Many thousands of American suffer from either acute and/or chronic Pancreatitis each year. This is a serious disease that often results in death. Pancreatitis can occur independent of Pancreatic carcinoma. Pancreatic cancer is particularly nasty being inevitably fatal and extremely painful until the last days when nerve endings are largely destroyed by tumor and inflammation. Chronic Pancreatitis can also be lethal particularly when pseudocysts or infection is present.
The Pancreas is a vital organ that loops around the GI tract from below the naval to underneath the solar plexus. It provides both an endocrine function (insulin) necessary to the maintenance of normal blood sugar and an exocrine function (digestive enzymes) necessary to absorb the nutrients from food. Pancreatitis can interfere in the production of these key enzymes and hormones.
The Pancreas can become inflamed from overuse of alcohol, "sludge" or stones in the gall bladder, autoimmune attack, or congenital defect. Once inflamed the Pancreas can become blocked, develop pseudocysts, and even become infected. The pain associated with pancreatic inflammation is intense. Dehydration, shock, and hyperglycemia may occur. Inflammation caused by excessive pancreatic enzymes can also occur in joints, the lining of the heart (endocarditis) and other vulnerable areas.
Prompt and proper diagnosis is necessary as a wide range of disorders generates abdominal pain. Usually, a battery of blood tests is conducted to look at pancreatic enzymes. A CAT scan can reveal the degree of inflammation and give important clues as to the status of pancreatic tissue including the presence or absence of pseudocysts, ascites, or tumor. An ECT can reveal information about the pancreatic ductwork, identifying abnormalities and blockages.
In severe cases treatment may include intravenous feeding, surgical drainage, surgical resection, removal of the gall bladder, transplantation, and medicines to replace key enzymes and hormones including lipase, amylase, and insulin. Relief from pain usually requires major narcotics including morphine, MSContin, OxyContin, Fentyl, and methadone. Pancreatic "attacks" can be a one-time affair, intermittent, or frequent. Episodes can last days to months or even years.
Cannabis is not a primary treatment for the underlying causes of Pancreatitis except as it relates to alcoholism (the primary cause of Pancreatitis) and inflammation (Cannabis is a decent anti-inflammatory).
There are two major areas where cannabis can be very helpful in treating the symptoms of Pancreatitis. The first is to help alleviate the loss of appetite (anorexia) and weight loss (cachexia) that can be life threatening. Cannabis food products are NOT recommended for this relief as the GI tract is overtaxed in Pancreatitis and usually requires rest. The best routes of administration are inhalation (vaporizer), tincture, and smoking. Increased appetite and significant weight gain have been reported with Cannabis use. Since weight loss from Pancreatitis can exceed 30% of total body weight, any nontoxic medicine that improves nutrition is vital. Some of the anorexia in Pancreatitis is caused by the simple fact that it hurts to eat.
The second major area where cannabis can be helpful is in pain relief. Many patients find that adjunctive therapy with medical cannabis replaces narcotics while others find they can significantly lower the dose and frequency of prescribed painkillers. Since Pancreatitis can last weeks to months, narcotic tolerance and addiction are a real concern. In many cases surgery(s) may have to be delayed until Pancreatic inflammation recedes. This means patients may be on powerful narcotics while awaiting surgery making the narcotics less effective in dealing with post-surgical pain.
Since surgery is often an option with Pancreatitis it is important to honestly discuss all drug use (including alcohol) with the physicians, surgeons, and anesthesiologists involved in treatment and procedures. Most anesthesiologists recommend that patients have as few medicines as possible "on board" just prior to surgery. After surgery pain management may become an important part of treatment along with diet modifications, glucose monitoring, and life style changes.
In all of this Cannabis, under physicians supervision, can play a helpful role.
Pancreatic Disease References: MEDLINEplus: Pancreatic Diseases
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