A Systematic Review on Cannabis Hyperemesis Syndrome and Its Management Options PMC
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 https://ecosoberhouse.com/ feel better. The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S.
Treatment / Management
The most effective treatment during the hyperemetic phase of CHS is the use of hot showers by patients. The effects of this learned behavior are temperature-dependent [6], fast acting [6], but short-lived [6,56,62]. Hot showers improve symptoms of nausea and vomiting [6,52–56,60,62,68,71], abdominal pain [6,56,71], and decreased appetite [68] during the hyperemetic phase. The precise mechanism by which hot bathing produces a rapid reduction in the symptoms of CHS is unknown.
What are the symptoms?
If symptoms persist and you continue to use cannabis, you may experience more severe problems that require hospitalization for treatment. They can begin as mild problems that make you feel sick in the morning. Δ9-tetrahydrocannabinol (THC) is the principle active compound in cannabis (Figure 1). The metabolism of THC occurs mainly in the liver via oxidation and hydroxylation reactions. In humans this is carried out largely by the CYP2C isoenzyme subfamily of the cytochrome P450 complex [19]. The true elimination plasma half-life of THC has been difficult to calculate, but several studies have estimated it to be in the range of 20–30 hours [20].
How is cannabis hyperemesis syndrome treated?
- The extract of the plant cannabis sativa has been reported to be used for decades in the control of pain and cramps, according to the Chinese literature [1].
- Cannabidiol, in contrast to THC, is non-psychotropic, has a low affinity for CB1 and CB2 receptors [27], and acts as a partial agonist at the 5-HT1A receptor [28].
- Doctors have a lack of knowledge of CHS, and this makes it hard to identify people with the condition.
- Symptoms are most common in early middle-aged adults who have used cannabis regularly since adolescence.
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. The only treatments available to people with CHS are those that restore hydration and help control nausea and vomiting. Doctors have also noticed that people in the hyperemesis stage take frequent showers and baths, which seem to relieve nausea.
Based on the categorization of functional disorders developed by Rome III, chronic marijuana use (CHS) is recognized as a mechanism for nausea and vomiting distinct from CVS [67]. Although both conditions share an astonishing similarity, there are several significant differences. For example, CVS patients cannabinoid hyperemesis syndrome usually have important psychological comorbidities including depression and anxiety [64,65]. In addition, CVS patients have a high prevalence of migraine headaches or a family history of migraines. Furthermore, gastric emptying rates in patients with CVS are often accelerated rather than delayed [46,65].
How Common Is CHS?
They’ll also examine your abdomen and may order tests to rule out other causes of vomiting. Cannabinoid hyperemesis syndrome (CHS) is a rare condition that develops in people who use cannabis frequently over a period of several years. CHS is a condition caused by chronic and repeated cannabis use that leads to severe nausea and vomiting. In one 2018 study, a group of researchers surveyed 2,127 U.S. adults between the ages of 18 and 49 at an emergency department in New York.
Cannabis can both induce and subdue vomiting, a paradox doctors don’t fully understand, Camilleri said. Medical marijuana has long been prescribed for nausea and appetite loss for people with cancer and HIV/AIDS, and the Food and Drug Administration has approved drugs with synthetic THC for use by chemotherapy patients. In two case reports, doctors used lorazepam (Ativan) to manage CHS-related nausea and vomiting. However, many experts consider these treatments to be ineffective for managing nausea and vomiting in people with CHS.
- People who use marijuana long-term — typically for about 10 to 12 years — are at risk of developing CHS.
- Typical antiemetics such as ondansetron, commonly known as Zofran, have often been found ineffective at suppressing nausea caused by CHS.
- After stopping cannabis use, symptoms typically start to disappear within one to two days though individual results can vary.
- A computed tomography (CT) scan of his abdomen and pelvis with contrast was unremarkable.
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 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. Many different treatments and dosages have been reported among case studies, which may not be generalized to the wider population. It is uncertain whether other adverse effects, rather than N/V, may have arisen from cannabinoid administration. Currently, there is no reliable management regime for patients with CHS with the exception of complete cessation of cannabis and response to conventional antiemetics is insufficient.