Cannabigerol (CBG) is a non-psychotropic cannabinoid that behaves as an antagonist at both the CB1 and 5-HT1A receptors [32]. This antagonism reverses the anti-emetic actions of low-dose CBD, which likely occurs at the 5-HT1A receptor [33]. The pro-emetic properties of CBD (at higher doses) and CBG may play a role in the severe nausea and vomiting observed in patients with Cannabinoid Hyperemesis Syndrome (Figure 2). The same factors apply to clinicians, specialists, nurses, and pharmacists, as well as other healthcare personnel, to consider the diagnosis in any chronic vomiting disorder, and to better inform themselves regarding the condition. They should also have the freedom and empowerment to speak up to other team members if they feel that this may be getting overlooked in the diagnostic picture. Since the only treatment is the removal of the offending agent, accurate diagnosis is the only portal to actual management.
Is CBD Bad for Your Heart, Liver, and Kidneys?
Of this patient population, 32.9% (95% confidence interval, range 24.5–40.3%) were considered to have met criteria for CHS (chronic cannabis use, episodes of sometimes severe nausea and vomiting, symptomatic relief from hot showers) [72]. If these results are applied to the general population of regular marijuana users in the US, it is possible that 2.75 million Americans (range 2.13–3.38 million) suffer from CHS [72]. It is likely many are not even aware that their symptoms relate to their cannabinoid use. Cannabinoid hyperemesis syndrome (CHS) is a paradoxical condition in which a long-term cannabis user suffers an episode of intractable vomiting that may last days separated by longer asymptomatic periods of weeks or months. Cannabinoids are often utilized for their antiemetic properties, so CHS can be a puzzling condition, and the diagnosis of CHS may be disputed by patients.
Can You Treat CHS Symptoms at Home?
And, like migraines, CVS sometimes runs in families, Lembo says. In addition, the disorder is slightly more common among people with seizure disorders. It is difficult to quantify the precise amount of cannabis consumed by patients who manifest CHS.
Clinical Features, Diagnosis and Treatment
Future studies following patients longitudinally for extended periods of time are needed. To diagnose CHS, a healthcare professional will study your symptoms and ask you questions. They’ll also examine your abdomen and may order tests to rule out other causes of vomiting. In one study, about 84% of people who received treatment for CHS stopped using cannabis, and of those, about 86% reported resolution of symptoms. Cannabinoid hyperemesis syndrome (CHS) is a very unpleasant — and potentially dangerous — complication of long-term marijuana use.
Additional pharmacological research is needed regarding the pro-emetic effects of additional cannabinoids and their metabolites. Another proposed explanation is that in susceptible individuals the pro-emetic effect of cannabis on the gut (e.g. delayed gastric emptying) overrides its anti-emetic CNS properties cannabinoid hyperemesis syndrome [62]. This hypothesis is supported by the demonstration of delayed gastric emptying on gastric emptying scintigraphy in some cases [6,55,62]. Further research is required to investigate the gastrointestinal physiology in these patients during both the acute attacks of hyperemesis and between episodes.
Case Series and Case Studies
- If you have symptoms, your doctor will do a physical exam and ask for your detailed medical history.
- Diagnosing CHS can be tricky since lots of different things can lead to abdominal pain, nausea, and vomiting.
- It is also unknown why only some individuals develop CHS when the use of cannabis is so widespread.
- Cannabinoid hyperemesis syndrome (CHS) is a medical condition that’s becoming more common among people who use cannabis.
- It’s thought that genetics may play a role because only a small number of people who regularly use cannabis develop CHS.
- Many people with CHS will compulsively shower or bathe — often for hours every day — to relieve CHS symptoms.
Therefore, substance abuse experts should be involved when the diagnosis is made. A 42-year-old CHS patient treated for hyperemesis in the hospital presented with a reddish-brown pigmented rash on his trunk and extremities. The rash could be diagnosed as erythema ad igne or thermal keratosis. The patient reported that he got the rash from prolonged exposure to hot water in showers that he took to relieve the symptoms of his CHS [143].
- For example, in two recently published series of adult patients with CVS, approximately one third of patients reported daily marijuana use [65,66].
- “Cannabinoid” refers to cannabis (marijuana) and “hyperemesis” is a word meaning “prolonged vomiting.”
- Substances like THC (tetrahydrocannabinol) and other chemicals in cannabis bind to molecules in your brain to trigger the “high” that can occur when using cannabis products.
- However, symptoms almost always return if you resume using marijuana.
- This has increased both the number of people using the drug and the “high” in the available weed.
- Articles that were clearly not relevant based on title and abstract were excluded.
- Cannabigerol (CBG) is a non-psychotropic cannabinoid that behaves as an antagonist at both the CB1 and 5-HT1A receptors [32].
- Cannabis has presumably been used by humans for thousands of years, [8] yet CHS is only now being recognized.
- Researchers have tried to explain what causes CHS, but further study is necessary.
- Cannabinoids discovered in the cannabis plant with known effects on the regulation of emesis include tetrahydrocannabinol, cannabidiol, and cannabigerol.
Differentiating Cyclic Vomiting, PV, and CHS
Understanding Cannabis Hyperemesis Syndrome
