Since it was first identified in 2004 in Australia, researchers have looked at the effects of cannabis on the vomiting centers of the brain. Researchers have only recently discovered CHS, so some doctors or healthcare professionals may not recognize the condition. Cannabinoid hyperemesis syndrome (CHS) is a rare condition that develops in people who use cannabis frequently over a period of several years.
Cannabinoid Hyperemesis Syndrome (CHS) and the Cyclic Vomiting Syndrome (CVS) in Adults
Cannabinoid Hyperemesis Syndrome is a new and under recognized clinical entity. Although its prevalence is unknown, numerous publications have preliminarily established its unique clinical characteristics. CHS should be considered as a plausible diagnosis in the setting of patients with recurrent intractable vomiting and strong history of cannabis abuse. Despite the well-established cannabinoid hyperemesis syndrome anti-emetic properties of marijuana, there is increasing evidence of its paradoxical effects on the gastrointestinal tract and CNS. Further initiatives are needed to determine this disease prevalence and its other epidemiological characteristics, natural history, and pathophysiology. Additional treatments are needed and efforts to discontinue cannabis abuse are paramount.
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The use of lorazepam for CHS is also off-label, so a person’s doctor would need to make them aware of this fact. Another doctor reported using a combination of injectable lorazepam and promethazine, another antinausea medication. Researchers have identified two receptors called CB1 https://ecosoberhouse.com/ and CB2 to which marijuana molecules attach. Receptors are specialized cells that respond to specific stimuli or changes in the environment. Typical antiemetics such as ondansetron, commonly known as Zofran, have often been found ineffective at suppressing nausea caused by CHS.
- Many people experience temporary relief from their nausea and vomiting when bathing in hot water.
- Along with the discovery of the CB1 and CB2 receptors has been the identification of endogenous arachidonic acid derivatives that bind to these receptors (Figure 1).
- CHS should be considered as a plausible diagnosis in the setting of patients with recurrent intractable vomiting and strong history of cannabis abuse.
Are there complications of cannabinoid hyperemesis syndrome?
As a somewhat new problem, CHS is often mistaken for other problems with the same symptoms. When combined with the fact that people may not reveal they use cannabis, getting the right diagnosis can take years. Cannabinoid hyperemesis syndrome (CHS) is a rare problem that causes constant vomiting. The characteristics, signs, and symptoms of CHS were discussed with the patient. The patient strongly felt as though these symptoms aligned with his clinical course over the prior 8 years. At time of writing, the patient had gone 20 months without requiring hospitalization; however, he had a recent relapse of marijuana use and subsequently required hospitalization.
Cannabinoid Hyperemesis Syndrome (CHS) and Marijuana Use
Your doctor probably should send you to see a stomach doctor, who knows more about your problem and can help you feel better. 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. Patients with CVS also have times where they are feeling sick to the stomach and can also throw up for between 12 hours to about a week. This can happen when you are stressed, excited, have an infection or when women have their period. The only way to prevent CHS is to avoid using any form of marijuana.
- As more states make recreational use of cannabis legal, it is thought that this problem will become more common.
- Most people who quit using cannabis experience no more CHS symptoms within 10 days, but sometimes it may take weeks or months for symptoms to stop.
- Treatment involves stopping cannabis use and symptom management.
- Within 10 minutes, nausea and vomiting stopped, and the person no longer felt abdominal pain.
- In one small study of eight patients hospitalized with CHS, four of the five who stopped using weed recovered from CHS.
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In the brain, CB1 receptors are localized to the cerebral cortex, hypothalamus, anterior cingulate gyrus, hippocampus, cerebellum, and basal ganglia [8]. In the gastrointestinal system, CB1 receptors are found on both intrinsic and extrinsic neurons, with the enteric nervous system serving as the major site of action [9]. Other organs where CB1 receptors have been identified are the spleen, heart, liver, uterus, bladder, and vas deferens [10]. In comparison, much less is known about the effects of the CB2 receptor.
Cannabinoid hyperemesis syndrome (CHS) can affect people who use cannabis (marijuana) long-term. Ironically, one of the potential complications of long-term cannabis use is a condition called cannabis hyperemesis syndrome (CHS). Cannabinoid hyperemesis syndrome is an uncommon reaction to cannabis use. In addition to frequent and severe vomiting, patients may have difficulty eating and drinking, and only find (temporary) relief in hot showers and baths. CHS is a rare condition that affects some habitual cannabis users.
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Certain individuals may have a genetic polymorphisms in the cytochrome P450 enzymes responsible for the metabolism of the cannabinoids [62,72]. This could result in excessive levels of pro-emetic cannabinoids or emetogenic metabolites. Such genetic variations have yet to be studied in patients diagnosed with CHS and represent an area for future research.
What are the symptoms of Cannabinoid Hyperemesis Syndrome?
