Cannabinoid Hyperemesis Syndrome

Cannabinoid hyperemesis syndrome (CHS) develops due to intemperate cannabis use. It is easily mistaken with other health issues like drug-seeking behavior, eating disorder, abdominal pain, nausea, and vomiting. These symptoms improve temporarily after a hot bath or shower.

However, the pathogenesis of this syndrome is still unclear, but it might include the exogenous cannabinoids accumulation inside the brain that regulates body temperature. This condition was explained by Allen (2004), Sontineni and their colleagues (2009) also made the diagnostic criteria easy.   

Patients of this syndrome generally remain undiagnosed, due to the unawareness and also individuals hardly admit they use marijuana. Patients suffering from this syndrome are increasing every year. In a study in 2009, it was seen that the patients have doubled up.

Stages of Cannabinoid Hyperemesis Syndrome

Prodromal Phase

In this phase, a person might experience morning nausea and food distaste. One might develop severe distaste and end up vomiting. It also prevents a person to eat normally and reduces food intake resulting in weight loss. This phase stays for one to two weeks.

Hyperemetic Phase

The patient develops severe symptoms that occur frequently and cyclically. One develops chronic nausea and might vomit as frequently as five times an hour. The patient might also develop abdominal pain resulting in eagerness to take frequent hot baths.

Recovery Phase

Symptoms minimize in this phase and problems might resolve as the patient minimizes cannabis intake. Symptoms might ease as early as after 12 hours one stops taking the drug. However, one might need a longer duration of up to 3 weeks to heal completely, depending upon the severity of the case. Moreover, the syndrome might reappear after taking cannabis and avoidance is the best way to control the syndrome.

Cannabinoid Hyperemesis Syndrome Causes

Long-term excessive marijuana use leads to CHS. This condition is generally seen in high marijuana users rather than who take the drug rarely. It is confused by many experts due to the insignificance. Some experts theorize that cannabis strains are rich in THC (up to 30 percent) and if taken for longer duration, it can increase the risk of this disorder.

Cannabinoid Hyperemesis Syndrome Symptoms

1. Abdominal Pain often called ‘colicky’
2. Cyclical vomiting
3. Recurrent nausea
4. Urge to take a hot bath to ease symptoms
5. Excessive sweating
6. Agitation and Anxiety
7. Abnormal heart rate or Tachycardia
8. Mild Fever
9. Excessive thirst or Polydipsia (water thirst)
10. Hypotension, blood pressure falls while changing position
11. Bloating
12. Dehydration
13. Diarrhea
14. Weight Loss

Cannabinoid Hyperemesis Syndrome Treatments

• Hot baths: It eases symptoms like nausea, vomiting and abdominal pain primarily in patients with cannabinoid hyperemesis syndrome. According to a journal report published in 2017, showed that 70 percent of the people with this syndrome reported that hot baths minimized CHS signs. Image Source: en.wikipedia.org
• Therapy: Cannabinoid hyperemesis disorder also involves therapies that are supportive like antiemetic medications, intravenous fluids. In the fourth phase of hyperemetic fluids might include proton pump inhibitors, sodium chloride solution, and lorazepam.
• Reduce Drug Intake: The most effective way to prevent cannabinoid hyperemesis syndrome is to minimize or avoid the intake of marijuana. However, this might be difficult for some individuals with marijuana addiction. Normally people are seen taking the normal amount of drug despite its consequences.

People suffering from this syndrome might have a severe drug use disorder. If the patient is unable to control the addiction, it is advisable to contact the rehab center that deals with marijuana abuse. These facilities might help the patient to overcome the drug abuse and live a drug-free and healthy life. However, CHS treatment is still getting explored, but there are certain practices that help to ease out the symptoms.

• Cannabis usage minimization, if one takes it for therapeutic reasons, people should opt for alternatives
• Proton Pump inhibitors are also used to treat gastritis symptoms
• To get rid of the drug abuse or to minimize the intake of marijuana, motivational training classes and CBT (cognitive behavioral therapy) are very effective
• If the patient has developed acute cases of the problem, one might need to undergo fluid replacement and electrolyte intravenously
• Experts are still researching for the medications like analgesics, antiemetics, anti-nausea medicines, sedatives, and analgesics to help the patient in relieving the problem

Cannabinoid Hyperemesis Syndrome Complication

Attacks can lead to various complications like acute kidney injury known as (CHARF) cannabinoid hyperemesis acute renal failure. It occurs due to excessive vomiting, hot showers and dehydration which can also lead to prerenal azotemia. If the syndrome remains unchecked for a longer duration, it might lead to prerenal failure. Experts advice staying aware and vigilant of this risk factor due to its life-threatening nature.