Cannabinoid Hyperemesis Syndrome CHS: Causes, Symptoms, Treatment

Tetrahydrocannabinol (THC) and cannabidiol (CBD) are the main cannabinoids in marijuana products. THC is what’s responsible for the “high” most people feel when they use marijuana. The only proven way to prevent cannabis hyperemesis syndrome is to avoid cannabis (marijuana).

• After about years of chronic marijuana use, patients begin to have a strong feeling of sickness, throwing up, and belly pain.
• Benzodiazepines are controlled substances that people must use with caution, particularly those with a history of drug use.
• The recovery speed may depend on the severity of physical trauma sustained through chronic vomiting and dehydration.
• Doctors often treat CHS patients who seek help at hospitals with fluids.
• Cannabinoids are compounds in the Cannabis sativa plant that bind to cannabinoid receptors in your brain, spinal cord, gastrointestinal tract and other body tissues.
• Indeed, with any syndrome that results in frequent vomiting, there is a concern for a disorder of electrolytes and fluid balance in the body.

Severe and uncontrollable vomiting increases the risk of dehydration and electrolyte imbalances, and in rare cases, patients can experience esophageal tears, Camenga said. Doctors often treat CHS patients who seek help at hospitals with fluids. To help you transition to the recovery phase, you can try a few home remedies such as regular hot baths. But too many of them may increase your risk for dehydration due to sweating. Marijuana has a lot of active chemical compounds called cannabinoids. When you use weed, these compounds bind to cannabinoid receptors found in your brain, digestive tract (gut), and certain cells in your body.

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• Pancreatitis – Inflammation of the pancreas causing severe abdominal pain and nausea.
• Severe and uncontrollable vomiting increases the risk of dehydration and electrolyte imbalances, and in rare cases, patients can experience esophageal tears, Camenga said.
• Researchers have identified two receptors called CB1 and CB2 to which marijuana molecules attach.

Experts know that, usually, cannabis sends anti-nausea signals to the brain. But in rare cases, after continued and heavy cannabis use, signaling to the cannabis receptors in the digestive tract goes wrong and causes nausea and vomiting. It just isn’t clear exactly why some people get CHS and others do not. But, researchers do know only cannabis users get this condition. In conclusion, in our study, similar to the results in the literature, the most important factor affecting OS and EFS was remission status before HSCT. Although different rates were detected between genetic subgroups in terms of HSCT outcome, the results were not statistically significant.

Understanding CHS: Symptoms, Causes, and Misdiagnosis

Doctors also noticed that individuals with CHS would take frequent hot showers and baths. They also experience episodes of vomiting that return every few weeks or months. The prodromal phase can last for months, or even years in some cases. Symptoms are most common in early middle-aged adults who have used cannabis regularly since adolescence. One theory behind CHS is that chronic overstimulation of the body’s endocannabinoid receptors leads to your body not being able to control nausea and vomiting. Research suggests that CHS is a permanent condition that can only be effectively treated by quitting cannabis.

In one small study of eight patients hospitalized with CHS, four of the five who stopped using weed recovered from CHS. One of the 4 who recovered went back to using marijuana and the vomiting resumed. 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.

For example, if you smoke weed, eat edibles, use tinctures, or dab or vape THC, tell your doctor about any or all of them. This word is a combination of “screaming” and “vomiting.” You’re in so much pain that you’re screaming while you’re vomiting. It tends to affect people who use cannabis at least once a week and happens more often in adults who’ve been using cannabis since their adolescent years. People who use marijuana long-term — typically for about 10 to 12 years — are at risk of developing CHS.

Cannabinoid Hyperemesis Syndrome (CHS) and the Cyclic Vomiting Syndrome (CVS) in Adults

One study found that 32.9% of self-reported frequent marijuana users who came to an emergency department for care met the criteria for CHS. With the widespread use, increased potency and legalization of marijuana in multiple states in the U.S., CHS may be becoming increasingly common. “The way to make the diagnosis is to come off cannabis, proving retrospectively that it’s the cannabis that was causing the symptoms,” Andrews explains. Because it requires many months of abstinence to diagnose CHS, some chronic cannabis users are reluctant to go down that path, experts say. Quitting cannabis use is the only way to get better if you have CHS. Contact your health care provider if you suspect you might have CHS or for information on treatment options for cannabis use disorder.

