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Pergolizzi et al. 20 provide an in-depth exploration of the pathogenesis of CHS. Cannabis contains over 100 different cannabinoids, with delta-9-THC and CBD being the primary compounds. These cannabinoids bind to cannabinoid receptors type 1 (CB1) and type 2 (CB2), which are distributed throughout the body. Specifically, CB1 receptors are primarily located in the brain, while CB2 receptors are found outside the central nervous system (CNS), in areas like the spleen, thymus, and other immune cell populations 21.
Diagnosis of CHS
It is believed that prolonged marijuana use leads to overstimulation of the body’s endocannabinoid system, which is involved in regulating functions like mood, appetite, and gastrointestinal processes. Additional research is underway regarding CHS, but the underlying mechanism is complex. It is possible that THC accumulates in the body with frequent, long-term marijuana use, which may be toxic to the gastrointestinal system. There are possible direct effects on the brain and central nervous system, which plays a large role in the normal vomiting processes.
Hyperemetic phase
Marijuana has a lot of active chemical compounds called cannabinoids. When you use weed, these compounds bind to cannabinoid receptors found in your brain, digestive tract (gut), and certain cells in your body. Tetrahydrocannabinol (THC) and cannabidiol (CBD) are the main cannabinoids in marijuana products. THC is what’s responsible for the “high” most people feel when they use marijuana.
The Munchies Effect: THC’s Appetite Boost
An intriguing point to keep in mind is that the Rome IV criteria include the phrase “resembling cyclical vomiting syndrome.” In that regard, it is important to distinguish between the two. These episodes of vomiting are often separated by weeks or months, and there is a return to baseline between episodes. Importantly, for the definition of cyclic vomiting syndrome, these episodes of vomiting cannot be attributed to other disorders. This factor is a key distinguishing feature from cannabis hyperemesis syndrome, where the toxicokinetics of cannabis itself influence the course of the disease. Benzodiazepines have been shown to be effective in managing acute symptoms of CHS, particularly for their rapid-acting anti-emetic and anxiolytic properties. These medications exert their effects by inhibiting the medullary and vestibular nuclei in the brain, which play a key role in nausea and vomiting regulation.
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- Most people with CHS who stop using cannabis have relief from symptoms within 10 days.
- As noted earlier, hot baths or showers provide temporary relief for many patients.
- The challenge of diagnosing and managing CHS, coupled with the resource strain of frequent hospital visits, may exacerbate the pressure on healthcare facilities.
- When these receptors are activated, they can influence mood and behavior, and in some individuals, may contribute to adverse psychological effects such as depression and suicidal ideation.
Quality is non-negotiable, opt for lab-tested products from dispensaries to avoid contaminants. THC can overdo hunger, per a 2014 study linking heavy use to higher calorie Sober living home intake (Penner et al., 2014). CBD and THC may interact with meds (e.g., via liver enzymes), so consult a doctor if on prescriptions.
How is cannabis hyperemesis syndrome treated?
THC, the principal exogenous cannabinoid in cannabis, is metabolized in the liver through oxidative and hydroxylation reactions by the CYP2C enzyme subfamily 22. THC is known for its antiemetic properties when it binds to both CB1 and CB2 receptors. The half-life of THC ranges from 20 to 30 hours, though this can vary depending on the cannabis product 23. THC is excreted in feces (60-85%) and urine (20-35%) as acid metabolites. Due to its lipophilic nature, THC accumulates in adipose tissue over time 24.
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- Our Drug Rehab Boston center offers specialized treatment for those struggling with marijuana addiction and CHS.
- A colleague diagnoses cannabis hyperemesis syndrome and recommends that you try a low dose of a benzo.
- But with repeated use of marijuana, certain receptors in the brain may stop responding to the drug in the same way.
- Based upon the clinical assessment, other investigations can help rule out differentials such as infection, pregnancy (especially ectopic pregnancies) or brain tumours.
You may need to see a gastroenterologist, a doctor who specializes in the digestive tract, for a proper diagnosis. The gut and brain chatter constantly via the gut-brain axis, a physiologic dialogue the ECS helps orchestrate. THC, for instance, slows gastric emptying, how fast food exits the stomach, easing nausea. A 2011 study in Neurogastroenterology & Motility found THC reduced vomiting in animals by targeting brainstem CB1 receptors (Parker et al., 2011).
People with this condition say that hot showers https://ecosoberhouse.com/article/dry-drunk-syndrome-symptoms-and-how-to-cope/ and baths temporarily relieve their symptoms, but the only way to get complete relief is to stop using cannabis altogether. 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. 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.