Cannabinoid hyperemesis syndrome: Causes, symptoms, and treatment

The patient strongly felt as though these symptoms aligned with his clinical course over the prior 8 years. At time of writing, the patient had gone 20 months without requiring hospitalization; however, he had a recent relapse of marijuana use and subsequently required hospitalization. Researchers need to study CHS in more detail to make it easier for doctors to recognize and treat the condition. Further studies are also necessary to determine the causes of CHS and its risk factors. In two case reports, doctors used lorazepam (Ativan) to manage CHS-related nausea and vomiting.

Pre-disposing factors

• Traditional anti-nausea medications are usually ineffective for CHS-related nausea.
• For supportive care, a clinician should work together with the pharmacist to see if any medications could contribute to the patient’s presentation.
• Some researchers have published their findings from their personal experience with the condition in clinical journals.
• Some people with CHS require pain relievers if abdominal pain is present.

To make a diagnosis, your healthcare provider will conduct a thorough physical examination and ask you about your past health and current symptoms. It’s helpful to volunteer your history of cannabis use with your provider if you are not asked about it. Compulsive hot showering or bathing may cannabinoid hyperemesis syndrome be critical in distinguishing CHS from CVS and other conditions with similar symptoms. Studies show that between 90% to 100% of people with CHS use hot showering or bathing to relieve symptoms. Researchers have proposed that this behavior may be included in the diagnostic criteria for CHS.

Dysregulated stress response in nausea and vomiting

Future research, both clinical and pre-clinical, should continue to investigate the underlying mechanism and pre-disposing factors of CHS, to further understand the consequences of high-dose cannabinoid use and dysregulation of the endocannabinoid system. If severe episodes of vomiting occur, hospitalization may be necessary to treat dehydration or stomach inflammation. CHS can lead to critical conditions like electrolyte depletion, seizures, kidney failure, shock, and brain swelling, all of which require medical attention.

Chronic Marijuana Use Can Cause Vomiting Issue

The primary treatment of cannabinoid hyperemesis syndrome is the cessation of cannabis use, as there are no consistently effective alternative treatments. Traditional anti-nausea medications are usually ineffective for CHS-related nausea. However, many patients find relief through hot showers, baths, or topical capsaicin cream, with about 60% reporting improvement with these methods.

First, doctors treating people with CHS advise them to stop using marijuana. During the hyperemesis stage, doctors focus on preventing dehydration and stopping the symptoms of nausea and vomiting. 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. Experts think that when you first smoke weed, your brain signals are more important, but after repeated use of the drug, the brain receptors may no longer respond to marijuana in the same way, causing more nausea and vomiting.

Can CBD cause CHS?

Imaging is up to the discretion of the clinician, depending on various specific factors of history or physical exam, which may be concerning for surgical processes. One study found that 32.9% of self-reported frequent marijuana users who came to an emergency department for care met the criteria for CHS. With the widespread use, increased potency and legalization of marijuana in multiple states in the U.S., CHS may be becoming increasingly common. Cannabinoid hyperemesis syndrome was first described in 2004, so there is limited research into the condition.

What causes cannabis hyperemesis syndrome?

Dental erosion from stomach acid can also be seen, particularly when the attacks are frequent. This can help you avoid more severe problems as your body is robbed of food and water from constant vomiting. Cannabinoid hyperemesis syndrome (CHS) is a somewhat rare problem that involves severe bouts of vomiting. As more states make recreational use of cannabis legal, it is thought that this problem will become more common.

Signs and symptoms

These chemicals can change the time it takes your stomach to empty food. If you do use cannabis, quitting can ward off future episodes of CHS. Symptoms will usually improve after 1 or 2 days, as long as you don’t use cannabis during this time. Symptoms of withdrawal can include disrupted sleep, increased heart rate, sweating, irritability and mood swings, according to the Centers for Disease Control and Prevention. Cannabis can be addictive, and people who stop using it can experience symptoms not unlike opioid or alcohol withdrawal, said Dr. Deepak Cyril D’Souza, director of the Yale Center for the Science of Cannabis and Cannabinoids.

It remains unknown how changes to the endocannabinoid system could lead to the development of CHS and more empirical research is needed to identify the mechanism. People with CHS also tend to have a strong urge to take very hot showers or baths. That’s because hot water can help ease cannabinoid hyperemesis syndrome symptoms like nausea. The hot temperature affects a part of the brain called the hypothalamus, which regulates temperature and throwing up. Cannabinoid hyperemesis syndrome (CHS), or cannabis hyperemesis syndrome, is caused by long-term cannabis (marijuana) use.

What happens if cannabis hyperemesis syndrome is left untreated?

Patients are often diagnosed with the syndrome based on the way they treat their own symptoms. Typically, patients can only find relief from intense and persistent nausea by taking hot baths or showers. Overnight, the nursing staff reported that the patient took multiple, prolonged hot showers. Upon further questioning, he reported the hot showers significantly helped the nausea and abdominal pain.