For those who intentionally restrict calories, it is important to work with a healthcare provider to do so in a healthful way. Extreme diets, crash diets, or fad diets may put people at risk for refeeding syndrome. The differential diagnosis related to chronic abdominal pain and recurrent bouts of emesis is expansive, which hinders identifying the underlying cause and proper treatment. Common possible diagnoses include gastroenteritis, gallbladder disease, peptic ulcer disease, celiac syndrome, appendicitis, pancreatitis, and functional dyspepsia. For our patient who had previously used cannabis, most of these were ruled out in the initial diagnostic evaluation through laboratory evaluation and imaging. Given the ubiquitous nature of the endocannabinoid system, dysregulation of its normal functioning can have dramatic and potentially adverse outcomes.
- SMA syndrome often arises due to recurrent bouts of emesis that trigger rapid weight loss; in the case presented here, the recurrent emesis was prompted by cannabis consumption.
- If you have cannabinoid hyperemesis syndrome (CHS), the best treatment is to stop using weed, even if you’ve been doing it for years with no previous side effects.
- It is also important to note that because of a knowledge gap, refeeding syndrome may not be recognized when it occurs.
- Patients must be informed that habitual cannabis use can result in cannabinoid accumulation in adipose tissue, leading to prolonged or recurrent symptoms that may take weeks to completely resolve.
Hyperemetic phase
- That’s because hot water can help ease cannabinoid hyperemesis syndrome symptoms like nausea.
- You’re more likely to get CHS if you use marijuana at least once a week and have been doing so since you were a teenager.
- Three retrospective studies were short-term, with small sample sizes, without a standardized reporting of outcomes and subject to the risk of bias found in Tables Tables33 and and44 24, 25, 28.
- A 2017 review of studies found that 97.4 percent of people who developed CHS reported using cannabis at least weekly.
Rare severe complications of CHS include heart rhythm abnormalities, kidney failure, seizures, and death. These supportive treatments can help people during the hyperemesis stage of the condition, but recovery depends on the person stopping their use of marijuana. Through a holistic and individualized treatment regimen, healthcare providers can navigate the challenges of CHS, offering hope and relief to those affected by this puzzling condition. Hot showers have emerged as an intriguing phenomenon in assuaging the symptoms of Cannabis Hyperemesis Syndrome (CHS), offering a peculiar yet effective avenue for relief.
Dysregulated stress response in nausea and vomiting
She sought care at multiple facilities until finally being diagnosed with superior mesenteric artery cannabinoid hyperemesis syndrome syndrome. Treatment was conservative with intravenous hydration, nasogastric feeding, and gastric decompression until duodenal compression was relieved. The patient’s condition had improved at 7-month follow-up, and she declined surgical consultation.
Guidelines for Refeeding Syndrome
- Recurrent emesis due to SMA syndrome, however, differs in that it results from compression of the duodenum.
- If you need help quitting, ask your doctor whether a drug rehabilitation program is a good fit for you.
- They may also prescribe antipsychotic medications such as haloperidol (Haldol) or olanzapine (Zyprexa) to help you calm down as you switch to the recovery phase.
- While it is effective, other medications are still needed in conjunction with topical capsaicin for total symptom resolution.178 The mechanism of how capsaicin reduces CHS symptoms is not known; therefore, its exact role in CHS treatment is not yet clear.
- For our patient who had previously used cannabis, most of these were ruled out in the initial diagnostic evaluation through laboratory evaluation and imaging.
For example, the drug affects the receptors in the esophageal sphincter, the tight band of muscle that opens and closes to https://ecosoberhouse.com/ let food go from your throat to your stomach. If this flap doesn’t work properly, your stomach acids might flow upward and cause you to have nausea and vomiting. As food is slowly added back to the body, healthcare providers (who might be a specialized team) will keep track of vital signs and electrolyte levels. The continued monitoring will also help determine how slowly nourishment needs to be added back to the body.
Refeeding syndrome might be diagnosed after a healthcare provider performs a physical exam and takes a careful history, especially of any digestive problems or changes related to eating and nutrition. In contrast, SMA syndrome is a rare gastrointestinal illness, and clinicians should be aware of the possible relationship between it and CHS, as highlighted by this and previous case reports 4,5. A high index of suspicion for the numerous possible CHS complications, including SMA syndrome, is warranted for clinicians when treating a patient with marijuana use and persistent cyclical vomiting. Frequent vomiting due to CHS can cause erosion of teeth enamel and may result in tooth loss. CHS may also cause dehydration, acute kidney injury, and low blood levels of chloride, potassium, sodium, and bicarbonate, which may require emergency department visits and hospitalizations.
