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Cannabinoid hyperemesis syndrome: Care instructions
Miriam, for example, got her prescription from a doctor she had never previously met, located in a cannabis medical clinic in the same building as the dispensary. They ask you a few questions, and then they write you a prescription and you walk out the door,” Miriam said. McIff is an outspoken advocate of supervised medical cannabis, but also an outspoken opponent of recreational legalization.
How can I prevent CHS?
If you are experiencing severe vomiting or other concerning symptoms, contact your health care provider. As many other health problems could lead to repeated vomiting, it’s important to discuss your complete health history, including your cannabis use, with any provider you see for your symptoms. As CHS is a relatively recently recognized and studied phenomenon easily confused with other diseases, there is a paucity of sizeable randomized control studies. Most resources and recommendations come from case studies and expert opinions. In addition to appropriate antiemetic therapy, fluid resuscitation, and management of the patient’s symptoms, patients must recognize behaviors and exposures that place them at risk for their pathology. Sober living home For supportive care, a clinician should work together with the pharmacist to see if any medications could contribute to the patient’s presentation.
- He says more research is needed to understand why some people suffer from the condition after prolonged cannabis exposure and others do not.
- Recent polls show that 88 percent of Americans favor legal medical use of cannabis, and 60 percent full legalization.
Cannabis Hyperemesis Syndrome (CHS)
Thus, learned behavior of bathing in hot water may be used to help diagnose CHS and differentiate it from other CVS 93. Over 90% of CHS patients exhibit this behavior 75, which is sometimes described as compulsive. The patient found that hot water relieved his symptoms better than anything else. After 3 days in the hospital (and no marijuana use), his symptoms resolved 94. It should be noted that in the case of CHS, compulsive showering in hot water is not an anxiety disorder but rather a learned behavior that the patient develops to relieve symptoms 94. Similar to hot water, capsaicin provides symptomatic relief of CHS 95, 96, 97 but not other vomiting disorders.
What causes cannabis hyperemesis syndrome?
- Symptoms of CHS usually show up years after a person starts using marijuana regularly.
- Skip foods and beverages that irritate the stomach, such as alcohol, caffeine, and spicy foods.
- Cannabinoid hyperemesis syndrome (CHS) is a condition that can happen to anyone who uses cannabis especially if you use it regularly.
- People with CHS might also struggle with an electrolyte imbalance, which can harm the heart, kidneys, and other vital organs.
- But why is CHS an episodic condition with sometimes very long asymptomatic periods between attacks?
Taking too many hot baths can increase dehydration due to sweating. 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. Many people with CHS will compulsively shower or bathe — often for hours every day — to relieve CHS symptoms.
Phase 2: Symptom Relief
A recent, published in 2016, case report describes the first use in the literature of propranolol to treat CHS 117. A 37-year-old man in profound distress suffering hyperemesis presents at the ED, stating he had similar experiences in the past which could be relieved with hot showers, but this time hot water provided no relief. The patient admitted he had smoked marijuana on a daily basis for the past 20 years. In the ED, the physician treated him with IV propranolol 1 mg as this had been effective in cases of CVS. The patient continued to experience symptoms and received a second dose of IV propranolol 1 mg an hour later, whereupon his symptoms stopped completely.
Understanding Cannabis Hyperemesis Syndrome
Cannabinoid hyperemesis syndrome (CHS) involves episodic cyclic vomiting that occurs in some cannabis users. Typical symptoms include intractable nausea and vomiting, refractory to conventional antiemetic therapy, often accompanied by abdominal pain. Other symptoms may include sweating, flushing, thirst, weight loss, and changes in body temperature.
In 2018, the International Cannabis Policy Study found that 27 percent of North Americans between 16 and 65 had used cannabis to help with pain, sleep, migraines, anxiety, depression and PTSD. Conditions that qualify under Utah’s medical cannabis law include HIV, Alzheimer’s, ALS, cancer, Crohn’s disease, epilepsy, multiple sclerosis and PTSD. Meltzer says it is important for clinicians to advise those with frequent cannabinoid use or hyperemesis about the risks and subsequent disease burden. He says many patients don’t realize that the syndrome is connected with their use of cannabis. Physicians should explain that and advise patients on resources to help them quit, he says.
Health News
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. Keep in mind none of these treatments will be effective if you continue using cannabis products. The researchers found that 32.9 percent of the participants reported having experienced symptoms of CHS in the past. Compulsive bathing or showering in hot water to soothe nausea is also a hallmark sign of CHS. Researchers are trying to understand why some people develop it and others chs symptoms and signs don’t.
Maternal cannabinoid use alone does not necessarily mean that hyperemesis is CHS. Gastric motility and gastroparesis must be discussed in the context of CHS. The enteric nervous system contains CB1 receptors, which, when activated, can inhibit GI motility by inhibiting the release of those transmitters that cause stomach contractions 47. This effect causes delayed gastric emptying and continues to inhibit transit through the small intestine. The effects are similar to gastroparesis and, thus, CHS may be caused by a functional gastroparesis. Activating CB1 receptors reduces gastric motility, resulting in delayed gastric emptying in murine 49, 50 and human studies 51, 52.