CB1 receptor activation in the hypothalamus and pituitary gland results in modulation of all hypothalamic-pituitary axes [38]. Receptor activation leads to inhibitory effects on the release of growth hormone, thyroid hormone, prolactin, and luteinizing hormone https://ecosoberhouse.com/ [38]. In animal studies mice lacking CB1 receptors demonstrate enhancement in circadian HPA axis activity peaks and impairment in glucocorticoid feedback [39]. While symptoms begin as mild, they can intensify and increase your risk of severe problems.
Prodromal stage
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.
What do experts know about CHS?
People who use marijuana long-term — typically for about 10 to 12 years — are at risk of developing CHS. But not every person who uses marijuana, even long-term use, develops CHS. Not everyone with the condition seeks medical help or tells their provider that they use marijuana. At this time, the only known way to cure CHS is by quitting cannabis. If you need help quitting cannabis, the Substance Abuse and Mental Health Services Administration offers a 24/7 helpline in English and Spanish. A representative can refer you to local treatment facilities, support groups, and community-based organizations.
- When you do this, your symptoms usually start to go away in few days to a few months.
- Patients with CVS also have times where they are feeling sick to the stomach and can also throw up for between 12 hours to about a week.
- “It’s the best medication that helps her sleep for the last five years.
- Overnight, the nursing staff reported that the patient took multiple, prolonged hot showers.
- However, many experts consider these treatments to be ineffective for managing nausea and vomiting in people with CHS.
Drugs & Supplements
Case reports have demonstrated a remission in CHS symptoms upon cessation of cannabis use for extended periods [6,51–54,57,59–62,68,71]. Unfortunately, many of these patients relapse upon resuming cannabis [6,59,61,62]. It has been suggested that many of these patients increase or continue their cannabis use because of their perception that it will have beneficial effects on nausea [52]. 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].
In one small study of eight patients hospitalized with CHS, four 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.
What are the possible complications of cannabinoid hyperemesis syndrome?
A 2016 case study describes two deaths due to complications of CHS. The cause of death in both people was found to be hyponatremic dehydration, also known as low sodium levels. Keep in mind none of these treatments will be effective if you continue using cannabis products. Stopping cannabis use is the only known way to permanently get rid of CHS. The researchers found that 32.9 percent of the participants reported having experienced symptoms of CHS in the past. A 2017 review of studies found that 97.4 percent of people who developed CHS reported using cannabis at least weekly.
At low doses, the effect of cannabis on your brain can have an antiemetic effect that suppresses nausea and vomiting. However, with repeated use in some people, it can have the opposite effect on the digestive tract. This results in the persistent vomiting and nausea characteristic of CHS. Extensive review of his medical record revealed that the patient had, in fact, presented to the ED with similar symptoms 11 times in the prior 8 years. The typical hospital course included supportive care with antiemetics and IV fluids. The patient’s symptoms typically resolved within 24 to 72 hours of hospitalization.
- There exists no epidemiological data regarding the incidence and prevalence of CHS among chronic marijuana users.
- But too many of them may increase your risk for dehydration due to sweating.
- However, researchers have yet to determine the cause of CHS since it does not affect all users of marijuana.
- This hypothesis is supported by the demonstration of delayed gastric emptying on gastric emptying scintigraphy in some cases [6,55,62].
- With the widespread use, increased potency and legalization of marijuana in multiple states in the U.S., CHS may be becoming increasingly common.
- The only proven way to prevent cannabis hyperemesis syndrome is to avoid cannabis (marijuana).
Cannabinoid hyperemesis syndrome (CHS) is a condition that you might get if you’ve regularly smoked weed or used marijuana in some other form for a long time. CHS causes you to have repeated episodes of vomiting, severe nausea, stomach pain, and dehydration. You’re more likely to get CHS if you use marijuana at least once a week and have been doing so since you were a teenager. “Cannabinoid” refers cannabinoid hyperemesis syndrome to cannabis (marijuana) and “hyperemesis” is a word meaning “prolonged vomiting.” Serotonin antagonism in the gastrointestinal tract from medications such as ondansetron, dolasetron, and granisetron likewise have varying levels of efficacy. Opioids, while often prescribed for the patient’s debilitating abdominal pain, are not appropriate for CHS, as they may, in fact, worsen nausea and vomiting.
- Because so little is known about Cannabinoid Hyperemesis Syndrome and its causes, few treatment approaches have been developed.
- Belly pain and a sense that you are going to vomit are also common.
There are some drugs that may help, such as amitriptyline, Camilleri said. Decades ago, most people had less opportunity to consume cannabis in daily life. “No kid could use continuously throughout the day and also be doing anything else, because they would have been smoking a joint before,” she said. When Dr. Deepa Camenga began her career about 20 years ago, she rarely if ever saw pediatric patients with CHS, she said.