Aiub Hasan

Multiple and forceful vomiting events can cause Mallory–Weiss tears with hematemesis and rarely lead to pneumomediastinum or Boerhaave’s syndrome 58. A comprehensive review of the literature identified a few of the approaches used by doctors to treat CHS. These include minor and major tranquilizers such as benzodiazepines and antipsychotics, coupled with antiemetics such as metoclopramide and ondansetron. A case study from Tunisia led credence to the use of antidepressants and anxiolytics, with cognitive behavioral therapy 5. In another case report, the use of the short acting benzodiazepine lorazepam initially given IV in an inpatient setting followed by a 6-day tapered prescription alleviated both nausea and vomiting 6.

What are other impacts of cannabis use?

They also experience episodes of vomiting that return every few weeks or months. Without more research, there is no definitive answer, but doctors have linked the increase in CHS cases to widespread legalization, along with higher tetrahydrocannabinol (THC) content in modern marijuana. The commercial industry that blossomed after legalization “touted its products as beneficial” while focusing on “engineering a quicker, more intense high,” the Times said. Kelly is a board certified Psychiatric-Mental Health Nurse Practitioner who earned her Master of Science degree in Nursing with a concentration in mental health at Fairleigh Dickinson University. Kelly has fourteen years nursing experience as a Registered Nurse, Nurse Manager, and Advanced Practice Nurse in both psychiatric and substance use disorder settings. She has worked in inpatient settings as well as provided community nursing as a Nurse Practitioner.

Hyperemetic phase

• Cannabis leads to upregulation of CB1 receptor activity in the hypothalamus, which enhances the hypothermic effects of THC.
• Additionally, it is caused by disturbances in the gut–brain axis that do not have any other identifiable organic pathology 11.
• Though the precise mechanisms remain unclear, higher amounts of marijuana consumption, genetic influences, and psychological stress lead to intoxication and paradoxically promote vomiting.
• CHS causes you to have repeated episodes of vomiting, severe nausea, stomach pain, and dehydration.
• Understanding the ECS and its effects on the vomiting center of the brain are fundamental to explain the effect of cannabis for this biphasic response 21.

Hundreds of people told the Times that they spent hours in hot baths and showers. Some were even “burned by scalding water,” and one was injured when “in desperation, he pressed his body against a hot car,” the outlet said. With there being so little research on the syndrome, experts are not sure why heat soothes the symptoms, “nor why certain chronic marijuana users develop it and others don’t,” said the Times. The onset of CHS appears to be related to the way marijuana interacts with the body’s endocannabinoid system, which helps regulate bodily functions like sleep, digestion and pain perception. Cannabinoid hyperemesis syndrome is an uncommon reaction to cannabis use.

• However, the development of drug candidates for CB1 is challenged by side effects, rapid tolerance buildup, and the risk of abuse 33.
• Not everyone with the condition seeks medical help or tells their provider that they use marijuana.
• One possible explanation for this is called “gate control theory,” which postulates that to some extent, the brain can regulate how much pain it perceives.
• It’s a condition that can lead to serious health complications if you don’t get treatment for it.

What are the symptoms of cannabinoid hyperemesis syndrome?

Cannabinoid hyperemesis syndrome (CHS) is a condition that you might get if you’ve regularly smoked weed or used marijuana in some other form for a long time. CHS causes you to have repeated episodes of vomiting, severe nausea, stomach pain, and dehydration. You’re more likely to get CHS if you use marijuana at least once a week and have been doing so since you were a teenager. “Cannabinoid” refers to cannabis (marijuana) and “hyperemesis” is a word meaning “prolonged vomiting.” Cannabinoid hyperemesis syndrome (CHS) can affect people who use cannabis (marijuana) long-term.

Understanding Cannabis Hyperemesis Syndrome

• This cycle can send patients on repeated visits to the ER, and in rare cases, can even lead to death from kidney failure.
• These ligands interact with G protein-coupled receptors (GPR), GPR18 and GPR55, peroxisome proliferator-activated receptors (PPARs), and TRPV1.
• Multiple and forceful vomiting events can cause Mallory–Weiss tears with hematemesis and rarely lead to pneumomediastinum or Boerhaave’s syndrome 58.

A number of reports highlight the role of hot showers in providing temporary symptomatic relief, which was a strategy that had been adopted by our subject with a good but time-limited effect. One hypothesis is that increasing body temperature corrects an upset of the thermoregulatory system in the hypothalamus, promoting the release of histamine and inducing vasodilation 8. He was a daily cannabis user for several years and had stopped using a week or so before the onset of the symptoms, as he was traveling to a country with more restrictive cannabis laws. His condition deteriorated rapidly, followed by emergency room attendance, thorough diagnostic work-up, and unsuccessful interventions, including https://ecosoberhouse.com/article/cannabinoid-hyperemesis-syndrome-what-is-chs/ intravenous treatment with the anti-emetic Ondansetron. The patient was referred to a psychiatrist after a suspected psychogenic etiology by the medical team.

Cannabinoid Hyperemesis Syndrome Diagnosis

If you have symptoms, your doctor will do a physical exam and ask for your detailed medical history. Let your doctor know how much marijuana you use and how often you use it. Although it was considered to be rare, the number of cases has increased with the legalization of marijuana in many places and the opening of retail stores to easily get it. This has increased both the number of people using the drug and the “high” in the available weed. It’s a serious medical problem that can cause major health issues if you leave it untreated.

History and Physical

This condition shares some clinical features with cannabis hyperemesis despite the different etiology. Mirtazapine likely affects the central nausea and vomiting circuits through 5-HT3 and H1 blockade and has been used in gastroparesis with significant improvement in nausea and vomiting 10. People with CHS also tend to have a strong urge to take very hot showers or baths. That’s because hot water can help ease cannabinoid hyperemesis syndrome symptoms like nausea. The hot temperature affects a part of the brain called the hypothalamus, which regulates temperature and throwing up. A telltale sign of CHS is that heat often Sober living house temporarily relieves the condition’s symptoms.

Cannabinoid Hyperemesis Syndrome Causes

With these new products, hospitals saw influxes of CHS, and researchers called for more public health guidance and education for providers. Additionally, since vomiting leads to dehydration, sipping small amounts of water or electrolyte-rich drinks can help prevent complications. Symptoms will usually improve after 1 or 2 days, as long as you don’t use cannabis during this time. The cause of death in both people was found to be hyponatremic dehydration, also known as low sodium levels. The researchers found that 32.9 percent of the participants reported having experienced symptoms of CHS in the past.

Camilleri also said that cannabis use is positively correlated with anxiety and depression, and noted that doctors should treat the whole patient and not just the disorder. Ultimately, the only way to guarantee health is by totally abstaining, he added. If the patient quits cannabis consumption, vomiting due to CHS largely subsides. It’s possible that with lower amounts or lower frequency, patients might be able to use cannabis again, but the science is unclear.