Cannabinoid Hyperemesis Syndrome Treatment, Symptoms, More

Nearly 20 years after CHS’s first report, current acute and long-term treatment strategies remain unfamiliar to many practitioners. And primary care providers, are vital in diagnosing and treating CHS as its prevalence rises. This https://ecosoberhouse.com/ will provide more data on CHS and facilitate the development of targeted novel therapeutic interventions for this condition in the future. Also, future longitudinal research exploring genetic predisposition and biomarkers could aid in diagnosing and treating CHS. It is also essential to study the public health implications of the legalization of cannabis in different states and its impact on healthcare utilization.

CHS Phases

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. During this phase, patients may experience morning nausea, abdominal discomfort, or anxiety about vomiting.

Alcohol Rehab & Recovery

Ceasing and abstaining from the use of cannabis is the only treatment that relieves and prevents symptoms of CHS, according to a systematic review on CHS management. While it is possible to return to feeling normal during the recovery phase, research indicates that symptoms recur if cannabis use resumes. Your digestive tract also has a number of molecules that bind to THC and related substances. For example, the drug can change the time it takes the stomach to empty. That’s the tight band of muscle that opens and closes to let food from the esophagus into the stomach. Long-term marijuana use can change the way the affected molecules respond and lead to the symptoms of CHS.

Causes and Risk Factors

Anyone who uses cannabis regularly can develop cannabinoid hyperemesis syndrome, but it is predominantly how long does it take to recover from cannabinoid hyperemesis syndrome found in adults who have been using cannabis at least once a week since their teenage years. It is not known exactly what causes cannabinoid hyperemesis syndrome and why only certain people seem to develop it. Research is ongoing on the exact way that cannabis triggers this problem. In the meantime, the best way to relieve CHS symptoms is to stop using the drug.

• The exact prevalence of CHS is hard to assess due to its variable presentation.
• They are found in lamina propria plasma cells and activated macrophages.

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. These foods/beverages are mostly acidic, but relationships between them and CHS have not been studied scientifically, although the co-use of weed and alcohol is well-known, the study authors said. If you have symptoms, your doctor will do a physical exam and ask for your detailed medical history. Let your doctor know how much marijuana you use and how often you use it.

Chronic cannabinoid usage can lead to recurrent N/V with distinct pathogenesis, known as CHS. There is a need for awareness among the medical community about what cannabis can and cannot do as CHS can lead to death 36. Three mechanisms have been proposed for the development of CHS; these are gastrointestinal CB1 overriding, cannabinoid lipid buildup, and genetic polymorphisms in the P450 system. The exact mechanism, however, remains unknown, and it is out of scope for this review to explore it further. CHS, cannabis hyperemesis syndrome; RCT, randomized-controlled trial. The aim of this systematic review was to highlight current management options for CHS as a potential adverse effect of long-term cannabis use in adults and older populations.

• Cannabis has many active ingredients, including tetrahydrocannabinol or THC.
• This phase begins with severe symptoms that intensify rapidly within a few hours 54.
• The patient had an over 10-year history of smoking cannabis and cigarettes and alcohol consumption of 4–5 units a week.
• In this phase, patients gradually resume normal eating and dietary habits.

A good patient–physician relationship helps achieve CHS remission sooner and avoids unnecessary diagnostic workups 106. Studies indicate that when patients trust their physicians, they are more likely to disclose sensitive health-related behaviors and adhere to medical recommendations 107. This trust also encourages patients to accept a CHS diagnosis, preventing them from seeking unnecessary medical consultations and receiving inappropriate treatments. Amitriptyline is initially started at a low dose of 10 mg at night and gradually increased to 10 mg every 1–2 weeks until the therapeutic effect is achieved 96. Slow up-titration helps to adapt and minimize anticholinergic side effects, including dry mouth, sedation, constipation, postural hypotension, palpitations, chronic fatigue, blurred vision, nightmares, and mild hallucinations.

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As cannabinoids are highly lipophilic and accumulate in adipose tissue, patients with chronic use accumulate cannabis in their body fat over time. Eventually, sufficiently high concentrations may be achieved to stimulate TRP channels to their emetic threshold (9). In several clinical trials, the most common adverse events in patients on cannabidiol included diarrhea, loss of appetite, and less commonly vomiting. Cannabis is the most commonly abused drug in the United States (US).

Diagnostic approach and management

At time of writing, the patient had gone 20 months without requiring hospitalization; however, he had a recent relapse of marijuana use and subsequently required hospitalization. Understanding the ECS and its effects on the vomiting center of the brain are fundamental to explain the effect of cannabis for this biphasic response 21. The ECS is composed of ligands, receptors, signaling, and Alcoholics Anonymous enzymes (its regulators and inhibitors) 22. In one small study of eight patients hospitalized with CHS, four of the five who stopped using weed recovered from CHS.