Blog

Studies focused on individuals diagnosed with CHS, as well as those Substance abuse with comparable conditions like CVS, were selected. Emphasis was placed on studies that reported on demographic information, symptom patterns, diagnostic criteria, and treatments. Only peer-reviewed articles, case reports, clinical trials, and review articles focusing on CHS or its comparison with similar disorders (e.g., CVS) were considered. Both primary research and secondary literature, such as systematic reviews and meta-analyses, were included to provide a broad perspective on the condition.

What do experts know about CHS?

Before admission to the treatment centre, the patient had been living in an apartment with a friend; he was unemployed and was receiving disability support. In some cases, lorazepam may be helpful to counteract the anxiety suffered by the patient, but lorazepam as treatment for CHS is generally not effective 116. Cannabis can be addictive, and people who stop using it can experience symptoms not unlike opioid or alcohol withdrawal, said Dr. Deepak Cyril D’Souza, director of the Yale Center for the Science of Cannabis and Cannabinoids. Other theories behind rising cases include the widespread legalization and cultural acceptance of cannabis, as well as the higher tetrahydrocannabinol (THC) content in modern marijuana, experts told the NewsHour.

What Are the Health Complications of CHS?

The patients continue using cannabis in this phase, believing in its anti-nausea effects. Sympathetic and parasympathetic systems play interlinked roles in emesis. The chemoreceptor trigger zone sends signals via the efferent vagus nerve, triggering responses in the parasympathetic and sympathetic nervous systems. This activation leads to the emetic reflex, which includes increased salivation, deep breathing, glottis closure, pyloric sphincter relaxation, retroperistalsis, and abdominal muscle contraction.

1 Can cannabis be a treatment for CHS instead of its cause?

Doctors have only identified cannabinoid hyperemesis syndrome in the recent past. That means a lot of research is still ongoing to figure out exactly why it happens. Current findings suggest that the body’s naturally stored cannabinoids might eventually overwhelm receptors in the gut or other systems, flipping the usual script where cannabis often helps with nausea. Cannabinoid Hyperemesis Syndrome (CHS) is a condition that develops after prolonged, heavy marijuana use.

• It is likely many are not even aware that their symptoms relate to their cannabinoid use.
• In light of the severity of their symptoms, these patients often require increased monitoring and accompaniment.
• While clinical features such as chronic cannabis use, intractable vomiting, and relief with hot baths are commonly reported, these are not pathognomonic.

Health Conditions

The small RCT published in support of capsaicin had large baseline differences between the capsaicin and placebo groups. The placebo group was “more sick”, having higher baseline nausea which was not corrected for in the analysis 7. We fix this by giving the water back through the veins and giving drugs to stop the sick feeling and lower the acid in the stomach. 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. We would like to acknowledge the work of Mrs. Chantal Briones, a community care nurse, who took the time to review with us the different therapeutic options and discuss long-term follow-up.

• Read on to understand what CHS is, how it develops, what the main signs are, and why seeking help is critical if you want to break free from this difficult cycle.
• Clinical pharmacists should have heightened awareness when patients present to the hospital with intractable nausea and vomiting and report relief with hot showering.
• The patient had an over 10-year history of smoking cannabis and cigarettes and alcohol consumption of 4–5 units a week.
• In addition, it is unclear why cannabis changes from a drug that has been known to ease nausea and vomiting, especially among patients undergoing chemotherapy, to causing nausea and vomiting in a subset of people.
• When dopamine receptors are blocked, the blockade reduces the effect of dopamine on the dopamine-2 receptors in the vomiting center 96.

In this case, it was not possible to confirm the amount of cannabis that was being used, because the patient denied any use at all; this forced the team to use clinical judgment. The patient expressed much frustration with the situation, and although he admitted to being aware that cannabis was the source of his symptoms, he continued to deny any recent usage. Pregnant women may not be forthcoming about their marijuana use, which can complicate diagnosis 121. Maternal cannabinoid use alone does not necessarily mean that hyperemesis is CHS. Chronic or excessive use of cannabinoids may also stimulate the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system in addition to disrupting the endocannabinoid system. The endocannabinoid system plays a role in allostasis of the autonomic nervous system following episodes of stress 55.

Symptoms will usually improve after 1 or 2 days, as long as you don’t use cannabis during this time. The family history was noncontributory for gastro intestinal disease or illness. His father had diagnoses of post-traumatic stress disorder, major depressive disorder, and schizophrenia.

Due to its widely known antiemetic properties, people who develop CHS will often increase the amount of cannabis they consume in hopes that it will cure the nausea, but it never helps. It goes to show how little we know about not only about the body, but also about the interaction between cannabis and cannabinoid receptors. When you stop using cannabis entirely, you can step into the recovery phase. Over days or sometimes months, the vomiting decreases, your nausea eases, and you can start eating normally again.

As CHS becomes an increasingly familiar diagnosis to clinicians, particularly in those regions of the world with liberalized or prevalent marijuana use, there still remain some puzzling questions. The pathogenesis of CHS is being elucidated and likely involves a prominent role of TRPV1 receptors. But why is CHS an episodic condition with sometimes very long asymptomatic periods between attacks? Another puzzling question is why CHS symptoms in many patients resolve completely in a very short period of time − even hours − when marijuana use is discontinued.

• In the last decade, several reports describing the structure and function of the CB1R, its allosteric ligands, and their translational potential have increased enormously.
• After you quit, you may still have symptoms and side effects for a few days to a few weeks.
• Hot showers have been reported to assist in stabilizing the hypothalamic thermostat, frequently altered by chronic cannabis use 51.
• When cannabinoids bind with brain receptors, they tend to prevent nausea and vomiting.
• The serum levels of psychiatric drugs may be reduced in patients suffering from CHS or other vomiting syndrome.
• This activity introduces the pathophysiology, clinical manifestation, and management of cannabis hyperemesis.
• “Cannabinoid” refers to cannabis (marijuana) and “hyperemesis” is a word meaning “prolonged vomiting.”

AEA and 2-AG are produced from cell membrane lipids and move to the extracellular space via diffusion, endocytosis, carrier transport, translocation, and possibly heat shock proteins 28. They stimulate the cannabinoid receptors in various brain regions, including the temporal lobe, orbitofrontal cortex, insula, and parahippocampal areas, to produce their effects 29. Understanding Substance abuse the ECS and its impact on the brain’s vomiting center is essential in the CHS pathophysiology 25,26. The ECS includes ligands, receptors, signaling pathways, and enzymes acting as regulators and inhibitors. This includes cannabinoids like AEA and 2-AG, their synthesizing and degrading enzymes, and receptors CB1 and CB2, which are crucial for understanding Cannabis’s biphasic effects 27. One possible treatment option involves the use of benzodiazepines, such as lorazepam, to control nausea and vomiting.