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Cannabinoid Hyperemesis Syndrome

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Tpain,


Two of the conditions you mentioned  (gastritis and gastroparesis) were some of the diagnosis I received along the way. Also, yes I tried milk of magnesia early on. I read that 1/4 of the recommended laxative dose can be used as an antacid. Antacids were helpful for immediate relief and I carried tablets with me throughout the summer. However, the doctor warned against long term use saying that they can increase acid production if the body becomes accustomed to them. 


 


The leafly article in post #22 mentioned 3 phases (2 excluding recovery), with the third being the hyperemetic phase. I definitely was not there. I'm thinking I was in a pre-prodromal phase because I did not have the morning sickness or nausea, just extreme abdominal pain after meals (pain directly proportional to meal size), and pain when first laying down at night. The only time i did not have pain (before starting the acid reducers) was when i was hungry. 


 


Maybe this thread about CHS will be a benefit to some future person with medically undiagnosable abdominal pain or vomiting. The leafly article also said symptoms go away with 1-2 days abstinence. Other articles I've read suggested 1 week or 1 month. In the meantime I can't wait to regain my weight and start vaping again. I'm guessing my tolerance will be decreased a bit so that should be interesting. 


 


I've been off the acid reducers for a week now with no symptoms. So I'm done with this thread. Sorry if anyone felt that my belief in CHS was offensive or threatening. That was never my intention. I was only seeking knowledge and relief. It was reassuring to see there is some compassion out there. 


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Maybe this thread about CHS will be a benefit to some future person with medically undiagnosable abdominal pain or vomiting. 

 

It would just make things worse with all the unqualified guessing about something that would be impossible to diagnose over the internet. 

See a real doctor.

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Sorry if anyone felt that my belief in CHS was offensive or threatening. 

 

It's just that this syndrome isn't real unless someone gets a proper diagnosis. That would take a real doctor with real office visits, and then it would still be very difficult to diagnose. I really don't think there's much realness about it at all.

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I'm sorry legacy that the drs have mis diagnosed you twice.

 

I wish I could help more.

 

maybe if you want to share all medical records and blood work, I would pour over the literature and look for possible problems. but it would still just be a guess from me, a high school drop out...

 

 

yeah, ginger root, cabbage and turmeric are great anti inflammatories. juicing those may help. or they may aggravate stomach too. always worth a shot...

 

the reason why I say it's not chs is because chs would be hours of nausea and vomiting after mj use. chs literally means cannabis hyper vomit.

 

 

em·e·sis/ˈeməsis/noun

the action or process of vomiting.

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I realize this is a really late post but just joined...

 

Cannabis/cannabinoid hyperemesis syndrome IS a real condition but really uncommon. I've been involved in the care of a hospitalized patient with characteristic symptoms but the diagnosis was made only after ruling out other more common problems. This included the patient undergoing an upper endoscopy for upper GI conditions like gastritis, ulcer, or gastroesophageal reflux/reflux esophagitis as well as evaluation of the gallbladder, small bowel, liver, etc.. It is not an easy diagnosis to make and I agree that healthcare providers that know about the condition seem to be too quick to pin that diagnosis on the patient. Personally, I believe that eagerness to make that diagnosis may come from a physician's personal belief that cannabis use is bad. I actually heard another physician say to the patient "see what happens when you use that stuff!" 

 

Someone asked how can cannabis cause this condition when it works so well to relieve nausea with chemotherapy. My response is that cannabis is not a single, simple compound that behaves predictably for many people and so there will be some people that have an unexpected response. For instance, although a lot of patients report that use of cannabis calms them and relieves anxiety, for a group of people just the opposite is true:  an exaggerated anxiety response. We are learning, with several supportive studies, that this reaction is more likely in patients with psychotic disorders AND also in patients who have a family history of psychotic disorders. Which is why it's not advisable to certify such patients (and I screen for and don't certify anyone with a history of psychotic disease or family history of such) for medical cannabis use. It's likely that CHS is a form of chronic toxicity rather than an exaggerated immediate response.  Hopefully, now that good research is being done for medical cannabis use, we'll soon have better information about this disorder.

