Cannabis hyperemesis syndrome: an update on the pathophysiology and management PMC

Despite this trend, a strict criterion for the diagnosis of CHS is lacking. Early recognition of CHS is essential to prevent complications related to severe volume depletion. The recent body of research recognizes that patients with CHS impose a burden on the healthcare systems.

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Haloperidol exerts antipsychotic effects by antagonizing cannabinoid hyperemesis syndrome dopamine D2 receptors in the mesolimbic and mesocortical pathways. Haloperidol is traditionally used to treat agitation; however, it has been used successfully as an antiemetic in general surgery and oncology. D2 receptors are also present in the chemoreceptor trigger zone, which may account for these antiemetic properties. Additional studies are warranted to determine haloperidol’s place in therapy and its optimal dosing.

History and Physical

Additional treatments include rehydration via intravenous fluids and proton pump inhibitors to reduce stomach acid. These findings suggest a complex genetic basis for CHS, involving multiple bodily systems and potentially predisposing individuals to other health conditions. Although research has not established a clear link between CHS and pesticides, some recommend avoiding cannabis that has been treated with pesticides, as some individuals may have more adverse reactions to certain chemical treatments. 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. There are multiple hypotheses regarding the pathophysiology of CHS; however, because of the multitude of active chemicals in cannabis and the existence of various sites of action, the definitive pathophysiological process is unknown.

Hyperemetic Phase

Cannabis can both induce and subdue vomiting, a paradox doctors don’t fully understand, Camilleri said. Medical marijuana has long been prescribed for nausea and appetite loss for people with cancer and HIV/AIDS, and the Food and Drug Administration has approved drugs with synthetic THC for use by chemotherapy patients. When you do this, your symptoms usually start to go away in few days to a few months.

What is the treatment for cannabinoid hyperemesis treatment?

This may be due to the small amount of THC that all CBD products contain. More research investigating CHS’s underlying mechanism will help determine if additional cannabinoids may cause CHS. It is a result of long-term cannabis use, and symptoms typically end when patients stop consuming cannabis. But they can also flare back up again if the patient returns to regular cannabis use. It isn’t entirely known what causes some people to experience the symptoms of CHS while others do not.

• There’s no cure for this syndrome, with the only known, surefire treatment being abstinence from marijuana.
• It isn’t entirely known what causes some people to experience the symptoms of CHS while others do not.
• Without knowing this background, providers often misdiagnose CHS as other conditions, like cyclic vomiting syndrome (CVS).

Complications

If you have a medical problem, please contact a qualified health professional. These ideas pull from a patchwork of cannabis research – some from animal models and others from human trials. For this reason, it’s important to take this report and related case studies with a grain of salt.

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For example, the drug affects the receptors in the esophageal sphincter, the tight band of muscle that opens and closes to let food go from your throat to https://ecosoberhouse.com/ your stomach. If this flap doesn’t work properly, your stomach acids might flow upward and cause you to have nausea and vomiting. As CHS is a relatively recently recognized and studied phenomenon easily confused with other diseases, there is a paucity of sizeable randomized control studies. Most resources and recommendations come from case studies and expert opinions. In addition to appropriate antiemetic therapy, fluid resuscitation, and management of the patient’s symptoms, patients must recognize behaviors and exposures that place them at risk for their pathology. For supportive care, a clinician should work together with the pharmacist to see if any medications could contribute to the patient’s presentation.

Pathological bathing behavior

In the meantime, hot showers or hot bathing may offer short-term relief. 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) can affect people who use cannabis (marijuana) long-term.