Capsaicin, a topical agent with an active compound derived from chili peppers, interacts with transient receptor potential vanilloid-1 (TRPV1) receptors 86. TRPV1 receptors are involved in the modulation of transmitting pain signals and altering pain perception 87. These TRPV1 Substance abuse receptors are present throughout the gastrointestinal (G.I.) tract and the medullary vomiting center.
- This suggests that prompt, accurate diagnosis of CHS may save the healthcare system considerable resources and spare the patient unnecessary testing and procedures.
- A recent, published in 2016, case report describes the first use in the literature of propranolol to treat CHS 117.
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Reports of severe volume depletion resulting in acute kidney injury and severe electrolyte disturbances with rhabdomyolysis have been reported in the literature 49. Severe and persistent vomiting can also lead to Mallory-Weiss tear 47. These studies exemplify the diagnostic difficulty in the identification of CHS and suggest that CHS may be more common than is reported. Many hypotheses have been proposed to explain the pathophysiology of CHS (Table 3); however, the GRADE quality of evidence to support any of the proposed mechanisms was very low. The endocannabinoid system is thought to play a role in gastrointestinal motility 123, 124 appetite 125, nausea/vomiting 126, inflammation 127, mood 128, sleep 129, pain 130, and more. There is also some evidence to suggest that cannabinoids interact directly with CB-1 receptors in the gastrointestinal tract and alter gastrointestinal motility 16, 92, 95, 132–134.
drug-drug interactions
Complications of CHS may include acute renal failure, hypokalemia, hypophosphatemia, esophageal injuries such as Mallory–Weiss tear, and pneumomediastinum. cannabinoid hyperemesis syndrome The primary treatment objectives are intravenous hydration and correction of electrolyte imbalances. Repeated abdominal imaging and extensive laboratory tests, in most instances, yield inconclusive results. Conventional anti-emetics, such as ondansetron and promethazine, are routinely utilized in the acute symptomatic phase 42. A systematic review by Richards et al. 64 showed that these standard anti-emetics are often ineffective when used alone and demonstrated superior efficacy with intravenous benzodiazepines. CHS tends to affect younger people; the patients reported in Table 2 ranged in age from 15 to 47 years.
What Causes CHS?
This level of distress highlights why CHS is much more than a minor digestive complaint. It represents a serious medical concern that can quickly spiral if someone doesn’t stop using marijuana or seek professional treatment. Continual bouts of extreme vomiting and pain can have a severe impact on overall health, including risks like dehydration and electrolyte imbalances. A 42-year-old CHS patient treated for hyperemesis in the hospital presented with a reddish-brown pigmented rash on his trunk and extremities. The patient reported that he got the rash from prolonged exposure to hot water in showers that he took to relieve the symptoms of his CHS 143. Cutaneous problems arise typically from prolonged and excessive exposure to very hot water, heating pads, or hot water bottles.
- If you or someone you care about is struggling with heavy marijuana use and unrelenting vomiting, learning about CHS might explain many of the symptoms you’re seeing.
- Marijuana vape pens have also made it more convenient for young people, with a significant increase of 10th and 12th graders using this method in 2020 compared to 2019, according to the National Institute on Drug Abuse 4.
- Andrews believes that if CHS symptoms were more consistent, it might motivate more patients to stop using cannabis.
- A systematic review of 29 cases of CHS in France was reported by Schreck et al.131 in 2018.
- Literature published between January 2004 and September 2012 was searched in PubMed using the terms “cannabinoid hyperemesis syndrome” and “cannabis hyperemesis syndrome”.
Education focusing on early warning signs could prevent the condition from worsening. Partnership with cannabis producers and retailers to include CHS warnings on packaging similar to alcohol and tobacco products will improve awareness among its users. With more online usage among youngsters, social media campaigns and videos can spread information and awareness of CHS in this population. Public health can aid in creating safe consumption guidelines on lower dose usage for patients using it for medicinal reasons.
Researchers are also comparing product types, dose patterns, and genetic markers. Large, multi-center studies may clarify which factors matter most and guide better treatments for acute flares. Many patients improve within days to weeks, though full resolution can take longer.
As cannabis legalization continues to spread across the country, doctors are sounding the alarm about the potential health risks of the quickly changing drug. One rare condition is sending chronic marijuana users to emergency rooms. Researchers are attempting to spread awareness about that condition, cannabinoid hyperemesis syndrome (CHS), and the need for more government oversight in the legal cannabis industry.
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While symptoms can be managed, the only way to stop CHS for good is to quit using cannabis in any form. Addiction rehab programs or CBT may be helpful resources for quitting cannabis. Speak with a doctor or healthcare professional if you or someone you know has symptoms of CHS. Karen gained expertise in developing training programs and technical documentation as a Senior Editor at Cisco Systems. She began her journey in cannabis as a patient, searching for a way to heal herself.
Cannabinoid hyperemesis syndrome follows a repeating cycle, with three distinct phases that people move through while continuing to use marijuana. These phases can last different lengths of time, and not everyone’s experience is identical. Long-term marijuana use, typically spanning 10 to 12 years or more, is the biggest risk factor for developing CHS. This variance suggests that a range of elements, including individual biology, metabolism, and genetics, can play a role. The condition is tricky because, in the early stages, a person might not vomit.