Importantly, for the definition of cyclic vomiting syndrome, these episodes of vomiting cannot be attributed to other disorders. This factor is a key distinguishing feature from cannabis hyperemesis syndrome, where the toxicokinetics of cannabis itself influence the course of the disease. Previously, she has had a similar but milder symptom for which she was evaluated. Previous esophagogastroduodenoscopy revealed no evidence of Barrett’s esophagus or sprue; however, reflux esophagitis was detected for which she was started on a proton pump inhibitor. CHS should be suspected in patients coming in with recurrent symptoms of abdominal pain, nausea and vomiting, and who have normal CBC, basic metabolic panel, lipase, https://ecosoberhouse.com/ and liver function tests. Patients should be directly questioned about marijuana use and whether symptoms are relieved with hot showers.
General Health
- Some people who use marijuana heavily get CHS while others don’t.
- But there are some other treatments that may help manage your symptoms and make you feel better.
- Higher rates of CHS are reported in people who use cannabis before age 16 years, have other substance use disorders, and/or smoke cigarettes.
- Marijuana has a lot of active chemical compounds called cannabinoids.
Since the 1990s, there has been a progressive change in the composition of the plant, with increases in the tetrahydrocannabinol (THC) and a reduction of cannabidiol (CBD).6 This trend correlates with increased cannabis use. Some individuals, for instance, also admitted to smoking 2000 mg of THC per day. 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. Your doctor may ask you questions, like how long you’ve been using cannabis and what type of products you normally use. For example, if you smoke weed, eat edibles, use tinctures, or dab or vape THC, tell your doctor about any or all of them.
Conditions
Her review of systems was negative for heart burn or reflux-type symptoms, diarrhea, melena, or hematochezia. WS is a 54-year-old African American male with a medical history of diabetes mellitus type 2, hypertension, obstructive sleep apnea, and gastroparesis. He has multiple admissions for intractable nausea, vomiting, and abdominal pain believed to be from diabetic gastroparesis despite a normal gastric-emptying study. Endoscopy done in prior admission showed duodenitis, gastritis, and esophagitis, and colonoscopy revealed diverticulosis. He had a negative gastric-emptying study of 6% retention at 4 hrs. His last hemoglobin A1c was 5 and his glucose has been well controlled.
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- The active phase is followed by a recovery phase when symptoms resolve and patients return to baseline, only to have it recur if marijuana use continues.
- ALiEM is your digital connection to the cooperative world of EM.
- Risk factors for CHS include heavy cannabis use (typically daily or multiple times per day) for more than 1 year.
Despite the scarcity of randomized controlled trials (RCTs) on optimal treatment approaches for CHS, a holistic care plan can significantly enhance patient outcomes and well-being. 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. You can then discuss your treatment options with your caregiver. You can work with him to decide what care will be used to treat you. The symptoms typically last a few weeks, though the throwing up should ease up in a day or two.
Supportive Care with Fluid and Electrolyte Replacement
The doctor said that the muscle contraction was due to an anxiety attack and that Brian was severely dehydrated. Another doctor asked Brian if he smoked marijuana, and he said that he did. Upon the third week of post-discharge follow-up, cannabinoid hyperemesis syndrome she had recovered from all CHS symptoms and was off dronabinol. She was also abstaining completely from all forms of marijuana or relevant derived products.
