People with CHS often find temporary relief from these symptoms by taking hot baths and showers. Although cannabis is a US Food and Drug Administration-approved treatment for nausea in certain cases, most commonly after chemotherapy, it also has been proved to cause episodic vomiting, known as CHS 2. This biphasic effect of cannabis is minimally understood but can be reasonably linked to THC dosage. The endocannabinoid system is responsible for the mechanisms involving cannabinoid receptors and the hypothalamic-pituitary-adrenal axis 2. Stimulation of this axis results in increased secretion of THC stored in adipocytes, which leads to an intoxicating effect and possible emesis with high dosage 2. Although topical capsaicin is a promising treatment for CHS when standard anti-emetic agents fail, the primary goal is preventing recurrence, which involves patient counseling and continuous support for cannabis cessation 7.
A Systematic Review on Cannabis Hyperemesis Syndrome and Its Management Options
The small RCT published in support of capsaicin had large baseline differences between the capsaicin and placebo groups. The placebo group was “more sick”, having higher baseline nausea which was not corrected for in the analysis 7. CHS is a newly identified condition, so doctors currently know little about it. No clinical guidelines exist, so they must rely on published case reports to treat people with CHS.
How soon after cannabis hyperemesis syndrome treatment will I feel better?
Additionally, some of the statistically significant studies did not measure symptom relief, instead looked at the reduced LOS in hospitals 23, 24, 25, 28, 31. Furthermore, LOS in the ED was used to measure the stabilization of N/V symptoms; however, it was not a marker of CHS cure. In addition to the https://ecosoberhouse.com/ lack of controlled studies, most of the articles published on CHS were descriptive case reports 20, 23, 26, 29, 30, 31, 33, 34, 35. This anecdotal evidence is important clinically; however, CHS and its management options need to be viewed in the broader context of controlled research.
Unveiling the Therapeutic Potential of Hot Showers in CHS Symptom Management
Notably, a hallmark behavior observed in CHS cases is the propensity for pathologic hot bathing or showering. While not exclusive to individuals with CHS, the act of hot bathing or showering manifests in approximately 80-90% of patients with this condition. As the utilization of cannabis transcends traditional boundaries, encompassing medical treatments, recreational indulgence, and wellness pursuits, the profound impact of THC and cannabinoids on gastrointestinal physiology is coming to light.
- If administering antiemetics, the nursing staff should be familiar with the adverse event profile so they can report any concerns that may arise.
- Superior mesenteric artery syndrome, although rare, is linked to high morbidity and mortality when the diagnosis is delayed; thus, it is crucial to consider it in the differential diagnosis for a patient with weight loss and abdominal pain.
- Rare diagnoses and disease interactions such as these, and lack of awareness of them, can lead to cognitive errors.
- Propranolol has also shown relief in N/V for individuals with severe recurrent CHS 34.
- The patient responded well to the treatment with a clinically significant improvement without any adverse reactions.
- This syndrome produces consequences ranging from volume loss to esophagus rupture 15.
- It’s still not clear which of the more than 100 cannabinoids found in cannabis are responsible for CHS, but it’s thought that CBD could potentially be a contributor.
- We assessed adults and older populations with N/V who were using recreational or medicinal cannabinoids.
- As more states legalize cannabis, more people are learning whether cannabis is right for them.
However, doctors may find it challenging to diagnose the syndrome because people tend not to report their use of marijuana. They also experience episodes of vomiting that return every few weeks or months. In refractory CHS cases, experimental therapies such as benzodiazepines, tricyclic antidepressants, and dopaminergic agents like haloperidol have been explored. While the evidence supporting their efficacy is limited, these options could be considered in specific scenarios where conventional treatments prove inadequate. Interestingly, patients dealing with Cyclical Vomiting Syndrome (CVS) also frequently mention this behavior. Yet, with the evolving comprehension of CHS, there is a likelihood that some cases attributed to CVS might actually be undiagnosed instances of CHS, marking it as pathognomonic.
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- Other known complications of forceful and uncontrolled vomiting include aspiration and subsequent pneumonitis or aspiration pneumonia as well as injury to the esophageal wall such as Boerhaave’s syndrome.
- The novel and highlighted unconventional management options for CHS can be solidified as best practice guidelines with future large-scale research initiatives.
In this article, we describe CHS and discuss the causes, symptoms, diagnosis, and treatment of the condition. This evolution has been accompanied by a concerning uptick in cases of Cannabinoid Hyperemesis Syndrome (CHS), characterized by distressing bouts of nausea and vomiting with varying degrees of severity. Chronic cannabinoid usage can lead to recurrent N/V with distinct pathogenesis, known as CHS.
What are the symptoms of cannabis hyperemesis syndrome?
Once at home, it is important to care for oneself through nutrition, hydration, and watching for changes or new symptoms. Small bowel enteroscopy then showed extrinsic duodenal compression in the third portion (Figure 3). Given the findings of an cannabinoid hyperemesis syndrome aortomesenteric angle of 18.1°, aortomesenteric distance of 5.0 mm, and visualized extrinsic compression via enteroscopy, our patient met the diagnostic criteria for SMA syndrome.
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