#25 Medical cannabis use in IBD - with Dr Jami Kinnucan from Mayo Clinic, Florida

We've seen a shift in mood around conversations on medical cannabis in inflammatory bowel disease.

While it's most definitely an area that needs tightly controlled monitoring and evidence-based advice, there's a thaw in the discussions that is seeing more IBD healthcare professionals having open talks with their patients about it - and vice versa.

So we were delighted when Dr Jami Kinnucan, IBD specialist at Mayo Clinic in Jacksonville, Florida - definitely the doyenne of complementary medicine in IBD - agreed to join us on this podcast episode to discuss a clear, evidence‑based look at medical cannabis use in Crohn’s disease and ulcerative colitis.

Key Topics Covered

• CBD vs THC: 
  Cannabis contains hundreds of phytocannabinoids, but CBD and THC are the most clinically relevant. Both act on the endocannabinoid system, which has a high concentration of receptors in the gut - explaining potential effects on pain, nausea, appetite and motility.
• Integrative, not alternative: 
  Dr Kinnuncan emphasises integrative medicine - evidence‑based therapies that complement IBD treatment. Cannabis should not replace proven medical therapies, as studies show it does not reduce inflammation or induce remission.
• What the research shows: 
  Five randomised trials found no improvement in CRP, faecal calprotecti, or endoscopy.
  However, patients reported better:
  • abdominal pain
  • nausea
  • appetite
  • diarrhoea
  • sleep
  • quality of life
• Why open dialogue matters:  
  Many patients assume “natural = safe” and hesitate to disclose cannabis use. But cannabinoids can interact with other medications via the liver. Honest, non‑judgmental conversations help clinicians spot interactions, hidden symptoms or missed diagnoses such as strictures or infection.
• Cannabis Hyperemesis Syndrome: 
  A recognised condition causing cyclical vomiting in daily long‑term users. Hot showers may temporarily relieve symptoms. The only true treatment is stopping cannabis for 30+ days.
• Holistic IBD care:  
  Dr Kinnucan discusses integrating lifestyle, diet, sleep, exercise, acupuncture, mindfulness and nutraceuticals (including emerging evidence for curcumin‑based supplements) alongside medical therapy.
• Practical advice for patients: 
  If you’re considering cannabis, first ensure your inflammation is properly assessed and treated. Cannabis may help symptoms, but it can also mask problems that need medical attention.

Dr Kinnucan is on X: @ibdgijami

Follow Rachel at @bottomlineibd

Follow Nigel at @crohnoid