Cannabinoid Hyperemesis Syndrome CHS: Causes, Symptoms & Treatment

For example, the drug affects the receptors in the esophageal sphincter, the tight band of muscle that opens and closes to let food go from your throat to your stomach. If this flap doesn’t work properly, your stomach acids might flow upward and cause you to have nausea and vomiting. Many people experience temporary relief from their nausea and vomiting when bathing in hot water. Some people with CHS may compulsively bathe in hot water for hours a day to find relief.

• Most people end up having an abdominal ultrasound, upper scope, and a test to see how fast stuff gets out of the stomach before we figure out that their problem is CVS or CHS.
• “Cannabinoid” refers to cannabis (marijuana) and “hyperemesis” is a word meaning “prolonged vomiting.”
• Doctors have also noticed that people in the hyperemesis stage take frequent showers and baths, which seem to relieve nausea.
• Some researchers have published their findings from their personal experience with the condition in clinical journals.
• Smoking extra marijuana won’t help your nausea but will make it worse.

Can You Treat CHS Symptoms at Home?

After stopping cannabis use, symptoms generally resolve within days or months. Compulsive bathing or showering in hot water to soothe nausea is also a hallmark sign of CHS. Nearly 100 different metabolites have been identified for THC [24]. The two major metabolites found in humans are 11-hydroxy-Δ9-tetrahydrocannabinol (11-OH-THC) cannabinoid hyperemesis syndrome and 11-nor-9-carboxy-THC- Δ9-tetrahydrocannabinol (THC-COOH) [20]. 11-OH-COOH is a psychotropic metabolite that is equipotent to THC in terms of producing psychic effects and lowering intraocular pressure [25]. THC-COOH, in contrast, is a non-psychotropic metabolite that possesses anti-inflammatory and analgesic properties [26].

• Neither the psychological treatments nor the pharmacological treatments seem to be that effective,” he said.
• You may need to see a gastroenterologist, a doctor who specializes in the digestive tract, for a proper diagnosis.
• Since it was first identified in 2004 in Australia, researchers have looked at the effects of cannabis on the vomiting centers of the brain.
• Patients are typically young adults with a long history of cannabis use.
• Another doctor reported using a combination of injectable lorazepam and promethazine, another antinausea medication.
• Patients are often diagnosed with the syndrome based on the way they treat their own symptoms.

Cannabinoid Hyperemesis Syndrome Diagnosis

The most effective treatment during the hyperemetic phase of CHS is the use of hot showers by patients. The effects of this learned behavior are temperature-dependent [6], fast acting [6], but short-lived [6,56,62]. Hot showers improve symptoms of nausea and vomiting [6,52–56,60,62,68,71], abdominal pain [6,56,71], and decreased appetite [68] during the hyperemetic phase. The precise mechanism by which hot bathing produces a rapid reduction in the symptoms of CHS is unknown.

What are the symptoms?

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. 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. If you have cannabis use disorder and need help quitting, professional treatment is available.

What happens if cannabis hyperemesis syndrome is left untreated?

In one study the average duration of cannabis use prior to onset of recurrent vomiting was 16.3 ± 3.4 years [62]. There are at least four reported cases where the time lag was equal to or less than three years [54,59,60]. Daily marijuana use is characteristic and often reported as exceeding three to five times per day. The hyperemetic phase of CHS typically lasts for only 24–48 hours [6], but the risk for relapse is high if the patient returns to cannabis use.

Cyclic Vomiting Syndrome (CVS)

Researchers aren’t sure exactly why weed causes CHS symptoms only in some people. Even cannabis products that don’t contain THC have the potential to cause or worsen CHS. Researchers are continuing to examine potential treatment options for CHS.

• Although its prevalence is unknown, numerous publications have preliminarily established its unique clinical characteristics.
• After stopping cannabis use, symptoms typically start to disappear within one to two days though individual results can vary.
• Experts believe only a fraction of habitual cannabis users develop CHS.

On the basis that only a small number of regular and long term users of marijuana develop CHS, some researchers suggest that genetics might play a role. Other researchers theorize that the effects of marijuana can change with chronic use. Ultimately, the only way to guarantee health is by totally abstaining, he added. https://ecosoberhouse.com/ 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. Experts also aren’t clear on what causes CHS, or why some people develop it while others don’t.

• Studies have demonstrated the efficacy of outpatient treatment options such as cognitive behavioral therapy and motivational enhancement therapy for marijuana dependence [73].
• Despite the well-established anti-emetic properties of marijuana, there is increasing evidence of its paradoxical effects on the gastrointestinal tract and CNS.
• Nausea and vomiting tend to return if they start using marijuana again.
• However, after abstaining from alcohol for long periods, the patient had continued recurrence of the symptoms and increased frequency of presentations to the ED.
• Initial symptoms are feeling sick to the stomach, belly pain and the feeling like you may throw up.
• It’s not clear if some people are more prone to the syndrome than others.

CHS Symptoms

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. If you have any symptoms of severe dehydration, like dizziness, confusion and a rapid heartbeat, call 911 right away. Researchers are currently studying several treatment options to manage the hyperemetic phase of CHS. Symptoms of CHS typically come on several years after the start of chronic marijuana use.

Vital signs were significant for mild hypertension (150/75), but the patient was afebrile with a normal heart rate. An abdominal exam revealed a nontender, nondistended abdomen with no signs of rebound or guarding. An initial workup showed a mild elevation of serum creatinine to 1.36 mg/dL (baseline is 1.10 mg/dL). Other workups, including complete blood count (CBC) with differential, complete metabolic panel, lipase, amylase, and urine analysis, were all unremarkable.