Cannabinoid Hyperemesis Syndrome StatPearls NCBI Bookshelf

Although topical capsaicin is a promising treatment for CHS when standard anti-emetic agents fail, the primary goal is preventing recurrence, which involves patient counseling and continuous support for cannabis cessation 7. With prolonged symptomatic CHS, complications arise due to potential electrolyte abnormalities, dehydration, and weight loss. This case report seeks to raise awareness of the effects of cognitive errors in clinical practice. This tendency to prematurely attribute symptoms to a known diagnosis https://ecosoberhouse.com/ and thereby overlook alternative and potentially more accurate explanations can lead to delays in diagnoses and treatments.

Health Challenges

When a patient presents with nonspecific symptoms, efforts must be increased to decrease the possibility of cognitive errors. With the increasing popularity of marijuana for medical and recreational use, a better understanding of the endocannabinoid system is needed to provide proper treatment of CHS and its subsequent conditions. Accurate reporting of THC intake is important to expanding knowledge of the paradoxical effects of cannabis as an anti-emetic and pro-emetic agent. Conservative treatment is most appropriate for alleviating symptoms of SMA syndrome and achieving clinical remission without surgical intervention 8.

Cannabis Hyperemesis Syndrome (CHS)

Let your doctor know how much marijuana you use and how often you use it. Marijuana has a lot of active chemical compounds called cannabinoids. When you use weed, these compounds bind to cannabinoid receptors found in your brain, digestive tract (gut), and certain cells in your body. Tetrahydrocannabinol (THC) and cannabidiol (CBD) are the main cannabinoids in marijuana products. THC is what’s responsible for the “high” most people feel when they use marijuana.

• Many researchers feel that CHS is underrecognized and underdiagnosed.
• Compulsive bathing or showering in hot water to soothe nausea is also a hallmark sign of CHS.
• Awareness of cognitive error is especially important in the context of the increasing prevalence of legalization of tetrahydrocannabinol/marijuana in several states.
• Cannabinoid hyperemesis syndrome (CHS) is a condition that you might get if you’ve regularly smoked weed or used marijuana in some other form for a long time.
• The almost pathognomic aspect of a patient’s presenting history is that their symptoms are relieved by hot baths or shower.

How should we treat cannabinoid hyperemesis syndrome in the ED?

Researchers are currently studying several treatment options to manage the hyperemetic phase of CHS. It’s a condition that can lead to serious health complications if you don’t get treatment for it. We aim to disrupt how medical providers and trainees can gain public access to high-quality, educational content while also engaging in a dialogue about best-practices in EM and medical education. (A) Sagittal view shows a narrowing of the distal duodenum at the level of the superior mesenteric artery, with an aortomesenteric distance of 5.0 mm. (B) Axial view with intravenous contrast provides an alternative perspective of decreased aortomesenteric distance.

• Frequent vomiting due to CHS can cause erosion of teeth enamel and may result in tooth loss.
• The Rome Foundation (Rome IV) has emerged as a beacon of clarity in the labyrinth of diagnosing Cannabinoid Hyperemesis Syndrome (CHS), categorizing it as a variant of cyclical vomiting syndrome under the umbrella of functional gut-brain disorders.
• 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.
• The fundamental and definitive treatment for CHS involves ceasing cannabis consumption.

Indeed, with any syndrome that results in frequent vomiting, there is a concern for a disorder of electrolytes and fluid balance in the body. Patients who fail to respond to antiemetic therapy cannabinoid hyperemesis syndrome 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.

Recovery phase

These therapies may offer transient relief but are not comprehensive solutions for CHS symptomatology. Hot showers have emerged as an intriguing phenomenon in assuaging the symptoms of Cannabis Hyperemesis Syndrome (CHS), offering a peculiar yet effective avenue for relief. While the precise physiological mechanisms underpinning this phenomenon continue to be explored, several theories shed light on why hot showers might hold therapeutic value for CHS patients. The diagnostic puzzle posed by CHS is compounded by the ubiquitous nature of gastrointestinal complaints in emergency departments globally, making it arduous to differentiate CHS from a myriad of potential causes of nausea and vomiting that extend beyond gastrointestinal origins.