04 Mar Navigating the Intricacies of Cannabinoid Hyperemesis Syndrome CHS: Understanding the Unseen Challenges
A high index of suspicion for the numerous possible CHS complications, including SMA syndrome, is warranted for clinicians when treating a patient with marijuana use and persistent cyclical vomiting. The patient was referred to a nutritionist for additional support and education. She had not gained substantial weight by 1 week after hospital discharge, and she reported continued nausea with no emesis. At a gastroenterology consultation 7 months after discharge, she had improvement of symptoms, although early satiety remained. Surgical consultation was not sought by the patient, and it remains unclear whether she continued to use cannabis upon symptom relief.
Vasodilatory Effects
- We report a case in which cognitive error substantially influenced a patient’s diagnosis and treatment.
- Brian went back on his depression medication, and the doctor recommended counseling.
- Haloperidol is traditionally used to treat agitation; however, it has been used successfully as an antiemetic in general surgery and oncology.
For our patient who had previously used cannabis, most of these were ruled out in the initial diagnostic evaluation through laboratory evaluation and imaging. During the patient’s hospital stay, nutritional support and intravenous hydration were provided. In addition, she was initially instructed on cannabis cessation and a trial of topical capsaicin for treatment of CHS. After the definitive diagnosis of SMA syndrome, a conservative approach of intravenous hydration and nasogastric feeding was applied to treatment. Gastric decompression was continued through a nasogastric tube until appropriate weight gain was achieved and the blockage was relieved, which allowed for discontinuation once oral intake could be tolerated.
Cannabis hyperemesis syndrome: 5 scientific answers to « scromiting » questions
Yet CHS is a very real condition, and while it may only affect a small percentage of people, it can be deadly. It is my mission to raise awareness of CHS in the hope that others do not have to endure the same fate as Brian. The emotional and physical toll of CHS has been devastating to some, as many sufferers were misdiagnosed and made many visits to the emergency room as a result.
Health Challenges
Patients with CVS also have times where they are feeling sick to the stomach and can also throw up for between 12 hours to about a week. This can happen when you are stressed, excited, have an infection or when women have their period. In refractory CHS cases, experimental therapies such as benzodiazepines, tricyclic antidepressants, and dopaminergic agents like haloperidol have been explored.
“Nearly always, people who continue using cannabis despite experiencing these effects have experienced it as beneficial in other parts of their lives,” he says. “Most https://ecosoberhouse.com/ reports suggest that CHS symptoms resolve within 1 to 2 weeks after stopping cannabis,” Kayser says. No, both doctors and people who have experienced it say that CHS isn’t permanent are there are treatments for it.
Recognition of CVS and CHS
Researchers are trying to understand why some people develop it and others don’t. Right now, the only known effective treatment for CHS is to stop using cannabis. Some people call certain symptoms of CHS “scromiting.” The term combines “vomiting” and “screaming.” You may have intense pain, which causes you to scream while you vomit.
Is cannabis hyperemesis syndrome (scromiting) permanent?
- Ironically, one of the potential complications of long-term cannabis use is a condition called cannabis hyperemesis syndrome (CHS).
- The characteristics of the prodromal phase in CHS patients seems to be significantly different from CVS 1, 2, 3, 4, 5, 6, 7, 8.
- If you need help quitting, speak to a healthcare provider or connect with your local addiction treatment services.
- I would call every day to see whether the results were in, but for months, I heard nothing.
- The aim of this review was to compare the patterns of disease of CVS and CHS.
- 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.
Although the potential pathophysiologic mechanisms (of CVS and CHS) remain obscure, animal studies and findings from basic research support the hypothesis of a paradoxical effect of cannabis in long-term abuse 4, 6. While paradoxical effects of cannabinoids are well known concerning emotions (e.g. relaxing effects vs. paranoia; euphoria vs. dysphoria), a potential emetic effect of cannabinoids is relatively unknown 6, 15. However, there is evidence that in chronic marijuana users suffering from CVS, marijuana could induce a cycle in about 5% of all cases 4. Chronic marijuana abuse is an insufficient criterion to distinguish CHS from CVS 1, 9, 11. It is extremely difficult to separate CHS from CVS in patients who use cannabis on a regular basis.
- People with CHS often find temporary relief from these symptoms by taking hot baths and showers.
- This can help you avoid more severe problems as your body is robbed of food and water from constant vomiting.
- This tendency to prematurely attribute symptoms to a known diagnosis and thereby overlook alternative and potentially more accurate explanations can lead to delays in diagnoses and treatments.
- A pregnancy test was negative, and urinalysis showed the presence of ketones and a specific gravity of 1.032 (reference range, 1.002–1.030).
- It is unclear whether the increased legalization of cannabis has also contributed to these findings, but this certainly could be a possibility.
Understanding Cannabis Hyperemesis Syndrome
We performed a literature review using the LIVIVO search portal for life sciences to develop a pragmatic approach towards these two syndromes. Our findings indicate that complete and persistent resolution of all symptoms of the disease following cannabis cessation is the only cannabinoid hyperemesis syndrome reliable criterion applicable to distinguish CHS from CVS. Psychiatric comorbidities (e.g. panic attacks, depression), history of migraine attacks and rapid gastric emptying may serve as supportive criteria for the diagnosis of CVS. Compulsive bathing behaviour, a clinical observation previously attributed only to CHS patients is equally present in CVS patients. Cannabinoid hyperemesis syndrome (CHS), or cannabis hyperemesis syndrome, is caused by long-term cannabis (marijuana) use.
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