There is very limited evidence to suggest that agents such as dopamine antagonists and capsaicin cream and avoidance of opiate pain medications may be of benefit. While many providers utilize these agents in practice and find them effective, prospective case-control studies are needed before recommendations can be made based upon effectiveness. The authors of this study acknowledge the potential difficulties of such studies, owing to the fact that CHS is a heterogeneous clinical entity, and thus, selecting a comparable group of patients may prove difficult.

Acronyms & Abbreviations

• The endocannabinoid system is thought to play a role in gastrointestinal motility 123, 124 appetite 125, nausea/vomiting 126, inflammation 127, mood 128, sleep 129, pain 130, and more.
• The healthcare provider will ask the patient about the symptoms, and it will also ask about past health and issues if there were any.
• A data architecture describes how data is managed, from collection through to transformation, distribution and consumption.
• From sinus infections and high blood pressure to preventive screening, we’re here for you.

But what has been noted is that if someone uses cannabis regularly for an extended period, the results could be the opposite. Some theories suggest that THC can make cannabinoid receptors act contrary to how they should behave. As a result, the consumer may experience cramps, vomiting, stomach pain, and other issues. Cannabinoid hyperemesis syndrome (CHS) is a very unpleasant — and potentially dangerous — complication of long-term marijuana use. Because of this possible complication, it’s important to use caution with marijuana and other cannabis products. If you think you have CHS or cannabis marijuana addiction use disorder, talk to a healthcare provider.

Cumulative Synthesis

There are many suggested pathophysiologic mechanisms of CHS, though evidence for each is minimal (see Table 3). It is not clear why cannabis appears to suppress emesis under certain circumstances and induces it in others. It is also unknown why only some individuals develop CHS when the use of cannabis is so widespread.

What causes cannabinoid hyperemesis syndrome?

The diagnostic criteria for CHS were ill-defined prior to the establishment of the Rome IV criteria of 2016.2223 Per the Rome IV criteria, all 3 of the following must be met to be diagnosed with CHS. They must be present for at least the last three months and the beginning of symptoms must be at least 6 months prior to the diagnosis being made. 5.2 We recognise less digitally mature providers can find it challenging to flow data against national specifications and may need support as we modernise CHS data architecture. By March 2025, we will engage with less digitally mature providers to understand their needs, and design any appropriate national support for them to subsequently flow data.

• If you have any symptoms of severe dehydration, like dizziness, confusion and a rapid heartbeat, call 911 right away.
• The articles were then segregated into diagnosis, pathophysiology, or treatment categories.
• Studies show that between 90% to 100% of people with CHS use hot showering or bathing to relieve symptoms.
• The only option to treat the condition long-term is to stop using marijuana.
• Once you do that, your repeated nausea and vomiting should go away and not return.

Cannabinoid Hyperemesis Syndrome (CHS) and Marijuana Use

She wondered if her gastric distress might have been caused by the marijuana she regularly and legally smoked at her home in Toronto. The pathophysiology of CHS is unclear secondary to a dearth of research dedicated to explicitly investigating its underlying mechanism. Nevertheless, some limited evidence suggests a dynamic interplay between cannabinoid metabolism and complex pharmacodynamics at the CB-1 receptor. Limited evidence also suggests that an individual’s genetics, as well as variability in the cannabinoid components of individual plants 131, may play a role in the manifestation of CHS.

The only proven way to prevent cannabis hyperemesis syndrome is to avoid cannabis (marijuana). People who use marijuana long-term — typically for about 10 to 12 years — are at risk of developing CHS. But not every person who uses marijuana, even long-term use, develops CHS. Symptoms of CHS typically come on several years after the start of chronic marijuana use.

The healthcare provider will ask the patient about the symptoms, and it will also ask about past health and issues if there were any. Many researchers tried to give more details on CHS and its causes, but it requires more studies as it is the newly described condition. The first cases were spotted in 2004 in South Australia, where doctors started treating cannabis users for vomiting, stomach pain, and more. The people who experienced the problems doctors treated were long-term define chs cannabis users. Compulsive hot showering or bathing may be critical in distinguishing CHS from CVS and other conditions with similar symptoms.

Reporting is often subjective and qualitative, and there is no metric for how much physiologically active compounds are contained in one joint, cone, bong, etc. In addition, higher THC content through selective breeding of plants and more selective use of female buds that contain more concentrated THC levels may cause CHS to appear in patients who report lower amounts of cannabis use 170. The quality of evidence for each main outcome of this systematic review was evaluated using the GRADE working group metrics 83. High-quality outcomes are defined as those for which further research is very unlikely to change our confidence in the estimate of effect.