Raise Awareness: Cannabinoid Hyperemesis Syndrome
Cannabinoid Hyperemesis Syndrome (CHS) is a rare condition that causes severe vomiting and abdominal pain in individuals who use cannabis products frequently or chronically. Marijuana is much more potent than it used to be and adolescent cannabis abuse has drastically increased by 245% since 2000 in the United States.
Even though cannabis is not physiologically addictive, it's thought to be psychologically addicting. Cannabis is the most commonly used federally illegal substance. The build up of tetrahydrocannabinol (THC) in the blood over time can lead to CHS in sensitive individuals who use marijuana frequently often multiple times per day, for an extended period of time.
Increased legality of marijuana has made it much more accessible to acquire; therefore, awareness and knowledge of CHS is essential in today’s modern world. It is important to be able to recognize signs and symptoms of cannabinoid hyperemesis syndrome and how to prevent it.
Pathophysiology
THC is the primary psychoactive component of cannabis that activates cannabinoid receptor 1 (CB1). CB1 activation modulates a wide range of physiological processes, including pain perception, appetite, mood, and memory.
Chronic cannabis use leads to dysregulation of the endocannabinoid system, which causes gastrointestinal dysfunction, changes in fluid and electrolyte balance, altered thermoregulation, inhibition of gastric secretions, lower esophageal sphincter relaxation, altered intestinal mobility, and overall delayed gastric emptying.
These changes lead to the symptoms associated with cannabinoid hyperemesis syndrome.
Signs + Symptoms
Symptoms of CHS occur in three stages and include severe nausea and vomiting, abdominal pain, and dehydration. The vomiting and nausea is typically so severe that it can lead to hospitalization. The first phase, the prodromal phase, consists of nausea, abdominal pain, and fear of eating. The second phase, the hyperemesis phase, is when heavy, uncontrolled nausea and vomiting, and severe abdominal pain occur. The last phase is the recovery phase which begins with cessation of cannabis products.
Diagnosis
A history of frequent or chronic cannabis use is often a key clue to the diagnosis. Other major diagnostic criteria include no response to conventional nausea medications, relief of symptoms with showering, abdominal pain, increased thirst, and delayed gastric emptying. 50% of individuals with CHS have decreased symptoms with a hot shower.
Treatment
Treatment of CHS involves stopping cannabis use and managing symptoms. In severe cases, hospitalization is likely necessary. Intravenous fluids, hot showers, benzodiazepines, haloperidol, and capsaicin cream can be used to treat dehydration, nausea, and manage other symptoms.
Prevention
The number one way to prevent CHS is to stop chronically using all cannabis products immediately. Individuals who use marijuana for medicinal purposes should work with their healthcare provider to develop a treatment plan that minimizes the risk of developing CHS.
Unfortunately, if you are a chronic marijuana user who suffers from CHS, you have to stop or the episodes will keep happening. Develop a new routine in place of your current cannabis one, and replace it with more holistic behaviors; such as, meditation, weight lifting, yoga, sauna bathing, being in nature, brewing tea, or connecting with friends who do not partake in cannabis use.
Final Thoughts
Cannabinoid Hyperemesis Syndrome (CHS) is a rare condition that causes severe vomiting and abdominal pain in individuals who use cannabis products chronically and frequently. The potency of marijuana has greatly increased and the use of cannabis amongst adolescents has skyrocketed. Hot showers are a simple way to relieve symptoms, but severe cases require hospitalization. Treatment involves stopping marijuana use and managing symptoms. The absolute way to prevent symptoms involves avoiding frequent and chronic use of cannabis products and finding a new hobby and developing a new routine.
Thank you for reading this article.