Cannabidiol, also known as CBD, has a number of known benefits for brain health, immunity, pain management, and gut health including for gallbladders. A Rare and Unexpected Side-Effect of Cannabis Use: Abdominal Pain due to Acute Pancreatitis This is an open access article distributed under the Creative Commons Attribution License, which
Cannabis – a word that stirs a lot of discussion and debate. But when we come to think of it, it’s just an herb, a plant that has been used for medicinal, religious, and trading purposes for decades. However, despite its historical merits, it is still considered controversial. Due to its psychotropic effects, it was declared illegal in the 17th century US.
Fortunately, a series of major discoveries about the plant and its connection to the human body prevailed. In 1964, scientists from Israel were able to identify and synthesize the cannabinoid tetrahydrocannabinol (THC). Soon after, other cannabinoids were identified, including cannabidiol (CBD). Another milestone achieved was in 1988 when scientists determined that the mammalian brain has receptor sites that respond pharmacologically to cannabinoids. These cannabinoid receptors comprise the endocannabinoid system (ECS), a network of specialized protein molecules embedded in cell membranes that affect various homeostatic functions.
Since those discoveries were made, more and more studies emphasizing the therapeutic effects of cannabis have been conducted. These boosted the popularity of CBD oil, a component of cannabis that doesn’t have the same hallucinogenic and mind-altering effect as the whole plant. Today, following some states’ legalization, CBD is slowly making its way to the mainstream pharmacological world.
How does CBD work?
CBD is one of the 85 known cannabinoids in cannabis. It is often confused and mistaken for THC, cannabis’ intoxicating component that gives the feeling of being “high.” CBD, however, does not trigger the same effect. Instead, it has been proven to have numerous healing properties, and it can counteract some negative effects of THC. In various studies, CBD has been identified as anti-inflammatory, anticonvulsant, anti-oxidant, anti-emetic, anti-tumorigenic, analgesic,
anxiolytic and antipsychotic. These properties make it a potential medicine for the treatment of numerous diseases.
CBD acts through the endocannabinoid system of the body. It also causes direct or indirect activation of various receptor-independent channels and different non-cannabinoid receptors and ion channels. These networks give CBD the ability to induce various effects through multiple molecular pathways. CBD’s interaction with these channels has been the subject of extensive research in the field of pharmacology. One of CBD’s most documented attributes is its anti-inflammatory property.
CBD for Inflammation
As we have emphasized time and again, inflammation is our body’s natural defense response to pathogens and injury. To a considerable extent, we need it. However, ongoing systemic inflammation is implicated in the development of many chronic and debilitating diseases. Patients with gallbladder and gastrointestinal issues should be particularly worried about chronic inflammation.
There are a lot of synthetic and natural anti-inflammatories available in the market today, but none of them work like CBD.
CBD counteracts inflammation via different pathways. It interacts with various receptors, hormones, fatty acids, and cell-signaling proteins to produce an anti-inflammatory effect. These may sound technical, but it is good to know that CBD has more ways than one to reduce or manage inflammation in the body.
5 CBD Health Benefits for Gallbladder and GI Patients
CBD can help patients suffering from the gallbladder and gastrointestinal diseases by:
1. addressing gastrointestinal symptoms and healing leaky gut.
2. reducing pain.
3. supporting metabolism.
4. supporting brain health.
5. supporting the immune system
CBD for Gut Health
Leaky gut is a common gastrointestinal problem characterized by various symptoms, including inflammation, gas, bloating, abdominal pain, and fatigue. It is caused by the disruption of the gut’s tight junctions to prevent the passage of toxic waste, undigested food, and harmful microorganisms into the bloodstream. Leaky gut may contribute to gallstones and the development of other GI diseases.
Although there is still no medicine that can instantly heal a leaky gut, there are many things we can do to help our body heal itself. We usually recommend the removal of any possible aggravations such as stress and avoidance of common food allergens. Once that is done, several supplements can be taken to allow the lining to heal.
One of the natural agents that can promote this action is CBD.
CBD decreases intestinal permeability by boosting the expression of a protein called claudin, which is responsible for cell-to-cell adhesion. CBD’s anti-inflammatory property also reduces intestinal damage mediated by a receptor pathway called PPARgamma. These mechanisms are beneficial not just for leaky gut patients but for those with inflammatory bowel diseases.
Patients with sepsis, Crohn’s disease, IBD, and BAD or bile acid diarrhea may also benefit from CBD’s ability to slow down gastric emptying and intestinal transit. Those with hyperacidity or GERD will also be glad that CBD can inhibit gastric acid secretion.
CBD for Pain Management
Cannabis is therapeutically famous as a pain-killer. That is why some patients with chronic pain or under palliative care are fighting to have access to it. Luckily, with the discovery of isolating CBD oil, many individuals can now use it legally and without the euphoric effect of THC in cannabis.
