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CBD For Gallbladder Pain Relief?

People want gallbladder pain relief without fear of long-term adverse side effects and recent studies show that CBD may help.

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Gallbladder Pain Relief

Gallbladder (not “gall bladder”) pain refers to any pain experienced due to a disease or injury affecting the gallbladder. The most common medical conditions that induce gallbladder pain include biliary colic, cholecystitis, gallstones, pancreatitis, and ascending cholangitis. Gallbladder pain may be dull or sharp, achy or crampy, sharp or sudden, and vary from mild to severe depending on the root cause. Gallbladder pain typically affects the abdomen and mid to lower back.

Gallbladder Anatomy

It’s important to fully understand the anatomy and function of the gallbladder to gain a better understanding of how certain conditions and diseases contribute to pain in the gallbladder. The gallbladder is a storage organ connected to the liver that stores bile used for digestion. The bile ducts connecting to the gallbladder are termed the hepatic duct.

The cystic duct from the gallbladder joins with the hepatic duct to creat the common bile duct, which transfers bile into the small intestines for digestion. The pancreatic duct also joins with the common bile duct before entering the duodenum. Bile is used to break down fats and amino acids during digestion in the small intestines. The gallbladder receives certain biological cues to release bile once the fat and amino acids enter the duodenum shortly after a meal is consumed. Interestingly, women have been shown to experience pain related to gallstones twice as much compared to men.

Gallbladder Pain Causes

There are various conditions and diseases that can cause pain in the gallbladder. One of the primary causes of pain that affect the gallbladder directly is blockage of any of the gallbladder ducts due to gallstones. The blockage may be partial or complete stop the flow of bile in the gallbladder ducts. Gallstones may also induce inflammation due to serious irritation or an infection of the tissues surrounding the gallbladder. Obstruction of the ducts results in increased pressure and ischemia (insufficient blood supply due to obstruction of blood vessels), which affects the tissues surrounding the ducts.

Gallstones form in the gallbladder but could potentially develop in any of the bile ducts. The gallbladder normally expels bile through ducts by squeezing the surrounding muscles to create compression. However, if gallstones or lingering bile matter is there, this squeezing may result in either partial or entire obstruction of the bile ducts which presses against the surrounding tissue and may be severe enough to prevent sufficient blood supply.

Blunt force trauma can also be responsible for causing gallbladder pain, such as after an accident or during intense contact sports. Infections of the bile ducts and the gallbladder itself can certainly cause pain as well.

Gallbladder Pain Symptoms

Gallbladder pain varies on the underlying cause, but the following explains the symptoms from common gallbladder pain causes:

  • Biliary colic (intermittent duct blockage): Sharp and sudden pain that gets worse over time in the right upper abdomen. Pain occasionally travels to the right shoulder of the back, and nausea or vomiting are commonly experienced. The pain typically goes away within 5 hours, but a mild, dull pain may continue for about 24 hours following the incident.
  • Cholecystitis (inflammation of the gallbladder tissue secondary to duct blockage): induces severe constant pain in the upper right abdomen that often travels to the right shoulder or upper back. Other symptoms include tenderness of the abdomen, sweating, nausea, vomiting, fever, chills, and discomfort that persist longer than biliary colic.
  • Acalculous cholecystitis: Inflammation of the gallbladder that’s not due to gallstones and is instead caused by trauma or injury. Severe pain and flu-like symptoms are often experienced with nausea, vomiting, fever, chills, and body aches.
  • Pancreatitis: Inflammation of the pancreas due to gallstones obstructing the pancreatic duct. Symptoms include severe upper abdominal pain that may travel to the back or shoulder, tenderness of the abdomen, pain after eating, nausea or vomiting, chills, and body aches.
  • Ascending cholangitis: Inflammation caused by infection to the biliary ducts. Symptoms typically include fever, abdominal pain, yellowing of the eyes, and skin (jaundice), delirium, and low blood pressure (hypotension). Cholangitis requires immediate medical attention.

If you’re experiencing any of the previous symptoms, seek immediate medical attention to avoid permanent damage to the gallbladder, pancreas, and other surrounding organs and tissues.

Gallbladder Pain Relief Treatment

If you’ve experienced an episode of severe gallbladder pain then your doctor will likely perform several diagnostic tests to determine the underlying cause of the pain. These tests include:

  • ultrasound
  • abdominal X-ray
  • CT scan
  • a liver function blood test

Medications

Taking an OTC pain medication can help reduce pain and inflammation of the gallbladder. These medications include ibuprofen (Advil, Motrin), acetaminophen (Tylenol), and naproxen (Alleve).

If your doctor diagnosed you with gallstones, you may be given a prescription of ursodiol (Actigall, Urso). Ursodiol can help dissolve gallstones, allowing them to pass through the bile ducts. However, it’s most effective against gallstones that are smaller and range from 2 to 3 millimeters. Also, it takes several months for the medication to become effective. You may need to be on ursodiol for several years since gallstones could return if you stop the medication.

Surgery

Surgery may be necessary in cases where the pain persists even after conservative treatments.

The most common surgery performed for gallbladder pain is cholecystectomy. This effectively removes the entire gallbladder from the body. You’ll be under heavy anesthesia for the entire procedure. Most people recover within a couple of months.

Most procedures involve keyhole surgery laparoscopy or open surgery.

CBD for Gallbladder Pain Relief?

CBD is short for cannabidiol, a naturally found compound from the Cannabis sativa plant. Cannabidiol is typically extracted from hemp (cannabis grown without the psychoactive compound tetrahydrocannabinol (THC). It’s then processed into oil and various commodities from foot creams to sports drinks.

