Importantly, for the definition of cyclic vomiting syndrome, these episodes of vomiting cannot be attributed to other disorders. This factor is a key distinguishing feature from cannabis hyperemesis syndrome, where the toxicokinetics of cannabis itself influence the course of the disease. If you have cannabinoid hyperemesis syndrome (CHS), the best treatment is to stop using weed, even if you’ve been doing it for years with no previous side effects.
Symptoms and Causes
Other known complications of forceful and uncontrolled vomiting include aspiration and subsequent pneumonitis or aspiration pneumonia as well as injury to the esophageal wall such as Boerhaave’s syndrome. While marijuana seems to bring on nausea in the stomach, in the brain it usually has opposite effect. When cannabinoids bind with brain receptors, they tend to prevent nausea and vomiting.
Cannabinoid Hyperemesis Syndrome: A Review of Potential Mechanisms
Some researchers have published their findings from their personal experience with the condition in clinical journals. Researchers have identified two receptors called CB1 and CB2 to which marijuana molecules attach. Receptors are specialized cells that respond to specific stimuli cannabinoid hyperemesis syndrome or changes in the environment. Researchers aren’t sure exactly why weed causes CHS symptoms only in some people. The two major metabolites found in humans are 11-hydroxy-Δ9-tetrahydrocannabinol (11-OH-THC) and 11-nor-9-carboxy-THC- Δ9-tetrahydrocannabinol (THC-COOH) [20].
Can You Treat CHS Symptoms at Home?
Changes to the endocannabinoid system in the hypothalamus from cannabinoid use could lead to a dysregulated stress response, and perhaps contribute to the development of CHS. This suggests that high doses of THC can lead to low levels of endocannabinoids within the hypothalamus, which may prevent inhibitory control of the HPA axis. More research is still needed to understand the impact of cannabinoids on hypothalamic endocannabinoid and endocannabinoid-related enzymes. While conventional antiemetic medications like serotonin 5-HT3 receptor antagonists and dopamine antagonists can be prescribed to manage nausea and vomiting in CHS patients, their efficacy in CHS cases is limited.
These studies only provide estimates, and rely on accurate diagnosis and disclosure of cannabis use; therefore, they are likely underestimations of the actual prevalence. Indeed, Habboushe et al.64 acknowledge the limitations of their estimation and conclude that CHS is much more prevalent than is recognized in society. Prevalence cannot accurately be determined until accurate diagnosis and classification are agreed upon.
Wellness Phase
Symptoms of CHS can resemble those of other conditions, such as cyclic vomiting syndrome. Notably, a hallmark behavior observed in CHS cases is the propensity for pathologic hot bathing or showering. While not exclusive to individuals with CHS, the act of hot bathing or showering manifests in approximately 80-90% of patients with this condition.
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- The management options included pharmacological treatments and water hydrotherapy which were compared to placebo.
- In one study the average duration of cannabis use prior to onset of recurrent vomiting was 16.3 ± 3.4 years [62].
- It’s helpful to volunteer your history of cannabis use with your provider if you are not asked about it.
- Changes to the endocannabinoid system in the hypothalamus from cannabinoid use could lead to a dysregulated stress response, and perhaps contribute to the development of CHS.
Researchers are continuing to examine potential treatment options for CHS. After stopping cannabis use, symptoms generally resolve within days or months. Despite the scarcity of randomized controlled trials (RCTs) on optimal treatment approaches for CHS, a holistic care plan can significantly enhance patient outcomes and well-being. It’s still possible to develop CHS if you use cannabis for many years without having any problems. THC and other chemicals in cannabis also bind to molecules in your digestive tract.
Cannabis Hyperemesis Syndrome (CHS)
- Ironically, one of the potential complications of long-term cannabis use is a condition called cannabis hyperemesis syndrome (CHS).
- We assessed adults and older populations with N/V who were using recreational or medicinal cannabinoids.
- Additional treatments are needed and efforts to discontinue cannabis abuse are paramount.
- With the continued use of cannabis and a lack of treatment, symptoms become more intense.
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