In this article, we describe CHS and discuss the causes, symptoms, diagnosis, and treatment of the condition. As CHS is a newly described condition, many doctors may find it challenging to diagnose and treat. Researchers have tried to explain what causes CHS, but further study is necessary. At this time, the only known way to cure CHS is by quitting cannabis. A 2016 case study describes two deaths due to complications of CHS. The cause of https://ecosoberhouse.com/article/dealing-with-ptsd-alcohol-blackouts-and-memory-loss/ death in both people was found to be hyponatremic dehydration, also known as low sodium levels.
Diagnosis
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. 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.
The Effects of Cannabinoids in the Brain
After about years of chronic marijuana use, patients begin to have a strong feeling of sickness, throwing up, and belly pain. This is normally when people go see a doctor to find out what is causing these problems. They start to feel better when they stop using marijuana but can feel bad if they use it again. Cannabigerol (CBG) is a non-psychotropic cannabinoid that behaves as an antagonist at both the CB1 and 5-HT1A receptors 32. This antagonism reverses the anti-emetic actions of low-dose CBD, which likely occurs at the 5-HT1A receptor 33.
Symptoms
But not every person who uses marijuana, even long-term use, develops CHS. An article of faith with advocates of legal recreational marijuana has been that the drug is safer than tobacco or alcohol. By Anna GiorgiGiorgi is a freelance writer with more than 25 years of experience writing health and wellness-related content. Treatment that helps prevent dehydration and loss of electrolytes can help reduce your risk of many of these problems. 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. Theara Coleman has worked as a staff writer at The Week since September 2022.
About 75 percent reported using cannabis regularly for over a year. But a 2019 study concluded that it potentially accounts for up to 6 percent of emergency room visits for recurrent vomiting. Researchers are trying to understand why some people develop it and others don’t. Right now, the only known effective treatment for CHS is to stop using cannabis.
Clinical Presentation of CHS
- Many researchers feel that CHS is underrecognized and underdiagnosed.
- In clinical practice CHS is most often confused with cyclic vomiting syndrome (CVS).
- THC accumulates largely within body fat which serves as a long-term storage site for the drug 20,22.
- 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.
- Since THC is stored in your body fat, it can take weeks to months before all the symptoms go away and you notice a difference.
- One possible treatment option involves the use of benzodiazepines, such as lorazepam, to control nausea and vomiting.
One study found up to 6% of people who went to the emergency room for cyclical vomiting had CHS. The only treatment that can get rid of CHS symptoms for good is to stop using cannabis completely. But there are some other treatments that may help manage your symptoms and make you feel better. Researchers have only recently discovered CHS, so some doctors or healthcare professionals may not recognize the condition. However, many experts consider these treatments to be ineffective for managing nausea and vomiting in people with CHS.
- Cannabinoid hyperemesis syndrome (CHS) happens when you have cycles of nausea, vomiting and abdominal pain after using cannabis (marijuana) for a long time.
- But because CHS is a somewhat newly discovered condition that was first diagnosed in 2004, some people may be underdiagnosed or misdiagnosed.
- CB2 receptors are likely involved in the inhibition of inflammation, visceral pain, and intestinal motility in the inflamed gut 9,14.
- Some people with CHS may compulsively bathe in hot water for hours a day to find relief.
- Compulsive hot showering or bathing may be critical in distinguishing CHS from CVS and other conditions with similar symptoms.
- When you do this, your symptoms usually start to go away in few days to a few months.
Treatment / Management
In the gastrointestinal system, CB1 receptors are found on both intrinsic and extrinsic cannabinoid hyperemesis syndrome 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. In the gastrointestinal system, CB2 receptors are expressed by lamina propria plasma cells and activated macrophages, as well as by the myenteric and submucosal plexus ganglia in human ileum 9,12,13.
THC concentration can be 10 times, or more, greater than in the marijuana Dylan sold to the Beatles. This can help you avoid more severe problems as your body is robbed of food and water from constant vomiting. Experts say the medical field is woefully behind on understanding the rapidly changing drugs. “There’s a difference in legalizing the original cannabis on the planet and the products that exist today,” neuroscientist Yasmin Hurd said to the Times. Hurd was the lead author of a 2017 report on the health effects of cannabis from the National Academies of Sciences, Engineering and Medicine, which warned that the lack of evidence-based information posed a public health risk.
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. The diagnostic criteria for CHS were ill-defined prior to the establishment of the Rome IV criteria of 2016.2223 Per the Rome IV criteria, all 3 of the following must be met to be diagnosed with CHS. They must be present for at least the last three months and the beginning of symptoms must be at least 6 months prior to the diagnosis being made.
- CHS is a rare condition that affects some habitual cannabis users.
- Ceasing and abstaining from the use of cannabis is the only treatment that relieves and prevents symptoms of CHS, according to a systematic review on CHS management.
- THC exhibits an anti-emetic effect in the central nervous system.
- In the gastrointestinal system, CB2 receptors are expressed by lamina propria plasma cells and activated macrophages, as well as by the myenteric and submucosal plexus ganglia in human ileum 9,12,13.
- In fact patients with CHS are often mislabeled as having CVS and vice versa.
What is the treatment for cannabinoid hyperemesis treatment?
Other researchers theorize that the effects of marijuana can change with chronic use. With the consumption of marijuana increasing due to the legalization of its recreational use in many states, doctors may receive more reports of side effects from marijuana use. It’s still not clear which of the more than 100 cannabinoids found in cannabis are responsible for CHS, but it’s thought that CBD could potentially be a contributor.