The reason why I know so much about this is that it happened to my son. TRPV-1 is also found in the peripheral nervous system and is thought to be involved in the dysregulation of the endocannabinoid system in the hypothalamus, and capsaicin is known to exert its effects on this system 12, 13. Capsaicin binds TRPV-1 with high specificity and responds to high temperature and substance P regulation 22.
Signs and symptoms
- While the precise physiological mechanisms underpinning this phenomenon continue to be explored, several theories shed light on why hot showers might hold therapeutic value for CHS patients.
- Researchers aren’t sure exactly why weed causes CHS symptoms only in some people.
- Concerns for cannabis hyperemesis syndrome were raised given the repeated bouts of abdominal pain, nausea, and vomiting with benign abdominal exam in the setting of recent increased use of marijuana.
The second-line agents include haloperidol, olanzapine, or topical capsaicin. Although some case reports have reported good outcomes in CHS with triptans (sumatriptan), we need more randomized controlled trials (RCTs) based on data on the triptans’ efficacy and long-term safety in marijuana-induced CHS. Dronabinol, which is a synthetic of delta-9-tetrahydrocannabinol (THC), has been used to manage nausea and vomiting caused by chemotherapy 10. It has been shown to be just as effective, if not better, than regular anti-nausea drugs 10. In a report about a pregnant patient with CHS, they found relief from symptoms using diphenhydramine, haloperidol, and dronabinol 6. However, the use of dronabinol for CHS is not widely studied, as most studies have focused on its use for chemotherapy-related nausea and vomiting 11.
For Health Professionals
- Serotonin antagonism in the gastrointestinal tract from medications such as ondansetron, dolasetron, and granisetron likewise have varying levels of efficacy.
- Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
- The profuse vomiting and potential dehydration inherent in CHS often mandate intravenous fluids administration to correct electrolyte imbalances and sustain hydration levels.
- 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.
Rare severe complications of CHS include heart rhythm abnormalities, kidney failure, seizures, and death. Risk factors for CHS include heavy cannabis use (typically daily or multiple times per day) for more than 1 year. Higher rates of CHS are reported in people who use cannabis before age 16 years, have other substance use disorders, and/or smoke cigarettes. The Rome Foundation (Rome IV) has emerged as a beacon of clarity in the labyrinth of diagnosing Cannabinoid Hyperemesis Syndrome (CHS), categorizing it as a variant of cyclical vomiting syndrome under the umbrella of functional gut-brain disorders. With the absence of definitive biomarkers, the diagnostic journey for CHS predominantly revolves around the process of exclusion. With the expanding acceptance and legalization of cannabis worldwide, healthcare providers face a crucial imperative to accurately identify CHS amidst https://ecosoberhouse.com/ a sea of similar clinical presentations.
- They agreed with the CHS diagnosis and ordered monitoring of his levels, which improved with the rehydration again.
- Another doctor asked Brian if he smoked marijuana, and he said that he did.
- One of the 4 who recovered went back to using marijuana and the vomiting resumed.
- The only known treatment to permanently get rid of CHS is to stop cannabis use completely.
- One limitation lies in its reliance on a solitary case without a comparison group, which hampers the applicability of the findings.
Differential Diagnosis
In one study, about 84% of people who received treatment for CHS stopped using cannabis, and of those, about 86% reported resolution of symptoms. 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 cannabinoid hyperemesis syndrome sometimes it may take weeks or months for symptoms to stop. Symptoms of CHS likely won’t return if you’ve completely stopped using cannabis. Cannabinoid hyperemesis syndrome (CHS) is a rare condition that develops in people who use cannabis frequently over a period of several years.
Cannabinoid-Associated Hyperemesis Syndrome Treated With Dronabinol: Killing a Poison With the Poison
Another study in 2017 by Dezieck et al. 4 reported similar findings that after the use of several antiemetics failed, their patients experienced resolution of symptoms with the use of topical capsaicin. In the case of our patient, she received antiemetics earlier with no relief which warranted the physicians to change to topical capsaicin that resulted in near resolution of symptoms. Some case reports and case series have also suggested the use of haloperidol to be effective 27–30. Severe nausea, vomiting, and stomach pain are the hallmark symptoms of cannabinoid hyperemesis syndrome (CHS).
