Cannabis Hyperemesis Syndrome: Causes, Treatment, and More

Propranolol is a nonspecific, lipophilic beta-1/beta-2-blocker that has been used to treat CVS, particularly in pediatric patients 119. The exact cause of Cannabinoid Hyperemesis Syndrome (CHS) is not fully understood. However, it is believed to be linked to long-term, heavy cannabis use. Cannabis affects the body’s endocannabinoid system, which helps regulate various functions like mood, appetite, and pain.

• When people with CHS stop using marijuana, their symptoms of nausea and vomiting usually disappear.
• Many individuals either avoid seeking medical help or don’t mention their marijuana use during a doctor’s visit.
• To lower the morbidity, CHS is best managed by an interprofessional team.

Cannabinoid Hyperemesis Syndrome: A Review of Potential Mechanisms

Indeed, the symptoms of pesticide poisoning are different than the symptoms of CHS. In addition, since pesticides are not exclusive to cannabis, there would be many similar cases that would not be solved with cannabis abstinence. While pesticides can lead to adverse health problems, this is likely not the cause of CHS. This could be another contributing factor in the pathophysiology of CHS (Fig. 1). Cannabis hyperemesis syndrome, a subtype of cyclic vomiting syndrome, causes repeated nausea and vomiting, with symptoms resolving during the recovery phase after cannabis cessation.

Understanding Cannabis Hyperemesis Syndrome

• It’s important to check with the insurance provider to confirm coverage details for specific treatments related to CHS.
• In one small study of eight patients hospitalized with CHS, four of the five who stopped using weed recovered from CHS.
• Cannabis Hyperemesis Syndrome (CHS) is a rare condition that affects regular marijuana smokers, particularly those with chronic cannabinoid use.
• A case series from France reported on 19 cases of CHS from 2012 to 2016, with the majority of patients male, with a mean age of 29.8 years (range 20–48 years), and all regular cannabis users with an average daily consumption of 10 cigarettes per day (range 2–20).
• 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.
• One doctor reported using injectable lorazepam to help control nausea and vomiting symptoms in an adult.

Because you still believe marijuana helps nausea, you might use it more often, accidentally making your condition worse. The ongoing but mild nature of this phase can fool people into thinking they just have a sensitive stomach or deal with morning sickness. CHS is a newly identified condition, so doctors currently know little about it. No clinical guidelines exist, so they must rely on published case reports to treat people with CHS. The only treatments available to people with CHS are those that restore hydration and help control nausea and vomiting. However, many experts consider these treatments to be ineffective for managing nausea and vomiting in people with CHS.

Acute cannabinoid-induced nausea and vomiting

You’ll stay in the hospital until you can hold down regular meals and your vomiting subsides. Diagnosing CHS might take time because not all medical professionals are familiar with it yet. You might need to share specific details or request a referral to a specialist, like a gastroenterologist, if symptoms persist. But once you and your provider identify CHS, you can start working on an effective plan to stop the cycle of vomiting. People might need to skip work, school, or social activities because they’re too sick to function normally.

• Pregnant women may not be forthcoming about their marijuana use, which can complicate diagnosis 121.
• Current findings suggest that the body’s naturally stored cannabinoids might eventually overwhelm receptors in the gut or other systems, flipping the usual script where cannabis often helps with nausea.
• Some people with CHS require pain relievers if abdominal pain is present.
• Hyperemesis syndrome is a condition marked by severe and persistent nausea and vomiting, often accompanied by abdominal pain and dehydration.

Hot showers for symptomatic relief were reported by 17/19 patients 128. Marijuana cessation was recommended to all patients, but there was no long-term follow-up. Unlike CVS and PV, CHS is not usually relieved by antiemetic pharmacological therapy, but many patients exhibit the learned behavior of taking hot showers and baths for temporary symptomatic relief. In some cases, IV haloperidol or lorazepam (for anxiety) may provide relief for the CHS patient 14, 89. In the literature, there is one case report of “atypical CHS” in which the patient found relief from cold showers or other ways to chill himself (use of a fan, lying on cold marble floor) but this case must be viewed as an outlier 99. Treatment guidelines published by the San Diego Emergency Medicine Oversight Commission recommend supportive care (rehydration), patient education, and counsel to stop the use of cannabinoids 100.

Cannabinoid Hyperemesis Syndrome (CHS): Causes, Symptoms, Treatment

In the context of cannabinoid hyperemesis syndrome (CHS), hyperemesis syndrome is a critical component, with patients experiencing recurrent episodes of severe vomiting, persistent nausea, and abdominal pain. These symptoms can be debilitating, leading to significant discomfort and health complications. On the second visit, CHS was diagnosed and the patients were treated with capsaicin cream 0.025% applied in a layer approximately 1 mm thick on the abdomen. In both cases, topical capsaicin provided symptomatic relief in about 30 min.

Recognizing the symptoms and their severity can lead to a more accurate diagnosis and effective treatment plan, ultimately improving the quality of life for those affected by this challenging condition. Doctors have only identified cannabinoid hyperemesis syndrome in the recent past. That means a lot of research is still ongoing to figure out exactly why it happens. Current findings suggest that the body’s naturally stored cannabinoids might eventually overwhelm receptors in the gut or other systems, flipping the usual script where cannabis often helps with nausea.

Cannabis hyperemesis syndrome (CHS) is a form of functional gut-brain axis disorder characterized by bouts of episodic nausea and vomiting worsened by cannabis intake. It is considered as a variant of cyclical vomiting syndrome seen in cannabis users especially characterized by compulsive hot bathing/showers to relieve the symptoms. CHS was reported for the first time in 2004, and since then, an increasing number of cases have been reported.

Health Conditions

Medications are sometimes used to manage symptoms, but they aren’t always fully effective Sobriety in controlling severe vomiting. Doctors might try anti-nausea drugs or pain relievers, but real progress usually hinges on quitting cannabis. If vomiting is so frequent that you’re dangerously dehydrated, you might need hospital care. In that setting, medical staff can give you IV fluids, add electrolytes, and provide nutrition if you can’t keep food down. When you stop using cannabis entirely, you can step into the recovery phase.

Management and Treatment

• However, he opposes recreational legalization — or even casual medical legalization where the difference gets blurred.
• In serious cases, doctors might insert a nasogastric tube, which goes through your nose into your stomach.
• By Anna GiorgiGiorgi is a freelance writer with more than 25 years of experience writing health and wellness-related content.
• With liberalization of marijuana laws and favorable public opinion about the healing properties of cannabis, CHS may be more frequently observed in clinical practice.
• Research suggests that CB1 receptors regulate the effects of marijuana on the gastrointestinal tract.
• One possible treatment option involves the use of benzodiazepines, such as lorazepam, to control nausea and vomiting.

This factor is a key distinguishing feature from cannabis hyperemesis syndrome, where the toxicokinetics of cannabis itself influence the course of the disease. Cannabinoid hyperemesis syndrome (CHS) happens when you have cycles of chs symptoms and signs 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.