Pancreas is a gland located behind the stomach and in front of the spine. Pancreatitis is an inflammation of pancreas, that results in various pancreatitis symptoms, which can severely change a persons life. Due to constant inflammation scarring of the organ is ongoing. This can lead to extreme pain. This health condition can greatly decrease the quality of life, that is why identifying it early on is very important.
THE ROLE OF PANCREAS IN OUR BODY
The pancreas has an endocrine and exocrine function. The endocrine part regulates the blood sugar levels with its hormones (insulin, glucagon) and the exocrine part regulates digestion and nutrient absorption. Exocrine part presents more than 85% of the entire organ and releases approximately 1.500 ml of fluid daily. This fluid is usually colourless, isotonic, and alkaline. It also has high values of digestion enzymes, which it releases to duodenum. Mechanisms lead by hormones, control the release of these enzymes with the nervous system.
The result of endocrine part failure leads to diabetes and exocrine part to pancreatic exocrine insufficiency. It can lead to many pancreatitis symptoms.
CHRONIC PANCREATITIS: CAUSES
Pancreas is a gland located behind our stomach. It releases insulin and glucagon, as well as digestive enzymes, which help with digestion and food absorption. When inflammation and scarring occur on the pancreas the organ can no longer produce the right amount of these enzymes. As a result, our body is no longer able to digest fats and other important parts of food.
Injuries to the parts of pancreas that produce insulin can lead to diabetes. The causes of chronic pancreatitis are different and consequently, discovering it is not an easy task.
Bad Habits
The most common reason for pancreatitis is bad habits, such as alcohol overuse (75% of cases). The type of alcoholic drink does not play a large role in this, quantity is much more important. However, commonly the start of this health condition is dependent on multiple factors that work simultaneously. One of the reasons is also smoking, which is recognized as an independent chronic pancreatitis risk factor nowadays.
Genetics
The family type evolves in individuals with genetic mutations. We think of them, when multiple family members have episodes of acute inflammation, or signs of chronic inflammation of pancreas. Less common reasons are increased blood fat levels, calcium in parathyroid or autoimmune inflammation of pancreas. We think of the last, when no clear reason for inflammation is found. Commonly, other organ damage is connected to the disorder (such as autoimmune thyroid inflammation).
The Unknown
In 30% of the cases the reason for chronic inflammation cannot be explained. In this case we are discussing an idiopathic version. Gallstones can be the cause of acute pancreatitis, but not the chronic one.
PANCREATITIS SYMPTOMS
We think about chronic pancreatitis symptoms if we are experiencing unexplained, repeatable, and strong stomach pain, occurring in the upper part of our abdomen. Most commonly, the exact location is right above the belly button.
Individuals can experience a piercing and radiant feeling in the back. We have to especially pay attention if a person is losing body weight, has grey, oily stool, which floats on the water. Additionally, we also have to pay attention to frequent urination (especially in the nigh time) and thirst, which can imply to diabetes.
Other symptoms include bloated stomach, nausea, dehydration, bleeding, infection, and vomiting.
CANNABINOIDS AND PANCREAS
Besides the well-known central nervous analgetic properties of consuming cannabinoids, the endocannabinoid system and its changes to pathologic conditions is in researchers spotlight in recent years. Especially, the immuno-modular function of cannabinoids and their affect on lymphocytes, which are the bases for their use in wide range of inflammatory conditions.
Anti-Inflammatory Properties
Cannabinoids are well known for their anti-inflammatory properties, which can have a very positive effect in pancreatitis. However, most studies were not yet conducted on people. For example, in 2013 study researchers found that CBD helps to improve the inflammatory condition in mice.
Although, research of cannabinoid effects on pancreatitis are limited, there are laboratory studies and reports of users.
In chronic pancreatitis (analysed samples), a decreased endocannabinoid system activity and increase with cannabinoid use could be noticed. It specifically decreases the activation of pancreas cells. These trials lay the foundation for cannabinoid values testing in treating chronic pancreatitis.
A Cleveland clinic foundation published important results of their research. They compared cannabis users with the rest of the population. They surveyed 2.8 million patients over 10-year period and the results were outstanding. The study concludes, that people with pancreatitis with cannabinoids in their blood were 3-4 times less likely to die in a hospital.
Anti-pain Properties
Besides anti-inflammatory properties, anti-pain properties are emphasised as well. Dr. Gardner of Darthmouth-Hitchcock Medical Centre claims, that cannabinoids help patients with acute and chronic pancreatitis.
Clinical management of painful chronic pancreatitis includes alcohol and tobacco, analgetic (opioids included), anti-depressives, and pancreas enzymes substitutes abstinence. Medical cannabis was suggested as a treatment for chronic pain and showed positive results in neuropathic and cancer pain.
He prescribes cannabis to many patients to help with pain, nausea, vomiting, and anxiety. He also claims he more often prescribes cannabis to patients compared to opioids and similar drugs, as positive results are clear and has little to no side effects.
Evidence of pancreatitis pain relief with cannabis use can also be found in the report titled U.S. National Library of Medicine clinical trial report from Radbound University. It includes a testimonials of chronic pancreatitis patients, who had positive results in using cannabis compounds.
Last but not least, we have to mention the paradox between cannabis and pancreas cancer, where anomaly is present. Pre-clinical trials suggest that THC can be harmful in pancreatitis and individual cases even connected pancreatitis with cannabis use. Similar paradox can also be found in obesity. Many results can also be dependent on cannabis cannabinoids ratio.
STILL MANY UNKNOWNS
The treatment of chronic pancreatitis still remains a clinical challenge without an absolute cure. Currently, we are only able to ease the symptoms for this medical condition. Meanwhile, some individuals report great improvements with the help of cannabinoids. The foundations for further research are set, however there are still many questions to be answered before we have the ultimate recipe. Until then, we will have a lot of experiments to do.
G. D. C.
19. 04. 2022
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