CHS usually starts after years of using marijuana many times a week. Initial symptoms are feeling sick to the stomach, belly pain and the feeling like you may throw up. After about years of chronic marijuana use, patients begin to have a strong feeling of sickness, throwing up, and belly pain.

Treatment

• While waiting for answers, she noticed an educational pamphlet on cannabinoid hyperemesis syndrome (CHS), a little-known illness characterized by an onset of intense vomiting.
• The vasodilation induced by heat exposure in hot showers can enhance peripheral blood vessel dilation, promoting improved circulation.
• The use of lorazepam for CHS is also off-label, so a person’s doctor would need to make them aware of this fact.

Though cannabis has become more culturally acceptable and more widely legal, both in the U.S. and abroad, its regular use is still a sensitive topic. A doctor confirmed that Brittany’s years of cannabis use had manifested in CHS. What was causing this intense stomach pain, Brittany wondered as https://ecosoberhouse.com/ she rode in an ambulance one late night in February. The symptoms typically last a few weeks, though the throwing up should ease up in a day or two. The best and only way to prevent or reduce your risk for CHS is to avoid or quit marijuana use. Your doctor may ask you questions, like how long you’ve been using cannabis and what type of products you normally use.

Unveiling the Complexities of Cannabinoid Hyperemesis Syndrome: Mechanisms Underlying CHS

Cannabis can both induce and subdue vomiting, a paradox doctors don’t fully understand, Camilleri said. Medical marijuana has long been prescribed for nausea and appetite loss for people with cancer and HIV/AIDS, and the Food and Drug Administration has approved drugs with synthetic THC for use by chemotherapy patients. One 2018 study found that 32.9% of self-reported frequent marijuana users who’d gone to the emergency room (ER) had symptoms of CHS. And a 2022 Canadian study found that ER visits for CHS-related problems had increased 13-fold between 2014 and 2021. (Recreational use and sale of cannabis in Canada was legalized starting in 2018). It’s not clear what percentage of all heavy marijuana users have experienced CHS.

Most people with CHS who stop using cannabis have relief from symptoms within 10 days. The only known treatment to permanently get rid of CHS is to stop cannabis use completely. You may have symptoms and side effects of CHS for a few weeks after quitting cannabis. When CHS flare-ups occur and the vomiting is profuse, people can become dehydrated, which is why they should seek urgent medical care. That way, they can receive intravenous fluids (with electrolytes) and anti-emetics drugs (anti-nausea medications such as ondansetron, promethazine, or prochlorperazine) to stop the vomiting. In other instances, they may be given a benzodiazepine (such as alprazolam) or an antipsychotic medication (such as haloperidol) to try to stop an episode in its tracks.

What happens if cannabis hyperemesis syndrome is left untreated?

• The profuse vomiting and potential dehydration inherent in CHS often mandate intravenous fluids administration to correct electrolyte imbalances and sustain hydration levels.
• 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.
• But not every person who uses marijuana, even long-term use, develops CHS.
• Importantly, for the definition of cyclic vomiting syndrome, these episodes of vomiting cannot be attributed to other disorders.

If administering antiemetics, the nursing staff should be familiar with the adverse event profile so they can report any concerns that may arise. Indeed, with any syndrome that results in frequent vomiting, there is a concern for a disorder of electrolytes and fluid balance in the body. Patients who fail to respond to antiemetic therapy are at high risk for dehydration and resulting in nutritional deficiencies. Other known complications of forceful and uncontrolled vomiting include aspiration and subsequent pneumonitis or aspiration pneumonia as well as injury to the esophageal wall such as Boerhaave’s syndrome. In older patients, especially those with hypertension, cardiovascular illnesses such as aortic pathology and atypical coronary artery syndromes may present as vague Drug rehabilitation abdominal pain, nausea, and vomiting.

Alpha beta depleted grafts were used in 10/18 patients who underwent haploidentical allo-HSCT. That said, “most people who smoke cannabis daily don’t get this,” says Christopher N. Andrews, a clinical professor of gastroenterology at the University of Calgary. “If it continued indefinitely, that would force a person to stop” using cannabis. Still “why some people seem to be vulnerable to this and not others really seems to be a mystery,” says D’Souza.