In this article, we describe CHS and discuss the causes, symptoms, diagnosis, and treatment of the condition. Most people with CHS who what is chs stop using cannabis have relief from symptoms within 10 days. Hot baths may relieve the nausea for a while, but they don’t cure CHS. Researchers are currently studying several treatment options to manage the hyperemetic phase of CHS. Some people call certain symptoms of CHS “scromiting.” The term combines “vomiting” and “screaming.” You may have intense pain, which causes you to scream while you vomit.
- Supportive care with IV fluids and anti-emetics is the mainstay of treatment in the acute phase of illness.
- For each treatment modality, reviewers explored the evidence and the study design.
- Clinicians often treat symptoms of CHS including nausea, vomiting, and abdominal pain with traditional pharmaceuticals.
- Although this information comes from case reports, doctors can use these criteria to diagnose the condition more quickly.
More Than a Hot Shower – Treatment for Cannabinoid Hyperemesis Syndrome (CHS)
This information is not published but raises questions regarding the role of an unidentified molecule, whether cannabinoid or non-cannabinoid (e.g., a pesticide) may precipitate of the syndrome. In practice, clinicians may have evolved treatment algorithms for managing CHS patients, but our search did not identify any studies reporting this. Sorensen et al. identified seven diagnostic frameworks, with significant overlap among characteristics listed by the various authors; however, there was no specific mention of how many of the above features are required for diagnosis. Clinicians should consider other causes of abdominal pain, nausea and vomiting to avoid misdiagnosis. Data were extracted from individual case reports and summarized as a single large cohort (individual case report synthesis). Next, after exclusion of duplicate cases, the individual case reports were combined with data from the case series and summarized as a single larger cohort (cumulative synthesis).
PATHOPHYSIOLOGY OF CHS
That compelling case series was not referenced in the otherwise excellent review 1. Haloperidol also has a long successful history of clinical use for post-operative nausea 7. Although I am certain haloperidol is unlikely to work in all patients, I am convinced it works often enough to warrant further investigation to determine optimal dosing, optimal timing, and the appropriate target patient. Thank you to Sorensen and colleagues for bringing the pharmacologic frustrations of CHS to the attention of readers. I welcome a collaborative prospective study in evaluating all proposed treatment options for CHS to optimize care for this challenging population.
Health Conditions
As CHS is a newly described condition, many doctors may find it challenging to diagnose and treat. Researchers have tried to explain what causes CHS, but further study is necessary. The only proven way to prevent cannabis hyperemesis syndrome is to avoid cannabis (marijuana). Many people with CHS will compulsively shower or bathe — often for hours every day — to relieve CHS symptoms. It’s a condition that can lead to serious health complications if you don’t get treatment for it. CHS symptoms typically present in a cyclical pattern every few weeks to months when cannabis is being used.
Benzodiazepines, followed by haloperidol and capsaicin, were most frequently drug addiction reported as effective for acute treatment, and TCAs for long-term treatment. As the prevalence of CHS increases, future prospective trials are greatly needed to evaluate and further define optimal pharmacologic treatment of patients with CHS. The incidence of cannabinoid hyperemesis syndrome in patients presenting to U.S. emergency departments is increasing. Furthermore, lengths of stay are reduced when unnecessary testing is avoided. I read with great interest Sorensen et al.’s review article on Cannabinoid Hyperemesis Syndrome (CHS) in the March issue of Journal of Medical Toxicology 1.
- When the two reviewers disagreed on article eligibility, a consensus was reached through discussion.
- Doctors have also noticed that people in the hyperemesis stage take frequent showers and baths, which seem to relieve nausea.
- CHS is also underdiagnosed because people sometimes use marijuana to suppress nausea and vomiting.
In this study, 96.8% of patients who ceased cannabis use experienced complete resolution of symptoms. This study is limited by the heterogeneity of the case series and case reports and the lack of controlled studies examining this syndrome. The internal validity of our findings is limited by the possibility of missing articles from our search strategy. We limited the search to English-language articles, so any relevant articles published in foreign languages were not included, and articles not indexed in MEDLINE, Embase, Web of Science, or the Cochrane Library would be missed.