Upon ingestion or administration, CBD can bind to vanilloid receptors in the body, which mediate pain perception, inflammation, and body temperature. This is one reason why some studies refer to CBD as antinociceptive, which means it can block the detection of painful or damaging stimuli by sensory neurons. This pain-killing effect lasts longer and is more effective than normal analgesics. Some CBD oil users even attest that the perfect dose of CBD can match the pain relief brought by morphine and oxycodone.
CBD’s anti-inflammatory effect contributes to reducing chronic pain since inflammation only makes it worse. CBD’s ability to increase the production and release of the happy hormone, called serotonin, also plays a significant role in managing pain.
CBD for Metabolism
The endocannabinoid system plays a central role in the neuronal control of food intake and energy balance. Since the ECS comprises metabolic enzymes, it plays a crucial role in several metabolic functions like energy storage, nutrient transport, and insulin sensitivity. CBD can therefore aid in metabolism both directly and indirectly.
Aside from boosting metabolism by supporting digestion and gut health, CBD stimulates the genes and proteins that hasten the breakdown of fat. CBD can turn white fat into brown fat, decreasing the risk of diseases and potentially promoting weight loss. CBD reduces the expressions of proteins needed to create new fat cells within the body. It also helps burn calories quickly by increasing the activity of mitochondria, the powerhouse of our cells.
However, it is important to note that overstimulation of the endocannabinoid system may result in opposite effects. Too much cannabinoid intake can boost the odds of developing metabolic syndromes such as obesity and diabetes. CBD oils with small amounts of THC may also yield a different metabolic effect as THC stimulates appetite and decreases satiation.
CBD for Brain Health
Because of the mind-gut connection, many gallbladder and gastrointestinal patients are suffering from brain fog, depression, and anxiety. Inflammation in the gut translates to inflammation in the brain. And brain inflammation is more likely to develop into neurodegenerative disease.
The good thing is that CBD supports brain health too!
CBD acts upon the dopamine, serotonin, and opioid systems in the brain. The dopamine system is associated with cognition and motivation, while the serotonin system is related to mood and behavior. These hormonal functions are why CBD administration can reduce anxiety, depression, and stress. Its ability to activate serotonin receptors makes it a potential therapeutic agent for individuals suffering from addiction, PTSD, neuropathic pain, and negative symptoms of schizophrenia. CBD’s effect on dopamine levels also helps improve memory and focus.
For neuroprotection, CBD helps support cellular repair and detoxification. This can reduce the risk of developing age-related neurodegenerative diseases. CBD also facilitates a deep and restful sleep for those with insomnia and thus suffering from brain fog and lethargy.
CBD for the Immune System
CBD has a two-phased response in the immune system. Low doses have a stimulatory effect, and high dosages can trigger inhibitory activity. Either way, it can be beneficial to different sets of people.
A few studies show CBD’s effect against cancer and HIV. However, there is still much to learn about the ability of CBD to boost the immune system. At the moment, there is more proof of CBD’s anti-inflammatory effects, which in turn lowers the body’s overactive immune system. This is only good in cases where the body’s immune system has gone awry, such as in autoimmune diseases.
As a potent immune suppressor, CBD is beneficial for patients with lupus, arthritis, Parkinson’s, and multiple sclerosis, among others.
CBD Dosage and Side Effects
Numerous studies validate that cannabidiol is well tolerated and safe in humans, even at high dosages and with long-term use. Its safety and compatibility with the human body have a lot to be a naturally-occurring compound within the endocannabinoid system.
It isn’t easy to quantify what amount is enough or too little regarding dosage. There is a massive discrepancy in the amounts used in studies, from as low as 10 mg to 1300 mg. There are also different qualities and concentration levels among CBD oils which makes it difficult to set a standard. It also doesn’t help that the FDA still hasn’t recognized CBD as a supplement or prescription medicine.
Best CBD Oil
Because of the lack of regulation and standardization, there are a lot of low-quality CBD oils available in the market today. Even if it is not openly sold in many states, it is still easy to order CBD online. It is available in many forms like soft gel tablets, oil droplets, infused gum, and many more. Therefore, it is important to know what type and what brand of CBD oils you can trust.
We recommend a company called Elixinol which has a good reputation. You can tell by the prices just how concentrated they are. They are only sold on their website. Note that there is no THC in any of their products except for 0.3% in their X-pen. They have a live chat so contact them with any questions or concerns.
A Rare and Unexpected Side-Effect of Cannabis Use: Abdominal Pain due to Acute Pancreatitis
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Acute pancreatitis is a frequently encountered disorder in patients presenting to emergency units. Biliary system disorders, alcohol consumption, infections, and drugs are among the causes of acute pancreatitis. However, it is sometimes difficult to determine the etiology of this disorder, particularly if the patient does not wish to disclose his consumption of cannabis, the use of which is illegal.
