Cannabinoid Hyperemesis Syndrome CHS: Causes, Symptoms & Treatment

Symptoms of CHS likely won’t return if you’ve completely stopped using cannabis. One study found up to 6% of people who went to the emergency room for cyclical vomiting had CHS. The only treatment that can get rid of CHS symptoms for good is to stop using cannabis completely. But there are some other treatments that may help manage your symptoms and make you feel better.

Symptoms and Causes

This activity introduces the pathophysiology, clinical manifestation, and management of cannabis hyperemesis. Data were extracted from individual case reports and summarized as a single large cohort (individual case report synthesis). Next, after exclusion of duplicate cases, the individual case reports were combined with data from the case series and summarized as a single larger cohort (cumulative synthesis). Median values (plus interquartile range) were calculated for age at diagnosis, cannabis use age of onset, and age at symptom onset. The duration of cannabis use prior to symptom onset was categorized as either less than or equal to 1, 2 to 5, 6 to 10, and greater than 11 years. The amount of cannabis consumed was categorized as either less than daily, daily, weekly, less than weekly, or dose not specified.

Assessment of Study Quality

It is often used with cancer patients because it decreases gut transit and increases colon compliance. People have used marijuana for centuries in order to feel high, as part of a spiritual practice, or to ease symptoms of pain, nausea, and vomiting. Its use for medicinal purposes is controversial and remains a matter of great debate among users, scientists, and governing bodies. We created Right as Rain to serve as a resource to connect you with health and wellness information you can trust from researchers, healthcare providers and faculty from UW Medicine and the University of Washington. Once you put your favorite lighters in a drawer and gift your go-to edibles to a friend, it typically takes between two to three weeks of abstinence to feel Substance abuse better and for symptoms to ease. If you’re not totally sold on abstinence quite yet, Walker says some people find temporary relief from symptoms through hot showers or baths.

Medical Marijuana and IBS Relief

The cumulative synthesis (see Table 1) demonstrated that among 64 patients with documented cannabis cessation, 62 (96.8%) had complete resolution of symptoms. The two patients who reported no resolution of symptoms did not have urine testing performed to confirm abstinence 8, 56. There was a significant overlap in the sorting of articles into the categories of diagnosis, pathophysiology, and treatment. We identified 116 articles related to diagnosis, 61 to pathophysiology, and 13 to treatment.

SAEM GRACE-4: Alcohol Use Disorder and Cannabinoid Hyperemesis Syndrome Management in the Emergency Department

Very limited evidence suggests that dopamine antagonist medications and the application of capsaicin cream to the abdomen may be helpful strategies to manage acute symptoms. Though there is not any direct evidence, avoidance of narcotic pain medication may be useful due to the possibility of worsening symptoms and creating dependence. Cannabinoid hyperemesis syndrome (CHS) can affect people who use cannabis (marijuana) long-term. One doctor reported using injectable lorazepam to help control nausea and vomiting symptoms in an adult.

Clinical diagnostic criteria for cannabinoid hyperemesis syndrome

Doctors have a lack of knowledge of CHS, and this makes chs syndrome it hard to identify people with the condition. The evidence supporting these theories is lacking, though, and further study is necessary to confirm the cause of CHS. Researchers are still trying to figure out exactly what causes CHS in some people who regularly use cannabis but not others. A visit with a pediatric clinician is an ideal time to ensure that a teenager knows the correct information, has the opportunity to make certain contraceptive choices, and instill the knowledge that the pediatric office is a safe place to come for help. Researchers are currently studying several treatment options to manage the hyperemetic phase of CHS. Symptoms of CHS typically come on several years after the start of chronic marijuana use.

Low-quality studies are defined as double-downgraded randomized trials or observational studies. Very low-quality studies are defined as triple-downgraded randomized trials or downgraded observational studies or case series/case reports. The only known treatment to permanently get rid of CHS is to stop cannabis use completely. You may have symptoms and side effects of CHS for a few weeks after quitting cannabis. In adult ED patients (over the age of 18) with moderate to severe alcohol withdrawal who are being admitted to hospital, we suggest using phenobarbital in addition to benzodiazepines compared to using benzodiazepines alone.

On the basis that only a small number of regular and long term users of marijuana develop CHS, some researchers suggest that genetics might play a role. Other researchers theorize that the effects of marijuana can change with chronic use. The only way to stop CHS and its symptoms is to completely quit using cannabis. Most people who quit using cannabis experience no more CHS symptoms within 10 days, but sometimes it may take weeks or months for symptoms to stop.

• The SAEM GRACE program addresses the best practices for the care of the most common chief complaints that can be seen on the tracking board of any emergency department in the country, based upon research and expert consensus.
• In addition, higher THC content through selective breeding of plants and more selective use of female buds that contain more concentrated THC levels may cause CHS to appear in patients who report lower amounts of cannabis use 170.
• Nevertheless, some limited evidence suggests a dynamic interplay between cannabinoid metabolism and complex pharmacodynamics at the CB-1 receptor.
• Although proponents of marijuana argue that it can be used safely, it is not without risks.
• Having IBS can be a very frustrating experience as its symptoms can be quite difficult to get under control.

Cannabis has presumably been used by humans for thousands of years, 8 yet CHS is only now being recognized. CHS has been reported numerous times in 9–11 large case series, small case series, and more than 80 individual case reports 6, 8, 11–82. There are many suggested pathophysiologic mechanisms of CHS, though evidence for each is minimal (see Table 3). It is not clear why cannabis appears to suppress emesis under certain circumstances and induces it in others. It is also unknown why only some individuals develop CHS when the use of cannabis is so widespread. If you need help quitting, speak to a healthcare provider or connect with your local addiction treatment services.

This may include providing information about potential cognitive, psychiatric, and physical harms of cannabis use, plus clear patient-centric recommendations. Many adolescents use cannabis to manage anxiety, depression, and/or prior trauma, in which case it is crucial to offer safer options, including psychotherapy and pharmacotherapy with well-studied efficacy and AEs. Indeed, with any syndrome that results in frequent vomiting, there is a concern for a disorder of electrolytes and fluid balance in the body. Patients who fail to respond to antiemetic therapy are at high risk for dehydration and resulting in nutritional deficiencies.