Because CHS is a fairly new medical condition, not all doctors know about it. Or they might think it’s something else, since repeated throwing up is a sign of many health problems. You may need to see a gastroenterologist, a doctor who specializes in the digestive tract, for a proper diagnosis.

Clinical Presentation, work up and differential diagnosis of Cannabinoid Hyperemesis Syndrome

The best characterized endocannabinoids are anandamide and 2-arachidonylglycerol (2-AG) [9]. The endocannabinoids are present in both the central nervous system [8] and enteric nervous system [15]. Anandamide and 2-AG are released locally on demand by neurons, are present in small quantities, and undergo rapid inactivation [8]. Endocannabinoids are thought to act as either neuromodulators or neurotransmitters [11]. Anandamide and 2-AG possess similar biochemical structures, but each has a distinct pathway for biosynthesis and degradation. Anandamide is synthesized from the precursor N-arachidonoyl phosphatidylethanolamine, while 2-AG is produced from an inositol-1,2-diacylglycerol precursor [8,16,17].

Deterrence and Patient Education

One milligram followed by 1 mg IV injections of propranolol 1 h apart led to rapid termination of N/V and complete resolution of hyperemesis after the second injection [34]. It should be noted there was limited evidence for propranolol use as it was the only case study we found involving a single patient [34]. The aim of this systematic review was to highlight current management options for CHS as a potential adverse effect of long-term cannabis use in adults and older populations.

Highlights of the Study

Case reports have demonstrated a remission in CHS symptoms upon cessation of cannabis use for extended periods [6,51–54,57,59–62,68,71]. Unfortunately, many of these patients relapse upon resuming cannabis [6,59,61,62]. It has been suggested that many https://ecosoberhouse.com/ of these patients increase or continue their cannabis use because of their perception that it will have beneficial effects on nausea [52]. Patient education should therefore be provided with emphasis on the paradoxical nature of the symptoms of CHS.

• In the meantime, the best way to relieve CHS symptoms is to stop using the drug.
• History taking should include an inquiry about the patient’s past and present medical illness, medication use, illicit drug use, and therapeutic or recreational use of cannabis.
• If this flap doesn’t work properly, your stomach acids might flow upward and cause you to have nausea and vomiting.
• Symptoms of CHS can resemble those of other conditions, such as cyclic vomiting syndrome.

cannabinoid hyperemesis syndrome (CHS) is a condition in which a patient experiences cyclical nausea, vomiting, and abdominal pain after using cannabis. The almost pathognomic aspect of a patient’s presenting history is that their symptoms are relieved by hot baths or shower. This activity introduces the pathophysiology, clinical manifestation, and management of cannabis hyperemesis. Multiple studies report pathological frequent and prolonged hot shower behaviors with CHS.

• It should be noted that the case series using capsaicin cream had a small patient sample cohort of only 1–4 patients; as a result, success in larger cohorts may be questioned [23, 26].
• Cannabinoid hyperemesis syndrome (CHS) is a very unpleasant — and potentially dangerous — complication of long-term marijuana use.
• Anandamide and 2-AG possess similar biochemical structures, but each has a distinct pathway for biosynthesis and degradation.
• Further, these behaviors could also be noted in CVS, preadolescents, and adolescents with no prior exposure to cannabis [8].
• It’s helpful to volunteer your history of cannabis use with your provider if you are not asked about it.

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