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. Cannabinoid hyperemesis syndrome (CHS) is a very unpleasant — and potentially dangerous — complication of long-term marijuana use. Because of this possible complication, it’s important to use caution with marijuana and other cannabis products. If you think you have CHS or cannabis use disorder, talk to a healthcare provider.
The Effects of Cannabinoids in the Brain
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. 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. 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. Typical antiemetics such as ondansetron, commonly known as Zofran, have often been found ineffective at suppressing nausea caused by CHS.
Cannabis Hyperemesis Syndrome (CHS)
Cannabidiol (CBD) and cannabigerol (CBG) are two additional cannabinoids found in cannabis that appear to modulate the anti-emetic properties of THC. Cannabidiol, in contrast to THC, is non-psychotropic, has a low affinity for CB1 and CB2 receptors [27], and acts as a partial agonist at the 5-HT1A receptor [28]. CBD enhances the expression of CB1 receptors in the hypothalamus and amplifies the hypothermic effects caused by THC [29]. In animals the effect of CBD on toxin-induced vomiting displays a biphasic response with low doses producing an anti-emetic effect whereas higher doses enhance vomiting [30,31]. To diagnose CHS, a healthcare professional will study your symptoms and ask you questions.
Cannabinoid Hyperemesis Syndrome (CHS) and Marijuana Use
- Approximately 9% of individuals who use cannabis report dependence at some point in their use [5].
- When people with CHS stop using marijuana, their symptoms of nausea and vomiting usually disappear.
- As CHS is a relatively recently recognized and studied phenomenon easily confused with other diseases, there is a paucity of sizeable randomized control studies.
- One of the 4 who recovered went back to using marijuana and the vomiting resumed.
- But not every person who uses marijuana, even long-term use, develops CHS.
- This consideration may prevent further unnecessary workup and health care costs for patients with CHS.
- Drugs with an anticholinergic effect may likewise block medullary mediated vomiting, though they may have minimal impact on visceral stimulation, including the crippling abdominal cramping pain that patients with CHS experience.
The PICO tool was used to inform and guide the keywords used in the search. We assessed adults and older populations with N/V who were using recreational or medicinal cannabinoids. The management options included pharmacological treatments and water hydrotherapy which were compared to placebo. The outcomes https://ecosoberhouse.com/ included the effectiveness of the interventions seen in decreasing N/V induced by cannabinoids. The age range of 18–85 years was chosen to include all adults and the older population, as this age group falls under the category of most frequent cannabis users and thus can develop CHS as well.
A Systematic Review on Cannabis Hyperemesis Syndrome and Its Management Options
If you have cannabis use disorder and need help quitting, professional treatment is available. Future studies are needed to better understand the etiology, prevalence, and risk factors for developing CHS (eg, understanding medical, psychiatric, ethnic, or socioeconomic conditions as well as amount and potency of cannabis). Randomized controlled clinical trials are needed to identify the optimal pharmacotherapy for managing CHS. This can help you avoid more severe problems as your body is robbed of food and water from constant vomiting.
What do experts know about CHS?
The retrospective cohort conducted by Yusuf et al. [25] had a moderate bias in selecting patients in the ED, as there was selective reporting of patient outcomes, as only the LOS in the ED was measured. Nabilone, sold under the brand name Cesamet©, is a synthetic cannabinoid cannabinoid hyperemesis syndrome with therapeutic use as an antiemetic and as an adjunct analgesic for neuropathic pain. Nabilone mimics THC, the primary psychoactive compound found naturally occurring in cannabis. When you do this, your symptoms usually start to go away in few days to a few months.
- There is a growing body of research showing the benefit of cannabis in the aforementioned disorders, and its legalization will further augment research on understanding its critical role in new drug developments [3,4].
- More studies will be required to evaluate the overall prevalence of this condition as well as if there are any changes following the liberalization of marijuana laws in many states.
- Similarly in Europe, cannabis use is prominent among young adults, with a prevalence that has increased from 5% in 1990 to 15% in 2005 [3].
Understanding Cannabis Hyperemesis Syndrome
Once you do that, your repeated nausea and vomiting should go away and not return. Since THC is stored in your body fat, it can take weeks to months before all the symptoms go away and you notice a difference. Smoking extra marijuana won’t help your nausea but will make it worse.
The ECS is composed of ligands, receptors, signaling, and enzymes (its regulators and inhibitors) [22]. The diagnostic criteria for CHS were ill-defined prior to the establishment of the Rome IV criteria of 2016.[20][21] 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. 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 need help quitting, ask your doctor whether a drug rehabilitation program is a good fit for you.
