As CHS is a relatively recently recognized and studied phenomenon easily confused with other diseases, there is cannabinoid hyperemesis syndrome 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.
Differential Diagnosis
- No clinical guidelines exist, so they must rely on published case reports to treat people with CHS.
- Since there are so many active chemicals in cannabis, the exact cause of cannabinoid hyperemesis syndrome is unknown.
- With there being so little research on the syndrome, experts are not sure why heat soothes the symptoms, “nor why certain chronic marijuana users develop it and others don’t,” said the Times.
- The only known treatment to permanently get rid of CHS is to stop cannabis use completely.
Doctors have also noticed that people in the hyperemesis stage take frequent showers and baths, which seem to relieve nausea. People in the hyperemesis stage will experience intense and persistent nausea and vomiting. On the basis that only a small number of regular and long term users of marijuana develop CHS, some researchers suggest that genetics might play a role. Other researchers theorize that the effects of marijuana can change with chronic use. With the consumption of marijuana increasing due to the legalization of its recreational use in many states, doctors may receive more reports of side effects from marijuana use. When people are sick, they can also sweat and just not feel right.
- But a 2019 study concluded that it potentially accounts for up to 6 percent of emergency room visits for recurrent vomiting.
- In one study of frequent cannabis users with potential CHS symptoms, 33% of participants met the definition of CHS.
- Researchers are trying to understand why some people develop it and others don’t.
- As people with CHS often only consult their doctors during the hyperemesis stage, there is a lack of knowledge regarding the treatment of people during the prodromal stage.
- And it’s true that if you’re vomiting because of nausea, you may feel better afterward.
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D’Souza speculates that it may have to do with some people’s endocannabinoid systems. The evidence supporting these theories is lacking, though, and further study is necessary to confirm the cause of CHS. Researchers have identified two receptors called CB1 and CB2 to which marijuana molecules attach. Receptors are specialized cells that respond to specific stimuli or changes in =https://ecosoberhouse.com/ the environment. But occasionally, patients who arrive at a hospital with what initially looks like CHS can instead have pancreatitis, gastritis, gastrointestinal reflux disease (GERD), appendicitis, or other problems.
Population Health Research Capsule.
This can happen when you are stressed, excited, have an infection or when women have their period. Anecdotally, Heard says, the number of CHS patients whose symptoms are serious enough that they end up at a hospital for treatment has leveled off at one or two per day at University of Colorado Hospital. He also warned that people with serious mental illnesses, such as schizophrenia, should be cautious about marijuana use, as studies show cannabis can exacerbate the effects of those illnesses. Neither the psychological treatments nor the pharmacological treatments seem to be that effective,” he said. Camilleri also said that cannabis use is positively correlated with anxiety and depression, and noted that doctors should treat the whole patient and not just the disorder. “There is evidence that if you send a message to the brain that competes with the message that’s causing the nausea, vomiting, that you can suppress it,” Camilleri said.
The throwing up can be bad and can cause you to be low on body water. We fix this by giving the water back through the veins and giving drugs to stop the sick feeling and lower the acid in the stomach. “If you want to talk about a recreational drug, I’ll tell you right now, I spend a lot more of my time taking care of patients who have problems with alcohol and methamphetamines than with cannabis,” he said. Ultimately, the only way to guarantee health is by totally abstaining, he added. If the patient quits cannabis consumption, vomiting due to CHS largely subsides. It’s possible that with lower amounts or lower frequency, patients might be able to use cannabis again, but the science is unclear.
What can I do to help my body recover from episodes of vomiting?
- People who use marijuana long-term — typically for about 10 to 12 years — are at risk of developing CHS.
- With these new products, hospitals saw influxes of CHS, and researchers called for more public health guidance and education for providers.
- In two case reports, doctors used lorazepam (Ativan) to manage CHS-related nausea and vomiting.
- This activity introduces the pathophysiology, clinical manifestation, and management of cannabis hyperemesis.
- Furthermore, lengths of stay are reduced when unnecessary testing is avoided.
- Medical marijuana has long been prescribed for nausea and appetite loss for people with cancer and HIV/AIDS, and the Food and Drug Administration has approved drugs with synthetic THC for use by chemotherapy patients.
“People with CHS often report temporary relief of symptoms from bathing in hot water, which may lead to compulsive bathing,” Angulo says. This suggests that the area of the brain that’s involved in regulating body temperature—the hypothalamus—might be involved in CHS, D’Souza says. Cannabinoid hyperemesis syndrome (CHS) happens when you have cycles of nausea, vomiting and abdominal pain amphetamine addiction treatment after using cannabis (marijuana) for a long time. People with CHS often find temporary relief from these symptoms by taking hot baths and showers. With widespread cannabis legalization across the country, a rare and painful disorder is emerging.
PROCESS TO DEVELOP CHS TREATMENT GUIDELINE
Speak with a doctor or healthcare professional if you or someone you know has symptoms of CHS. To diagnose CHS, a healthcare professional will study your symptoms and ask you questions. They’ll also examine your abdomen and may order tests to rule out other causes of vomiting. In one study, about 84% of people who received treatment for CHS stopped using cannabis, and of those, about 86% reported resolution of symptoms.
If you think you have CHS or cannabis use disorder, talk to a healthcare provider. Per the consensus guideline, treatment should focus on symptom relief and education on the need for cannabis cessation. Capsaicin is a readily available topical preparation that is reasonable to use as first-line treatment. Antipsychotics including haloperidol and olanzapine have been reported to provide complete symptom relief in limited case studies. Conventional antiemetics including antihistamines, serotonin antagonists, dopamine antagonists and benzodiazepines may have limited effectiveness. Emergency physicians should avoid opioids if the diagnosis of CHS is certain and educate patients that cannabis cessation is the only intervention that will provide complete symptom relief.
What is the treatment for cannabinoid hyperemesis treatment?
When expanded to the general U.S. population, research indicates that about 2.75 million Americans annually may experience CHS. With the continued use of cannabis and a lack of treatment, symptoms become more intense. Problems with keeping food and water down can lead to dehydration. The only treatment known to cure CHS is to stop using cannabis and not resume its use.