The HPA axis and sympathetic nervous system must balance their roles to mediate the stress. The response to stress is important in survival, but long-term stress can have negative effects on one’s health 31. Endocannabinoids play their part in allostasis by promoting recovery from stress and further bring back homeostasis of the neurotransmitters, neurohormones, and neuropeptides 32. Other cannabinoids, such as CBD and cannabigerol (CBG), may also contribute to the development of CHS. At low doses, CBD is known to be antiemetic, but at higher doses, it can become proemetic. CBG has the potential to reverse the antiemetic effects of CBD, suggesting that CHS could https://ecosoberhouse.com/article/are-psychedelics-addictive-side-effects-and-risks/ result from the interplay between high levels of CBD and its reversal by CBG 25,26.

Deterrence and Patient Education

During a flare-up, people with CHS also often take hot baths or showers, sometimes multiple times per day, to try to relieve their discomfort. “People with CHS often report temporary relief of symptoms from bathing in hot water, which may lead to compulsive bathing,” Angulo says. This suggests that the area of the brain that’s involved in regulating body temperature—the hypothalamus—might be involved in CHS, D’Souza says. With cannabis use on the rise, awareness of hyperemesis cannabis syndrome must increase. Better education can help people recognize symptoms early and seek treatment, improving outcomes and reducing healthcare burdens. If you suspect CHS, consulting a healthcare professional can guide you toward effective management and support.

Health Conditions

Working with a counselor and taking a tricyclic antidepressant (such as amitriptyline) “can help with marijuana cessation,” Angulo says. The only way to stop CHS and its symptoms is to completely quit using cannabis. Most people who quit using cannabis experience no more CHS symptoms within 10 days, but sometimes it may take weeks or months for symptoms to stop. Symptoms of CHS likely won’t return if you’ve completely stopped using cannabis. One study found up to 6% of people who went to the emergency room for cyclical vomiting had CHS. Experts believe only a fraction of habitual cannabis users develop CHS.

Pathological bathing behavior

The patients continue using cannabis in this phase, believing in its anti-nausea effects. Both CVS and CHS are complex gastrointestinal conditions influenced by several entities, including genetic, environmental, and lifestyle factors. While their genetic underpinnings are still not fully understood, research has suggested potential genetic predispositions for each. The CVS has strong links to mitochondrial dysfunction and neurobiological pathways related to migraine, while CHS is primarily influenced by chronic cannabis use and endocannabinoid system dysfunction. Understanding these primary differences in the pathophysiology between these two disease entities is crucial for clinicians when diagnosing, especially since they share overlapping gastrointestinal symptoms.

Cannabinoid Hyperemesis Syndrome Diagnosis

• While their genetic underpinnings are still not fully understood, research has suggested potential genetic predispositions for each.
• To make a diagnosis, your healthcare provider will conduct a thorough physical examination and ask you about your past health and current symptoms.
• Shrine, indicating its use in ancient Jewish religious ceremonies 2.
• Researchers need to study CHS in more detail to make it easier for doctors to recognize and treat the condition.

Serotonin antagonism in the gastrointestinal tract from medications such as ondansetron, dolasetron, and granisetron likewise have varying levels of efficacy. Drugs with an anticholinergic effect may likewise block medullary mediated vomiting, though they may have minimal impact on visceral stimulation, including the crippling abdominal cramping pain that patients with CHS experience. Opioids, while often prescribed for the patient’s debilitating abdominal pain, are not appropriate for CHS, as they may, in fact, worsen nausea and vomiting. Changes to the endocannabinoid system in the hypothalamus from cannabinoid use could lead to a dysregulated stress response, and perhaps contribute to the development of CHS.

This strange syndrome is linked to regular cannabis use—and cases have doubled

A novel pilot randomized controlled trial by Dean et al. 88 showed that topical 0.1% capsaicin reduced nausea from the baseline by 46% at 60 min, compared to 24.9% in the placebo topical cream group. Additionally, capsaicin’s anti-emetic effect was more effective at 60 min than 30 min after the first application 88. Significant improvements in nausea and vomiting, as well as shorter length of hospital stay, were noted in patients treated with 0.075% topical capsaicin applied to the abdominal region 62. People with CHS also tend to have a strong urge to take very hot showers or baths. That’s because hot water can help ease cannabinoid hyperemesis syndrome symptoms like nausea. The hot temperature affects a part of the brain called the hypothalamus, which regulates temperature and throwing up.

Prevalence of CHS

To fully get better, you need to stop using marijuana all together. Some people may get help from drug rehab programs to help them quit. The hyperemetic phase may continue until the person completely stops using marijuana. It often only happens in people who have regularly used marijuana for several years.

For many cannabis users, the symptoms can be confusing and alarming because cannabis is often thought to help with nausea. Ironically, one of the potential complications of long-term cannabis use is a condition called cannabis hyperemesis syndrome (CHS). As cannabis legalization continues to spread across the United States, healthcare systems may face an increasing burden from cannabis-related conditions like CHS. Hospitals and emergency departments, especially in regions with high cannabis use, are likely to see a rise in patients presenting with the characteristic symptoms of CHS. The challenge of diagnosing and managing CHS, coupled with the resource strain of frequent hospital visits, may exacerbate the pressure on healthcare facilities. Adequate training and resources should be provided to healthcare professionals to ensure that CHS is correctly identified and treated, and also to help manage the increased patient load.

For example, the drug can change the time it takes the stomach to empty. That’s the tight band of muscle that opens and closes to let food from the esophagus into the stomach. Long-term marijuana use can change Twelve-step program the way the affected molecules respond and lead to the symptoms of CHS. The susceptibility to CHS may also be influenced by cytochrome CYP450 metabolism and genetic polymorphisms. Variations in genes encoding enzymes like CYP2C9, CYP2C19, and CYP3A4 can lead to an excess accumulation of cannabinoid metabolites, potentially triggering vomiting.