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What is Cannabinoid Hyperemesis Syndrome CHS? Part 1

cannabinoid hyperemesis syndrome diet

Both cannabinoid hyperemesis syndrome (CHS) and cyclic vomiting syndrome (CVS) cause people to feel sick to the stomach and throw up at times, while feeling normal at other times. This is more common in men than women and usually starts around 35 years old. These two conditions are hard to distinguish between and the main difference is CHS happens with using a lot of marijuana. Cannabinoid hyperemesis syndrome (CHS) happens when you have cycles of nausea, vomiting and abdominal pain after using cannabis (marijuana) for a long time. People with CHS often find temporary relief from these symptoms by taking hot baths and showers.

Contenidos ocultar
1 How soon after cannabis hyperemesis syndrome treatment will I feel better?
2 Clinical Presentation, work up and differential diagnosis of Cannabinoid Hyperemesis Syndrome
3 What is the treatment for cannabinoid hyperemesis treatment?
4 Cannabis Cessation

How soon after cannabis hyperemesis syndrome treatment will I feel better?

cannabinoid hyperemesis syndrome diet

Hot baths may relieve the nausea for a while, but they don’t cure CHS. Researchers are currently studying several treatment options to manage the hyperemetic phase of CHS. 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 heroin addiction 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.

cannabinoid hyperemesis syndrome diet

Clinical Presentation, work up and differential diagnosis of Cannabinoid Hyperemesis Syndrome

The symptoms typically last a few weeks, though the throwing up should ease up in a day or two. One study looking at Reddit posts on the subject found that spicy food, greasy food, coffee, black tea, and alcohol were frequently mentioned as CHS triggers. These foods/beverages are mostly acidic, but relationships between them and CHS have not been studied scientifically, although the co-use of weed and alcohol is well-known, the study authors said. They may also prescribe antipsychotic medications such as haloperidol (Haldol) or olanzapine (Zyprexa) to help you calm down as you switch to the recovery phase. Researchers aren’t sure exactly why weed causes CHS symptoms only in some people. Δ9-tetrahydrocannabinol (THC) is the principle active compound in cannabis (Figure 1).

What is the treatment for cannabinoid hyperemesis treatment?

  • Standard anti-emetic treatments are typically not effective, and no standardised treatment protocol exists for CHS.
  • When you use marijuana for many years, it can start to slowly change how the receptors in your body respond to the cannabinoid chemicals.
  • In women, a pregnancy test is necessary to assess for any pregnancies, especially ectopic pregnancies.
  • THC is excreted mainly as acid metabolites, with 60–85% cleared through the feces and 20–35% in the urine 20,21.
  • For example, in two recently published series of adult patients with CVS, approximately one third of patients reported daily marijuana use 65,66.

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. For supportive care, a clinician should work together with the pharmacist to see if any medications could contribute to the patient’s presentation. If administering antiemetics, the nursing staff should be familiar with the adverse event profile so they can report any concerns that may arise. One 2018 study found that 32.9% of self-reported frequent marijuana users who’d gone to the emergency room (ER) had symptoms of CHS.

Cannabis Cessation

Patient education should therefore be provided with emphasis on the paradoxical nature of the symptoms of CHS. Furthermore, some authors have reported referring patients to drug rehabilitation programs in an attempt to raise the likelihood of long-term cannabis cessation 54,71. Studies have demonstrated the efficacy of outpatient treatment options such as cognitive behavioral therapy and motivational enhancement therapy for marijuana dependence 73. Two case series and numerous individual case reports have been published on Cannabinoid Hyperemesis Syndrome (CHS) (Table 1). Patients present with recurrent episodes of nausea, vomiting, and dehydration with frequent visits to the emergency department. Patients are typically young adults with a long history of cannabis use.

  • CHS should be considered as a plausible diagnosis in the setting of patients with recurrent intractable vomiting and strong history of cannabis abuse.
  • An intriguing point to keep in mind is that the Rome IV criteria include the phrase «resembling cyclical vomiting syndrome.» In that regard, it is important to distinguish between the two.
  • This underscores the critical need to correlate symptoms with cannabis consumption, ruling out overlapping diagnoses that could be mistaken for CVS.
  • Another proposed explanation is that in susceptible individuals the pro-emetic effect of cannabis on the gut (e.g. delayed gastric emptying) overrides its anti-emetic CNS properties 62.
  • If you have cannabis use disorder and need help quitting, professional treatment is available.
  • The differential diagnosis of nausea and vomiting is extensive and includes a broad range of pathologic conditions affecting the gastrointestinal tract, the peritoneal cavity, CNS, as well as endocrine and metabolic functions 63.

cannabinoid hyperemesis syndrome diet

In nearly all cases there is a delay of several years in the onset of symptoms preceded by chronic marijuana chs symptoms and signs abuse 6. In one study the average duration of cannabis use prior to onset of recurrent vomiting was 16.3 ± 3.4 years 62. There are at least four reported cases where the time lag was equal to or less than three years 54,59,60. Daily marijuana use is characteristic and often reported as exceeding three to five times per day.

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