Navigating the Intricacies of Cannabinoid Hyperemesis Syndrome CHS: Understanding the Unseen Challenges

Psychological stress, such as post-traumatic stress disorder or a history of physical and sexual abuse, are potential triggers for disrupting the expected anti-emetic effects of THC. Though the precise mechanisms remain unclear, higher amounts of marijuana consumption, genetic influences, and psychological stress lead to intoxication and paradoxically promote vomiting. The endogenous ligands, AEA and 2-AG, are derived from arachidonic acid. 2-AG is mainly located in the brain and is primarily involved in the signaling process. AEA and 2-AG are produced from cell membrane lipids and move to the extracellular space via diffusion, endocytosis, carrier transport, translocation, and possibly heat shock proteins 28.

• Multiple studies report pathological frequent and prolonged hot shower behaviors with CHS.
• “Cannabinoid” refers to cannabis (marijuana) and “hyperemesis” is a word meaning “prolonged vomiting.”
• While both CHS and Cyclic Vomiting Syndrome (CVS) cause severe vomiting, their causes differ.
• They must be present for at least the last three months and the beginning of symptoms must be at least 6 months prior to the diagnosis being made.
• If you need help quitting, ask your doctor whether a drug rehabilitation program is a good fit for you.

Cannabinoid Hyperemesis Syndrome (CHS) and Cyclic Vomiting Syndrome (CVS)

An even more troubling piece of the puzzle is that many people who feel nauseated due to CHS may try to use more marijuana to alleviate their symptoms, not realizing they’re only making the problem worse. Understanding that cannabis might be the root cause of your nausea is essential for breaking out of the loop. Experts believe only a fraction of habitual cannabis users develop CHS. But because CHS is a somewhat newly discovered condition that was first diagnosed in 2004, some people may be underdiagnosed or misdiagnosed. Always what is alcoholism consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Cannabinoid Hyperemesis Syndrome (CHS): Causes, Symptoms, Treatment

Patients chs syndrome who fail to respond to antiemetic therapy are at high risk for dehydration and resulting in nutritional deficiencies. Other known complications of forceful and uncontrolled vomiting include aspiration and subsequent pneumonitis or aspiration pneumonia as well as injury to the esophageal wall such as Boerhaave’s syndrome. One 2018 study found that 32.9% of self-reported frequent marijuana users who’d gone to the emergency room (ER) had symptoms of CHS. And a 2022 Canadian study found that ER visits for CHS-related problems had increased 13-fold between 2014 and 2021.

Can You Treat CHS Symptoms at Home?

The CHS group achieved a 70% improvement, and the CVS group achieved an 80% improvement following the treatment with amitriptyline 5. Sometimes, doctors actually recommend cannabis for specific conditions like cancer-related nausea. In small doses, it might indeed help reduce certain stomach problems. However, these beneficial effects seem to backfire when use becomes too frequent or too heavy.

The Impact of CHS

As a somewhat new problem, CHS is often mistaken for other problems with the same symptoms. When combined with the fact that people may not reveal they use cannabis, getting the right diagnosis can take years. After stopping cannabis use, symptoms typically start to disappear within one to two days though individual results can vary. However, symptoms almost always return if you resume using marijuana. With the continued use of cannabis and a lack of treatment, symptoms become more intense.

Recovery Phase

The ongoing but mild nature of this phase can fool people into thinking they just have a sensitive stomach or deal with morning sickness. The rise in cannabis legalization could also mean more people have ready access to stronger strains. Since high-potency cannabis can pack a more powerful effect on the body, it’s possible that even fewer years of use could lead to CHS in some cases. Notably, a hallmark behavior observed in CHS cases is the propensity for pathologic hot bathing or showering. While not exclusive to individuals with CHS, the act of hot bathing or showering manifests in approximately 80-90% of patients with this condition. In one study, about 84% of people who received treatment for CHS stopped using cannabis, and of those, about 86% reported resolution of symptoms.

Medical Marijuana

While their genetic underpinnings are still not fully understood, research has suggested potential genetic predispositions for each. The CVS has strong links to mitochondrial dysfunction and neurobiological pathways related to migraine, while CHS is primarily influenced by chronic cannabis use and endocannabinoid system dysfunction. Understanding these primary differences in the pathophysiology between these two disease entities is crucial for clinicians when diagnosing, especially since they share overlapping gastrointestinal symptoms.