patients at Kelowna Gastroenterology perceived similar levels of satisfaction, quality of care, and quality of communication with both in-person and telehealth appointments. This suggests that telehealth practices may be a cost-effective, sustainable appointment style that provides comparable quality to in-person appointments. Funding Agencies None


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