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Symptoms of CHS likely won’t return if you’ve completely stopped using cannabis. Researchers have only recently discovered CHS, so some doctors or healthcare professionals may not recognize the condition. In two case reports, doctors used lorazepam (Ativan) to manage CHS-related nausea and vomiting. Although this information comes from case reports, doctors can use these criteria to diagnose the condition more quickly. CB1 receptors are mostly present in the brain, but they also occur in other organs. Research suggests that CB1 receptors regulate the effects of marijuana on the gastrointestinal tract.
This positions cannabis as a promising ally for conditions like nausea, IBS, and IBD. Since 2004, doctors have identified key symptoms and characteristics of the condition that can help speed up diagnosis. However, researchers have yet to determine the cause of CHS since it does not affect all users of marijuana. One possible treatment option involves the use of benzodiazepines, such as lorazepam, to control nausea and vomiting. Benzodiazepines are controlled substances that people must use with caution, particularly those with a history of drug use. When people with CHS stop using marijuana, their symptoms of nausea and vomiting usually disappear.
What are the symptoms of CHS?
They are in the cerebral cortex, anterior cingulate gyrus, hippocampus, cerebellum, and basal ganglia. In the https://ecosoberhouse.com/article/best-alcohol-abuse-recovery-diet/ gastrointestinal system, they are present on both intrinsic and extrinsic neurons of the enteric nervous system 31. During the last decade, the discovery of CB1R allosteric modulators has provided new tools to target the CB1R 32. The CB1 receptor is a valuable target for treating a wide range of disorders, including anxiety, pain, and neurodegeneration. However, the development of drug candidates for CB1 is challenged by side effects, rapid tolerance buildup, and the risk of abuse 33.
Table 1. Characteristics of Cannabinoid Hyperemesis Syndrome (CHS) and Cyclic Vomiting Syndrome (CVS).
One 2018 study found that 32.9% of self-reported frequent marijuana users who’d gone to the emergency room (ER) had symptoms of CHS. And a 2022 Canadian study found that ER visits for CHS-related problems had increased 13-fold between 2014 and 2021. (Recreational use and sale of cannabis in Canada was legalized starting in 2018). It’s not clear what percentage of all heavy marijuana users have experienced CHS. The ECS doesn’t stop at appetite; it’s deeply embedded in digestion. CB1 and CB2 receptors line the gut, influencing motility, inflammation, and microbial balance.
⃣ Hyperemesis Phase (Active Episodes)
- Stick to bland, easy-to-digest foods like rice, bananas, and lean proteins.
- These changes from hot bathing are probably not specific to CHS but can be seen across all functional nausea and vomiting disorders, including CVS, and are probably aggravated by cannabis use 9.
- Other cannabinoids, such as CBD and cannabigerol (CBG), may also contribute to the development of CHS.
- CBT and motivational approaches can be provided individually or in groups 93.
- However, doctors exercise caution when prescribing lorazepam because it is a controlled substance with the potential for abuse and addiction.
However, doctors may find it challenging to diagnose the syndrome because people tend not to report their use of marijuana. CHS typically affects individuals younger than 50 years, with a median age of 28 years. Notably, the median age for cannabis initiation in these patients is 16, suggesting that early cannabis use may play a role in CHS development.
- One study looking at Reddit posts on the subject found that spicy food, greasy food, coffee, black tea, and alcohol were frequently mentioned as CHS triggers.
- (Recreational use and sale of cannabis in Canada was legalized starting in 2018).
Triggers (top) and therapies (bottom) mentioned at least three times in our reviewed sample displaying words and phrases of posts. Many people with CHS will compulsively shower or bathe — often for hours every day — to relieve CHS symptoms. Symptoms of CHS typically come on several years after the start of chronic marijuana use. The symptoms typically last a few weeks, though the throwing up should Alcoholics Anonymous ease up in a day or two. This article is opinion, written and medically reviewed by Hytiva’s Chief Science Officer, Robert Seik, PharmD, FMNM based on emerging medical research.
Understanding CHS
The difficulty in diagnosing CHS arises because its symptoms overlap with other gastrointestinal and metabolic disorders, such as gastroparesis, cyclic vomiting syndrome, or peptic ulcer disease. Overlapping symptoms such as abdominal pain and cyclic vomiting are especially difficult to pinpoint to a specific illness. Cannabis hyperemesis syndrome (CHS) is a condition that leads to repeated and severe bouts of nausea, vomiting, and abdominal pains. Symptoms of CHS usually appear after 10 to 12 years of chronic use. Due to the rise in CHS prevalence, likely from cannabis legalization in more states, public health outreach programs can play a crucial role in bringing awareness and prevention to this condition.
Cannabis, Appetite, and Digestion: A Comprehensive Guide to Its Effects and Uses
This effect is thought to be mediated through capsaicin’s interaction with the TRPV-1 receptor, which plays a role in the endocannabinoid system and may modulate nausea and vomiting pathways 41. Most CHS patients present to the emergency department multiple times, often undergoing various diagnostic tests, including lab work and advanced imaging, which typically yield negative results. Common clinical findings include signs of dehydration, electrolyte imbalances, and ketonuria following episodes of severe nausea and vomiting. Studies exploring novel treatments, diagnostic criteria, or the pathophysiology of CHS were also prioritized. If you’re a long-term cannabis user experiencing cyclic vomiting, abdominal pain, and relief with hot showers, consult a healthcare provider for a proper diagnosis.
1. Prodromal Phase
Amitriptyline use is not advised during pregnancy, and it is classified as a Category C drug by the FDA. Carnett’s sign refers to pain elicited by tensing the abdominal muscles or performing a straight leg raise. Lidocaine patches have been proposed as a means to relax the rectus muscle, potentially alleviating abdominal pain during acute flares 91. In patients with CHS, elevated urinary concentrations of the cannabis metabolite carboxy-THC (THC-COOH) exceeding 100 ng/mL are indicative of significant chronic cannabis exposure. Long-term cannabis use is known to alter digestive responses, contributing significantly to CHS symptoms. The rise in THC levels within modern cannabis products has been a substantial factor in the increasing risk of developing CHS.
As CHS is a newly described condition, many doctors may find it challenging to diagnose and treat. Researchers have tried to explain what causes CHS, but further study is necessary. Other pharmacologic alternatives were also explored with mixed to unproven efficacy. You can work with him to decide what care will be used to treat you. She is a communications expert working with Dr. Green Relief, specializing in creating engaging content that promotes holistic health and well-being. Olivia is interested in the intersection of mental health, mindfulness, and alternative therapies, which she explores through her writing.
