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].
Diagnosis and management of cannabinoid hyperemesis syndrome
I would call every day to see whether the results were in, but for months, I heard nothing. Finally, on March 6, 2019 — my birthday — I was able to pick up the autopsy report. The official cause of death was dehydration due to cannabinoid hyperemesis syndrome. There is a new condition that is affecting marijuana users at a growing rate, and it’s called cannabinoid hyperemesis syndrome (CHS). At low doses, the effect of cannabis on your brain can have an antiemetic effect that suppresses nausea and vomiting.
Review Questions
Medical treatment is essential for anyone experiencing extreme vomiting, since it can cause serious, and even fatal dehydration. Paradoxically, CHS causes excessive vomiting and is related to long-term marijuana use. Understanding what CHS is, can help us better understand why the syndrome affects some people the way it does. This systematic review is the first and most comprehensive characterization of the CHS literature. We believe that these evidence-based recommendations will improve diagnosis, highlight the limitations of pathophysiology understanding, and provide guidelines for treatment of this difficult condition.
Cannabinoid Hyperemesis Syndrome Management
The only way to end CHS symptoms is to completely stop using all marijuana products. After you quit, you may still have symptoms and side effects for a few days to a few weeks. 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.
Dysregulated stress response in nausea and vomiting
It should be noted there was limited evidence for propranolol use as it was the only case study we found involving a single patient [34]. If you have cannabis use disorder and need help quitting, professional treatment is available. Habboushe concluded in his study that as many as 2.75 million regular cannabis users may suffer from symptoms of CHS, though many of them may be mild. Mild symptoms can serve as a warning to discontinue cannabis use to avoid more severe distress down the line, Habboushe said. A study published last year in the journal Basic & Clinical Pharmacology & Toxicology surveyed urban emergency room patients who smoked marijuana 20 or more days a month. First described 15 years ago, CHS symptoms follow heavy cannabis use and include intense stomach pain, bouts of vomiting and debilitating nausea.
- A study published last year in the journal Basic & Clinical Pharmacology & Toxicology surveyed urban emergency room patients who smoked marijuana 20 or more days a month.
- Furthermore, LOS in the ED was used to measure the stabilization of N/V symptoms; however, it was not a marker of CHS cure.
- CHS is a constellation of symptoms including severe cyclical nausea and vomiting and epigastric or periumbilical abdominal pain as a result of long-term cannabis use.
- Cannabinoid hyperemesis syndrome (CHS) is a paradoxical condition in which a long-term cannabis user suffers an episode of intractable vomiting that may last days separated by longer asymptomatic periods of weeks or months.
- Symptoms are most common in early middle-aged adults who have used cannabis regularly since adolescence.
Highlights of the Study
Smoking extra marijuana won’t help your nausea but will make it worse. Cyclical nausea and/or vomiting was the most common feature (97.2%) followed by epigastric pain (28.9%) and abdominal pain described as cyclical (24.6%) (Table 2). Management cannabinoid hyperemesis syndrome was defined as administration of any medication, administration of intravenous (IV) fluids and any other invasive procedure. Those suffering from severe nausea sometimes turn to hot showers or baths to relieve their symptoms.
- The belief in marijuana as a therapeutic and benign agent is so pervasive among some patients and certain healthcare personnel that they will persist in using cannabinoids, even if they are educated about the role of marijuana as a potential proemetic [1, 13].
- If this flap doesn’t work properly, your stomach acids might flow upward and cause you to have nausea and vomiting.
- The Drug Abuse Warning Network (DAWN) states that marijuana mentions (the number of times “marijuana” is mentioned in a medical record) have increased 21% from 2009 to 2011 [3].
- The cannabis plant contains over four hundred different chemicals, with sixty possessing cannabinoid structures [76].
- One of the 4 who recovered went back to using marijuana and the vomiting resumed.