Confusion exists in the medical literature secondary to a failure to recognize chronic marijuana use as a source of vomiting. For example, in two recently published series of adult patients with CVS, approximately one third of patients reported daily marijuana use [65,66]. 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].
Clinical Presentation, work up and differential diagnosis of Cannabinoid Hyperemesis Syndrome
The only proven way to prevent cannabis hyperemesis syndrome is to avoid cannabis (marijuana). Some people call certain symptoms of CHS “scromiting.” The term combines “vomiting” and “screaming.” You may have intense pain, which causes you to scream while you vomit. It’s a condition that can lead to serious health complications if you don’t get treatment for it. It’s still not clear which of the more than 100 cannabinoids found in cannabis are responsible for CHS, but it’s thought that CBD could potentially be a contributor.
Are there complications of cannabinoid hyperemesis syndrome?
- The first reports came from doctors treating regular users of marijuana for nausea and vomiting in South Australia.
- Furthermore, gastric emptying rates in patients with CVS are often accelerated rather than delayed [46,65].
- Some may be finding that there can be very real — and serious — complications that come with cannabis use.
- Some people call certain symptoms of CHS “scromiting.” The term combines “vomiting” and “screaming.” You may have intense pain, which causes you to scream while you vomit.
About 75 percent reported using cannabis regularly for over a year. But a 2019 study concluded that it potentially accounts for up to 6 percent of emergency room visits for recurrent vomiting. Δ9-tetrahydrocannabinol (THC) is the principle cannabinoid hyperemesis syndrome 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].
Cyclic Vomiting Syndrome (CVS)
Patients 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. While marijuana seems to bring on nausea in the stomach, https://ecosoberhouse.com/ in the brain it usually has opposite effect. When cannabinoids bind with brain receptors, they tend to prevent nausea and vomiting. Cannabinoids are compounds in the Cannabis sativa plant that bind to cannabinoid receptors in your brain, spinal cord, gastrointestinal tract and other body tissues. Examples of cannabinoids include tetrahydrocannabinol (THC) and cannabidiol (CBD).
Can You Treat CHS Symptoms at Home?
Because so little is known about Cannabinoid Hyperemesis Syndrome and its causes, few treatment approaches have been developed. If you are experiencing symptoms of Cannabinoid Hyperemesis Syndrome, the most common advice is to stop using cannabis and see if your symptoms resolve in the following days, weeks, or months. This seems to be the most effective way to completely resolve symptoms.
What is the treatment for cannabinoid hyperemesis treatment?
Although this information comes from case reports, doctors can use these criteria to diagnose the condition more quickly. CB1 receptors are mostly present in the brain, but they also occur in other organs. Research suggests that CB1 receptors regulate the effects of marijuana on the gastrointestinal tract. Scientists do not know much about the function of the CB2 receptors.
- CB2 receptors are likely involved in the inhibition of inflammation, visceral pain, and intestinal motility in the inflamed gut [9,14].
- Since the only treatment is the removal of the offending agent, accurate diagnosis is the only portal to actual management.
- The symptoms typically last a few weeks, though the throwing up should ease up in a day or two.
- Research is ongoing on the exact way that cannabis triggers this problem.
- CHS symptoms typically present in a cyclical pattern every few weeks to months when cannabis is being used.
When you do this, your symptoms usually start to go away in few days to a few months. Over time, the symptoms will go away completely unless you start to use again. It’s important to be honest about your marijuana use if you have symptoms of CHS. Without knowing this background, providers often misdiagnose CHS as other conditions, like cyclic vomiting syndrome (CVS). One study found that 32.9% of self-reported frequent marijuana users who came to an emergency department for care met the criteria for CHS.
How common is cannabis hyperemesis syndrome?
Although both conditions share an astonishing similarity, there are several significant differences. For example, CVS patients 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]. Table 2 summarizes some of the epidemiological and clinical characteristics that may help distinguish CVS and CHS.