Acute pancreatitis is an inflammatory disorder of pancreas, caused mainly by biliary system disorders, alcohol consumption, and infections [1, 2]. Acute pancreatitis may also be caused by some drugs such as antibiotics (metronidazole), immunosuppressants (azathioprine), antihypertensives (angiotensin converting enzyme inhibitors, furosemide or thiazide diuretics), aspirin, or valproic acid [1, 3]. Case of acute pancreatitis due to cannabis has been rarely reported in the literature . In this paper, because of its rarity, a case of cannabis-induced acute pancreatitis has been presented.
A 44-year-old male patient presented to our Emergency Department with complaints of abdominal pain and nausea. He stated that he had been suffering from abdominal pain for one week. In other medical centers he had formerly visited, he had been told that his pain was due to a stomach disorder and, for therapy, a proton pump inhibitor had been commenced. Upon continuation of his complaints, the patient had presented to our Emergency Unit.
At the time of presentation, the patient had epigastric tenderness, but the other systemic findings were normal. His arterial blood pressure was 130/80 mm Hg, pulse was 86/minute, and body temperature was 37°C. His blood tests were as follows: WBC, 12.800/µL, CRP, 0.60 mg/L, and serum electrolytes, serum calcium, AST, ALT, GGT, and bilirubin within their normal ranges. However, his serum amylase and lipase were 294 IU/L and 935 U/L, respectively (Ranson criteria score: 0). Dual testing with lipase and amylase had a sensitivity of 93% for pancreatitis . The patient gave no history of a chronic disease, regularly medications used, alcohol consumption, or trauma. He had no history of a recent febrile disease, either. However, one of the family members stated that the patient was regularly taking cannabis powder that he had been preparing for a long time and stopped cannabis when his pains began.
On the abdominal computed tomography scan performed to determine the etiology and pancreas damage, there were no abnormalities in the pancreas, no peripancreatic fluid (Balthazar grade A acute pancreatitis), no gall stones, and no dilation in the biliary system. Following a consultation, the patient was hospitalized in the Clinic of Gastroenterology. Endoscopy revealed grade B esophagitis, two ulcers of 5 and 8 mm in the antrum, and a 1 cm ulcer in the duodenum. The computed tomography showed no penetration of the duodenal ulcer to the pancreas.
On the 3rd day of hospitalization, the patient’s amylase and lipase levels were normalized, and, thereupon, the patient, who was thought to have had cannabis-induced pancreatitis, was discharged from the hospital with the necessary recommendations.
Cannabis is a plant belonging to the Cannabaceae family. The active substances of cannabis are cannabinoids in resin, which are obtained through dried and then powdered leaves of the plant. The major cannabinoid in hashish is tetrahydrocannabinol (THC), which is responsible for the pharmacological effect of hashish. Powder hashish is obtained by drying the high THC-containing parts of female cannabis in the shade and then by grinding and sifting the dried parts.
The mechanism by which THC causes acute pancreatitis has not been fully clarified [4, 6]. There are two cannabinoid receptors in the human body, namely, CBI and CBII; CBI is found in the central nervous system, peripheral endothelial cells, and smooth muscle cells, whereas CBII is found in macrophages. These two receptors are also present in the pancreatic tissue . The receptors affect the gastrointestinal system both positively and negatively [7, 8]. By decreasing gastric acid and intestinal secretions, they delay the gastric emptying [6, 9].
Dembiński et al.  have shown that, via CBI receptors, cannabinoids increase the blood supply and DNA synthesis in the gastric mucosa and inhibit the inflammatory mediator interleukin-1β. Studies on mice with cerulein-induced pancreatitis have shown that administration of anandamide, a cannabinoid receptor agonist, to mice increases the severity of pancreatitis, but the reason for this effect is not clearly explained [10, 11]. Some authors think that this increase in severity may be due to the effect of cannabinoids on the pancreatic canal and Oddi’s sphincter [1, 4, 10]. The effect of cannabinoids on gastric secretions and emptying can be the cause of gastric and duodenal ulcers present in our patient.
In our case, Naranjo score was +1; the mean of this score is possible adverse drug reactions .
We achieved this score from the answers of the questions shown below.
The other questions answers were as follows: do not know or not done (0 points).
In conclusion, patients may not give a history of cannabinoid use which is illegal. In order to determine the etiology in patients with acute pancreatitis attacks, the use of hashish should also be questioned. Hashish consumers present to the emergency units with frequently repeated pancreatitis attacks .
Conflict of Interests
The authors declare that there is no conflict of interests regarding the publication of this paper.
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