The vasodilation induced by heat exposure in hot showers can enhance peripheral blood vessel dilation, promoting improved circulation. This increased blood flow to the skin and peripheral tissues may help shift blood volume away from the gastrointestinal tract, potentially alleviating nausea and vomiting symptoms by reducing visceral hypersensitivity and enhancing overall comfort levels. Ultimately, the treatment of any illness is the removal of precipitating factors, not merely the management of its symptoms.
Cannabis Hyperemesis Syndrome (CHS)
And a 2022 Canadian study found that ER visits for CHS-related problems had increased 13-fold between 2014 and 2021. (Recreational use and sale of cannabis in Canada was legalized starting in 2018). It’s not clear what percentage of all heavy marijuana users have experienced CHS. If you need help quitting, speak to a healthcare provider or connect with your local addiction treatment services. If you have cannabis use disorder and need help quitting, professional treatment is available.
Vasodilatory Effects
- Common triggers include certain foods like alcohol, caffeine, chocolate, and greasy items.
- Some may resume cannabis use without issues, while others may feel symptoms returning after just one exposure.
- CHS, cannabis hyperemesis syndrome; RCT, randomized-controlled trial.
- The ramifications of misdiagnosing CHS can extend far beyond financial burdens, potentially obstructing the timely recognition of life-threatening conditions and compromising the quality of care and life for affected individuals.
However, after abstaining from alcohol for long periods, the patient had continued recurrence of the symptoms and increased frequency of presentations to the ED. 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. As people with CHS often only consult their doctors during the hyperemesis stage, there is a lack of knowledge regarding the treatment of people during the prodromal stage. Currently, doctors do not have treatment guidelines for the management of CHS. Most of the evidence on effective treatment and management comes from published case reports.
Symptoms and Causes
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. CHS, cannabis hyperemesis syndrome; RCT, randomized-controlled trial. More research on CHS is needed to enhance knowledge translation, education, and create awareness in the medical community on the side effects of cannabinoids and to propose the best treatment options. Because CHS is a fairly new medical condition, not all doctors know about it. Or they might think it’s something else, since repeated throwing up is a sign of many health problems.
During the recovery phase, if patients cease marijuana use, they remain asymptomatic; however, if patients continue to use marijuana, they often have recurrence of the hyperemesis phase.5 The diagnosis of cannabinoid hyperemesis syndrome is difficult as it is a diagnosis of exclusion. With the cannabinoid hyperemesis syndrome changing climate of marijuana laws, it is an important condition to consider when establishing a differential. More studies will be required to evaluate the overall prevalence of this condition as well as if there are any changes following the liberalization of marijuana laws in many states.
- If you need help quitting, ask your doctor whether a drug rehabilitation program is a good fit for you.
- If symptoms persist and you continue to use cannabis, you may experience more severe problems that require hospitalization for treatment.
- If you have cannabis use disorder and need help quitting, professional treatment is available.
- While any amount of long-term cannabis use can lead to CHS, daily cannabis use seems to be more likely to cause CHS than using it less often.
The only definitive treatment of cannabis hyperemesis syndrome is the removal of cannabis exposure, which may ultimately require extensive coordination between the committed patient, an empathic and dedicated primary care physician, and appropriate substance use counseling and resources. An electrocardiogram may be useful to assess the patient’s QTc interval, especially in the context of antipsychotic medication use, as well as before the administration of certain antiemetics, which may prolong the QTc interval to extreme lengths. In women, a pregnancy test is necessary to assess for any pregnancies, especially ectopic pregnancies. Imaging is up to the discretion of the clinician, depending on various specific factors of history or physical exam, which may be concerning for surgical processes. Cannabinoid hyperemesis syndrome (CHS) is a very unpleasant — and potentially dangerous — complication of long-term marijuana use.
