Cannabinoid Hyperemesis Syndrome CHS: Causes, Symptoms, Treatment

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The only way to end CHS symptoms is to completely stop using all marijuana products. After you quit, you may still have symptoms and side effects for a few days to a few weeks. Abdominal examination revealed a soft, non-tender and non-distended abdomen. Biochemical tests were negative for electrolytes and acid–base abnormalities. The patient reported active use of marijuana for past ∼10 years; smoked at least five joints a day. However, the gastroenterologist agreed with the CHS diagnosis and ordered more blood work.

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Your brain will adjust, and you’ll likely regain enjoyment in activities you loved before. 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 doctor was clueless as to what to do to help Brian quit smoking and suggested that we could try a stress center.

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Conditions

A case report described by Parvataneni et al. 35 revealed a 30-year-old female with intermittent N/V who was unresponsive to conventional emetics such as ondansetron. She was discharged symptom-free 24 h later after the administration of aprepitant 35. A major limitation of this case report is that the dosage of aprepitant was not described. CHS, cannabis hyperemesis syndrome; CB1, cannabinoid receptors 1; CTZ, chemoreceptor trigger zone; THC, tetrahydrocannabinol.

Management of CHS

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A pregnancy test was negative, and urinalysis showed the presence of ketones and a https://ecosoberhouse.com/ specific gravity of 1.032 (reference range, 1.002–1.030). Additional investigations on the second day of admission indicated decreased values for thyrotropin, ceruloplasmin, and total iron-binding capacity, and she was positive for hepatitis A antibody and had an indeterminate value for hepatitis B surface antibody (Table 1). Results of an autoimmune hepatitis panel were negative, and other results were within the reference range.

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  • Although the exact mechanism of action for cannabinoids are yet to be determined, there are 3 main hypotheses regarding CHS gastrointestinal cannabinoid receptors 1 (CB1), overriding cannabinoid lipid buildup and genetic polymorphisms in the P450 system.
  • Cognitive errors are pervasive in medical practice – influencing clinical decision-making and thereby disease management.
  • 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.
  • Since the 1990s, there has been a progressive change in the composition of the plant, with increases in the tetrahydrocannabinol (THC) and a reduction of cannabidiol (CBD).6 This trend correlates with increased cannabis use.

It’s a serious medical problem that can cause major health issues if you leave it untreated. If you have any symptoms of severe dehydration, like dizziness, confusion and a rapid heartbeat, call 911 right away. The exact causes of Cannabinoid Hyperemesis Syndrome remain unknown, but researchers have proposed several theories. One theory is that frequent cannabis use leads to the buildup of cannabinoids in the body, cannabinoid hyperemesis syndrome which can affect the endocannabinoid system and trigger symptoms of CHS. Another theory suggests that CHS combination of genetic and environmental factors could be a link to the cause of CHS.

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Rare diagnoses and disease interactions such as these, and lack of awareness of them, can lead to cognitive errors. Cognitive errors are pervasive in medical practice – influencing clinical decision-making and thereby disease management. These errors can lead to misdiagnosis, delayed treatment, and, ultimately, prolonged distress for patients. A case study which examined clonazepam in treatment-resistant individuals with CHS revealed that 2 doses of 0.5 mg of clonazepam led to rapid cessation of adverse symptoms, complete symptomatic relief and discharge within 24 h after administration 29.

  • The patient reported active use of marijuana for past ∼10 years; smoked at least five joints a day.
  • There is a new condition that is affecting marijuana users at a growing rate, and it’s called cannabinoid hyperemesis syndrome (CHS).
  • Several treatments have been described to relieve N/V in CHS; however, there are limited controlled data to support management decisions.
  • The presented side effects of cannabinoid drugs suggest that further studies are needed to evaluate the safe concentrations of cannabinoid drugs.
  • Richards and Dutzak 34 presented a single case study that examined an extreme case of CHS in the ER who had intractable N/V, abdominal discomfort and who was unresponsive to standard antiemetics.
  • It’s not clear what percentage of all heavy marijuana users have experienced CHS.
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