THC is the popular compound known for producing the high and euphoria associated with smoking or consuming marijuana. However, CBD doesn’t share THC’s psychoactivity and produces effects that do not cause intoxication or euphoria. This may be very appealing to those with gallbladder pain but can’t be under the influence of a substance, whether due to work, social circles, safety concerns, or personal beliefs but still want pain relief.

The FDA only views CBD as a treatment option for seizures caused by two rare forms of epilepsy under the pharmaceutical “Epidiolex.” However, clinical studies are demonstrating CBD and other cannabinoid’s potential in treating various conditions that cause pain and inflammation. As of now, it looks like cannabidiol may be a promising treatment option for those seeking gallbladder pain relief.

Why Is CBD Getting So Popular?

CBD is exploding in popularity, and there are several reasons involved. The first is that during the midst of a devastating opioid crisis, Americans are pursuing alternatives to traditional pain medication. Drugs like highly addicting opioids come with various side effects and concerns. People want gallbladder pain relief without fear of long-term adverse side effects. Nonprescription pain medications aren’t always effective, and nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to produce adverse side effects when used in the long term.

Research grants are being awarded to investigate CBD’s efficacy in treating a variety of illnesses that cause pain and inflammation. Studies are also finding that CBD has enormous potential considering its vast array of effects on the body due to indirectly with the body’s endocannabinoid system (ECS).

The ECS is a critical and complex bio-system that’s directly responsible for maintaining homeostasis in addition to various other physiological functions like pain sensation, mood, appetite, sleep, memory, immune function, and many more.

CBD also possesses notable anti-psychotic and anxiolytic properties; studies are already investigating CBD’s role in treating psychiatric disorders like schizophrenia, anxiety, and depression.

The recent 2018 Farm Bill federally legalized the sale and growing of hemp and hemp-extracts. This has caused CBD products to explode in quantity because CBD products must contain less than 0.3 percent THC to be legally sold. Hemp is cannabis Sativa grown without the psychoactive compound THC. If a hemp plant produces more than 0.3 percent THC, then it becomes illegal and reclassified as marijuana.

The Drug Enforcement Agency (DEA) still lists cannabis or marijuana as a schedule 1 substance, making it illegal to grow, buy, sell, or possess. However, several states have already legalized both medicinal and recreational use of cannabis, with many following in their path. In these states, cannabis use is permitted even when prohibited by the federal government. We know, it’s very confusing.

Hopefully, the federal government will get on the same page as everyone else and recognize that cannabis does possess medicinal properties (Schedule 1 substances are considered highly addicting and are believed to have no medicinal benefit). Always check your state and local laws regarding CBD purchase and use as they do vary by state.

How To Take CBD for Gallbladder Pain Relief

The most common way to take CBD for gallbladder pain is by taking CBD oil and placing drops under the tongue where it’s quickly absorbed into the bloodstream. Since there aren’t any established clinical guidelines for dosing CBD, let alone for specifically gallbladder pain relief, dosing will mainly be slowly titrating until pain relief is achieved. To do, place the smallest amount of CBD oil under the tongue, wait a brief period, then slowly increase the number of drops. Always read the bottle as there are likely dosing instructions and further information about how much and how frequently CBD oil can be taken.

The next most common way to take CBD for gallbladder pain is to apply a CBD-infused topical on the affected area locally. CBD topicals are usually cream, salve, or balm and often include additional beneficial ingredients to help increase its efficacy in providing pain relief. Always check your container to make sure the product doesn’t include any ingredients that may induce an allergic reaction. You could start by applying a small amount of the CBD topical to the upper abdomen area or back and then reapplying after some 30-60 minutes until the pain subsides.

There is no best dose of CBD for gallbladder pain because it’s highly dependent on various factors, including weight, pain severity, metabolism, genetics, and likely more. What works for your friend may do nothing for you. This is why it’s important to be mindful and observant of how CBD affects you and slowly work your way up until you find a dose that’s best for your pain symptoms. Thankfully, CBD is well tolerated by most people, and studies have determined that CBD appears to produce little to no toxicity.

CBD doesn’t normally produce observable side effects, let alone adverse ones. However, side effects from CBD tend to be mild and could be dry mouth, nausea, fatigue, or headache. There have not been any deaths confirmed to be due to CBD, and most people can take CBD without experiencing life-threatening side effects.

Suffering from gallbladder pain? Learn more about the causes of gallbladder pain and treatment options including CBD.

A Rare and Unexpected Side-Effect of Cannabis Use: Abdominal Pain due to Acute Pancreatitis

Mehmet Husamettin Akkucuk

1 Department of Emergency Medicine, Başkent University School of Medicine, Saray Mahallesi Yunus Emre Caddesi No. 1, Alanya, 07400 Antalya, Turkey

Mustafa Erbayrak

2 Department of Gastroenterology, Başkent University School of Medicine, Saray Mahallesi Yunus Emre Caddesi No. 1, Alanya, 07400 Antalya, Turkey

Abstract

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.

1. Introduction

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 [4]. In this paper, because of its rarity, a case of cannabis-induced acute pancreatitis has been presented.

2. Case

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 [5]. 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.

3. Discussion

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 [6]. 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. [7] 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 [2].

We achieved this score from the answers of the questions shown below.

Are there previous conclusive reports on this reaction? = yes (+1 points).

Did the adverse reaction improve when the drug was discontinued? = yes (+1 points).

Are there alternative causes that could have caused the reaction? = yes (−1 points).

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 [4].

Conflict of Interests

The authors declare that there is no conflict of interests regarding the publication of this paper.

A Rare and Unexpected Side-Effect of Cannabis Use: Abdominal Pain due to Acute Pancreatitis Mehmet Husamettin Akkucuk 1 Department of Emergency Medicine, Başkent University School of Medicine,