The following information is presented for educational purposes only.
Medical Marijuana Inc. provides this information to provide an understanding
of the potential applications of cannabidiol. Links to third party websites
do not constitute an endorsement of these organizations by Medical Marijuana
Inc. and none should be inferred.
Interstitial cystitis is a chronic bladder condition that typically affects
women in their 30’s and older. Studies have shown cannabis helps reduce
bladder inflammation and manages urinary frequency and pain symptoms.
Overview of Interstitial Cystitis
Interstitial cystitis, or painful bladder syndrome is a condition that
causes severe bladder pressure and pain and causes the need to urinate
frequently. The chronic condition is more common in women than in men.
Interstitial cystitis causes a person to feel the need to urinate more often
and when the bladder is holding smaller volumes of urine.
The pain associated with interstitial cystitis is typically located in the
pelvic region and in the area between the vagina and anus in women or
between the scrotum and anus in men. The symptoms associated with
interstitial cystitis typically fluctuate, flaring up in response to things
like long periods of sitting, stress, exercise, sexual activity and
menstruation. Interstitial cystitis can lead to the stiffening of the
bladder wall, which reduces bladder capacity and makes a person have to
urinate more frequently. Having to urinate frequently and experiencing pain
commonly interferes with daily life.
The cause of interstitial cystitis is unknown, but a defect in the
protective lining of the bladder, which allows toxic substances in urine to
irritate the bladder wall, has been associated with the condition.
There is no cure for interstitial cystitis. However, medications and other
therapies, like nerve stimulation, bladder training, and stretching of the
bladder, can help in managing symptoms.
Findings: Effects of Cannabis on Interstitial Cystitis
Research suggests that cannabis can help reduce bladder inflammation and
urinary frequency because of its impact on the body’s endocannabinoid
system. Both cannabinoid receptors, CB1 and CB2, have been found to be
located in human bladders (Wang, Wang & Bjorling, 2013).
Tetrahydrocannabinol (THC) and cannabidiol (CBD), two major cannabinoids
found in cannabis, activate the CB2 receptors of the endocannabinoid system.
In an animal study, researchers discovered that the activation of CB2
receptors with cannabinoids were effective at inhibiting inflammation.
Bladder swelling was reduced and urinary frequency was inhibited in the
group that received cannabinoid treatment. These findings suggest that THC
and CBD, which activate the CB2 receptors, could help in the treatment of
chronic bladder diseases like interstitial cystitis (Wang, Wang & Bjorling,
2014). Another study confirmed that activating CB2 receptors with a
cannabinoid inhibited the severity of bladder inflammation (Wang, Wang &
Bjorling, 2013). In animal studies, THC and other cannabinoids were found to
inhibit electrically-evoked bladder contractions, which suggests a
relationship between CB1 receptors and bladder function (Pertwell &
Fernando, 1996) (Fullhase, et al., 2014).
The administering of THC and CBD were found to significantly decreased
urinary urgency and the number and volume of incontinence episodes in
multiple sclerosis patients with bladder dysfunction. In addition, pain and
quality of sleep significantly increased (Brady, et al., 2004). Another
study also found that cannabis significantly reduced urge incontinence
episodes in multiple sclerosis patients (Freeman, et al., 2006).
Cannabis has also proven effective for managing the pain associated with
interstitial cystitis. A case study found that a 31-year-old woman diagnosed
with chronic cystitis and who’s pain had proven intractable to other
treatments for about 20 years experienced a significant reduction in pain
when taking oral THC. Throughout treatment, the patient had to reduce dosage
because of psychotic side effects, confusion and bad dreams. However, once
the dosage was reduced, the patient continued to experience a reduction in
pain, but with diminished side effects, and remained stable for six months
until completion of the case study (Krenn, Daha, Oczenski & Fitzgerald,
2003). An animal study also showed that THC was effective at suppressing
pain in hypersensitive bladder disorders like interstitial cystitis
(University of Pittsburgh Medical Center, 2006).
States That Have Approved Medical Marijuana for Interstitial Cystitis
Currently, only the state of Illinois has
approved medical marijuana specifically for the treatment of interstitial
cystitis. However, in Washington
any condition can be approved for medical marijuana as long as a DC-licensed
physician recommends the treatment. In addition, a number of other states
will consider allowing medical marijuana to be used for the treatment of
interstitial cystitis with the recommendation from a physician. These states
include: California (any
debilitating illness where the medical use of marijuana has been recommended
by a physician), Connecticut (other
medical conditions may be approved by the Department of Consumer
Protection), Massachusetts (other
conditions as determined in writing by a qualifying patient’s physician), Nevada (other
conditions subject to approval), Oregon (other
conditions subject to approval), Rhode
conditions subject to approval), and Washington (any
“terminal or debilitating condition”).
Several states have approved medical marijuana for treating “chronic pain,”
which is a common symptom associated with interstitial cystitis. These
states include: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New
Mexico, Ohio, Oregon, Pennsylvania, Rhode
Island and Vermont.
The states of Nevada, New
Dakota, Montana, Ohio and Vermont allow
medical marijuana to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania and Washington have
approved cannabis for the treatment of “intractable pain.”
Recent Studies on Cannabis’ Effect on Interstitial Cystitis
Regular THC and CBD treatments reduced pain that had proven intractable
to other treatments in a 31-year old chronic cystitis patient.
A case of cannabinoid rotation in a young woman with chronic cystitis.
Brady, C.M., DasGupta, R., Dalton, C., Wiseman, O.J., Berkley, K.J., and
Fowler, C.J. (2004, August). An open-label pilot study of cannabis-based
extracts for bladder dysfunction in advanced multiple sclerosis. Multiple
Freeman, R.M., Adekanmi, O., Waterfield, M.R., Waterfield, A.E., Wright, D.,
and Zajicek, J. (2006, November). The effect of cannabis on urge
incontinence in patients with multiple sclerosis: a multicentre, randomised
placebo-controlled trial (CAMS-LUTS). International
Urogynecology Journal and Pelvic Floor Dysfunction,
Fullhause, C., Campeau, L., Sibaev, A., Storr, M., Hennenberg, M., Gratzke,
C., Stief, C., Hedlund, P., and Andersson, K.-E. (2014, January). Bladder
function in a cannabinoid receptor type 1 knockout mouse. BJU
Krenn, H., Daha, L.K., Oczenski, W., and Fitzgerald, R.D. (2003, January). A
case of cannabinoid rotation in a young woman with chronic cystitis. Journal
of Pain and Symptom Management,
Pertwee, R.G., and Fernando, S.R. (1996, August). Evidence for the presence
of cannabinoid CB1 receptors in mouse urinary bladder. British
Journal of Pharmacology,
University of Pittsburgh Medical Center. (2006, May 21). Marijuana-derived
Drug Suppresses Bladder Pain In Animal Models. ScienceDaily.
Retrieved November 9, 2015 from www.sciencedaily.com/releases/2006/05/060521103039.htm
Wang, Z.-Y., Wang, P., & Bjorling, D. E. (2013). Activation of cannabinoid
receptor 2 inhibits experimental cystitis. American
Journal of Physiology – Regulatory, Integrative and Comparative Physiology, 304(10),
Wang, Z.-Y., Wang, P., and Bjorling, D.E. (2014, April). Treatment with a
cannabinoid receptor 2 agonist decreases severity of established cystitis. The
Journal of Urology,
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