 

In the meantime, this is a pretty uncommon problem, probably a lot less common than many of my colleagues think. I have personally performed thousands of upper endoscopies and have only encountered 1 patient in the last 10 years that truly had this disorder. 

 

Dr. Free

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First of all, I'm extremely supportive of the medical use of cannabis for conditions that have evidence that such use is helpful. Secondly, my point was that although this IS a real condition, it is rare and very much over-diagnosed by the medical community. In this specific case, the patient gave a specific, detailed history of chronic, heavy use (recreational, not medical) but this diagnosis wasn't made even then until all other more likely diagnoses had been excluded. I see many patients for a variety of reasons who give a history of cannabis use and don't assume their symptoms are related to cannabis use. And finally, yes, I am a board-certified physician who is compassionate and caring about my patients and I believe that I have the expertise to make appropriate, professional comments about the topic being discussed. Just because a condition is outside of someone's realm of experience doesn't mean that the condition doesn't exist.

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Three recent studies on the condition:

 

"Cannabinoid hyperemesis: a case series of 98 patients." Mayo Clinic Proceedings, 2012; 87(2): pp 114-119.

 

"Cannabinoid hyperemesis syndrome as the underlying cause of intractable nausea and vomiting." Journal American Osteopathic Association, 2011; 111(3): pp 166-169.

 

"Cyclic vomiting presentations following marijuana liberalization in Colorado." Journal of the Academy of Emergency Medicine, 2015; 22(6): pp 694-699.

 

Perhaps, as you say, this is not a real condition. There does, however, appear to be a significant amount of evidence to the contrary. Denying that the condition exists is no more helpful to those rare patients with the condition than is overdiagnosing the condition and missing the underlying problem for those many other patients who don't have this condition.

Edited by DrFree

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That's the exact point of my posts, glad you finally realized that. This is a condition that is probably very rare but far too often incorrectly diagnosed (i.e. overdiagnosed) for a variety of reasons. 

 

Perhaps one of the reasons physicians are so reluctant to engage in conversation with the medical marijuana community is what I just experienced-- judgmental, biased, and accusatory responses to a good-faith effort from a physician who actually believes in the medical use of cannabis. 

 

Good luck to the next caring physician who wants to join this forum!

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Just thought I'd share an update on my unexplainable abdominal pain. I returned to cannabis (mostly vaping for maybe the past 6 months) but limited to 2-3 sessions per week. No problems. Hoping it stays that way. 

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The interesting part would be the cure for it.

 

If this was happening to me I would be deconstructing my cannabis to see which part of it was the problem. Also, I would look for clues like thinking about what other things cause the symptoms. The patient will have to be the one to solve this. Just like with allergies, the patient is the detective. 

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After I tried to change up the cannabis every which way I could think of, then I would up my water intake and take an antihistamine like Claritin to see if that made any difference. . 

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4/19/18 article from Herb...

Thomas Hodorowski, who had CHS, told the New York Times, “The pain was unbearable, like somebody wringing my stomach out like a washcloth.” 

Sounds about right.

Fortunately i've returned to vaping about once per day, sometimes more or less without any symptoms. 

 

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Seems like your syndrome has died away as the reports of it on the net have also died off.

Very suspect when cannabis use is always on the rise as more states legalize, but reports of a syndrome associated with chronic use goes away with it falling out of the fake news reports. Very suspect indeed. 

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Food for thought;

Aspartame, the artificial sweetener causes cyclic vomiting. It was used in most diet sodas and has been discontinued and replaced recently in many. 

So we have cannabis use on the rise as cyclic vomiting cases diminish. And at the same time we see aspartame use diminishing along with cyclic vomiting cases diminishing. Maybe we have a real cause of the problems that were not properly diagnosed and blamed on cannabis use. 

Edited by Restorium2

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Cannabinoid hyperemesis syndrome can occur with cannabis use and is characterized by recurrent nausea, vomiting, and crampy abdominal pain. These symptoms have been reported to be improved temporarily by taking a hot shower or bath, or more fully by stopping the use of cannabis.

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