Chronic Cannabis Use Leads to Intestinal Discomfort, Nausea, and Vomiting: Understanding the Syndrome, Its Signs, and Possible Remedies
In the medical community, a condition known as Cannabinoid Hyperemesis Syndrome (CHS) has emerged as a significant concern, particularly among long-term marijuana users. First documented in the medical literature in 2004, researchers in South Australia reported on 10 individuals who exhibited symptoms of CHS, which were preceded by chronic cannabis use [2][4].
Although a similar condition was mentioned in a case study involving a 22-year-old man in 1996, it did not specifically define CHS as we know it today [1]. The 2004 description is widely recognized as the first formal documentation of CHS.
CHS symptoms can be debilitating, with weekly marijuana use, severe, recurring nausea and vomiting that follow a pattern, abdominal pain, morning nausea and vomiting, weight loss of more than 5 kg during the hyperemesis stage, and normal bowel habits being common indicators.
The syndrome is often underdiagnosed due to patients not reporting their marijuana use. Doctors currently lack treatment guidelines for CHS and rely on published case reports. During the hyperemesis stage, doctors focus on preventing dehydration and stopping symptoms of nausea and vomiting.
In some cases, doctors may recommend vitamin B-6, ondansetron (Zofran), promethazine (Phenergan), metoclopramide (Reglan), dexamethasone (Decadron), famotidine (Pepcid), droperidol (Inapsine), or lorazepam (Ativan) to alleviate symptoms, but many experts consider these treatments ineffective.
Lorazepam, in particular, is used with caution due to its potential for abuse and addiction, and its off-label use for CHS. Interestingly, two case reports have shown lorazepam's effectiveness in managing CHS-related nausea and vomiting, with one doctor reporting successful control of symptoms within 10 minutes using injectable lorazepam.
As the laws regarding the possession and use of marijuana change, CHS may become more prevalent due to more people having legal access to the drug. However, the causes of CHS are not fully understood, and further research is necessary.
Researchers have identified CB1 and CB2 receptors as potential targets for marijuana molecules, with CB1 receptors regulating the effects of marijuana on the gastrointestinal tract. When individuals with CHS stop using marijuana, their symptoms usually disappear.
One interesting behaviour observed in individuals with CHS is their tendency to take frequent hot showers or baths to alleviate their symptoms. As more research is conducted and awareness grows, it is hoped that effective treatment guidelines and a better understanding of the causes and risk factors of CHS will be established.
In the realm of health-and-wellness and mental-health, the effectiveness of various therapies-and-treatments for Cannabinoid Hyperemesis Syndrome (CHS) remains under debate. For instance, while some experts suggest that lorazepam, a benzodiazepine, may offer temporary relief for CHS-related nausea and vomiting, its long-term use is approached with caution due to potential abuse and addiction concerns. On the other hand, scientific research is shedding light on the role of CB1 and CB2 receptors, identifying them as potential targets for managing CHS symptoms, particularly those related to the gastrointestinal tract. As awareness and research continue to grow, it is expected that targeted fitness-and-exercise, nutrition, and lifestyle modifications may also play a role in managing and preventing CHS.
