The primary symptoms of Cannabinoid Hyperemesis Syndrome (CHS) are recurrent severe nausea, vomiting, and intense abdominal pain. It is important to recognize these symptoms for timely intervention. Home remedies can offer temporary relief for those chs hyperemetic phase suffering from CHS. Hot showers or baths are commonly reported to alleviate nausea and vomiting, providing immediate relief for many patients. Despite these insights, the precise mechanisms behind CHS remain unclear. The complexity of how cannabis interacts with various receptors in the brain and gastrointestinal system makes it a multifaceted issue.
What is cannabis hyperemesis syndrome?
Anandamide and 2-AG possess similar biochemical structures, but each has a distinct pathway for biosynthesis and degradation. Anandamide is synthesized from the precursor N-arachidonoyl phosphatidylethanolamine, while 2-AG is produced from an inositol-1,2-diacylglycerol precursor 8,16,17. The metabolism of anandamide is principally carried out via fatty acid amide hydrolase (FAAH), whereas the major enzyme metabolizing 2-AG is monoacylglycerol lipase (MAGL) 18. Additionally, not all cannabis users develop CHS, causing further difficulty in describing the syndrome.
- Certain individuals may have a genetic polymorphisms in the cytochrome P450 enzymes responsible for the metabolism of the cannabinoids 62,72.
- Younger individuals who start using cannabis before the age of 16 are at a heightened risk for developing CHS.
- The hyperemetic phase may continue until the person completely stops using marijuana.
- With the large prevalence of marijuana use in the world, why does it appear that so few patients develop CHS?
- Cannabis products are frequently used to reduce symptoms of certain medical conditions, but in rare cases, prolonged cannabis use may result in certain symptoms like nausea, vomiting, and abdominal pain.
- People have lots of allergies, but is it possible to have a cannabis allergy?
The Exogenous Cannabinoids
In one small study of eight patients hospitalized with CHS, four marijuana addiction 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 CHS and don’t stop using, your symptoms like nausea and vomiting are likely to come back. 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. Most people with CHS who stop using cannabis have relief from symptoms within 10 days.
Cannabinoid Hyperemesis Syndrome Treatment
But with repeated use of marijuana, certain receptors in the brain may stop responding to the drug in the same way. That may cause the repeated bouts of vomiting found in people with CHS. Lots of patients with CHS find relief from heat therapy such as hot showers & baths, a heating pad also works! Although there’s no official reason for why this provides relief for CHS patients, scientists believe that warm temperatures correct the cannabis-induced disequilibrium at the thermoregulatory centers. Heat/hot showers also activates TRPV1 which helps with inhibiting pain signals, resulting in analgesic and antiemetic effects. Rimonabant, a CB1 antagonist, blocks the appetite stimulating qualities of the cannabinoids in the hypothalamus and has been marketed for the treatment of obesity and metabolic dysfunction 34.
- The pro-emetic effects of two of these cannabinoids, CBD and CBG, have been discussed in this review and could conceivably play a role in the development of CHS.
- This statistic underscores the need for continued research and awareness to better understand and manage this condition.
- As cannabis use becomes more prevalent, healthcare providers are seeing an increase in a concerning condition called Cannabinoid Hyperemesis Syndrome (CHS).
- Intravenous fluids restore electrolyte balance and offer immediate relief.
- Brief intervention can include motivational interviewing toward reducing harm and/or use.
- The characteristics, signs, and symptoms of CHS were discussed with the patient.
How Long Does It Take to Recover from Cannabinoid Hyperemesis Syndrome?
Importantly, they are all mutations that are not found in frequent cannabis users without CHS symptoms. These genes impact the TRPV1 receptor, dopamine receptors, and the enzyme CYP2C9 (which is responsible for metabolising THC in the liver). Each of these genes impact some aspect of cannabinoid metabolism or CHS symptomatology—suggesting that this isn’t a coincidence. CHS is a paradoxical condition where long-term cannabis use leads to severe episodes of vomiting and nausea https://ecosoberhouse.com/ – symptoms that cannabis is often used to treat.
CBD enhances the expression of CB1 receptors in the hypothalamus and amplifies the hypothermic effects caused by THC 29. In animals the effect of CBD on toxin-induced vomiting displays a biphasic response with low doses producing an anti-emetic effect whereas higher doses enhance vomiting 30,31. Depending on the severity of a patient’s symptoms, they may require additional treatment on top of ending cannabis consumption. In some rare cases, those with severe symptoms during the hyperemesis phase may require hospitalization, where they may receive treatment for dehydration or stomach inflammation. Since only a small portion of frequent cannabis consumers appear to develop CHS, it’s possible that genetics may play a role.
- Subsequently, the effects of cannabis on the digestive tract may become more apparent, resulting in the symptoms of CHS.
- The cannabis plant contains over four hundred different chemicals, with sixty possessing cannabinoid structures 76.
- These compounds are referred to as endogenous cannabinoids, or endocannabinoids.
- Nearly 100 different metabolites have been identified for THC 24.
- A recent review has explored numerous potential explanations regarding various pharmacokinetic and pharmacodynamic factors of the cannabinoids 72.
- Following the hyperemetic phase is the recovery phase, in which patients resume normal eating patterns and symptoms begin to improve.
During this time, symptoms subside and patients will regain their appetite. If a patient consumes cannabis again after recovering from CHS, there is a high potential that symptoms will return and they will re-enter the prodromal phase of the illness. CHS is not permanent in the sense that most people will recover from symptoms once they stop consuming cannabis products. However, once a patient develops CHS, any future cannabis consumption may prompt a recurrence of the condition. A study of 98 CHS patients found that the only patient whose symptoms were not improving upon a follow-up medical visit had started consuming cannabis again.
How soon after cannabis hyperemesis syndrome treatment will I feel better?
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. 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. The patient’s urine drug screen (UDS) was positive for tetrahydrocannabinol (THC). A computed tomography (CT) scan of his abdomen and pelvis with contrast was unremarkable.