Article by Angela Stelmakowich, Growth Op
A fatigued and dehydrated woman had to be hospitalized for nausea, vomiting and chronic abdominal burns from using heating pads to treat painful symptoms later diagnosed as being related to cannabinoid hyperemesis syndrome (CHS).
The 27-year-old woman, a daily recreational cannabis consumer, was unaware she had CHS — symptoms of which include ongoing nausea, repeated vomiting, stomach pain, decreased food intake and dehydration, notes a recently published BMJ case report.
By the time the woman was hospitalized, she was a regular user of heating pads as heat therapy. The pads had replaced warm and hot showers, which had helped to alleviate her symptoms but she was scalded on several occasions after falling asleep on the shower floor.
A CHS review published in late 2016 showed that 92 per cent of affected patients reported using compulsive hot showers and baths for symptom relief.
“The exact mechanism by which hot showers provide relief from CHS remains unclear,” the case report explains. As CB1 cannabinoid receptors “are found in the hypothalamus, it is hypothesized that warm temperatures correct the cannabis-induced disequilibrium at the thermoregulatory centres, which could explain compulsive hot bathing,” it adds.
The report goes on to note that “heat therapy with warm showers also promotes vasodilation on the skin, which causes a redistribution of congested blood from the gut with diversion to the skin, ‘cutaneous steal syndrome,’ relieving splanchnic congestion which alleviates symptoms.”
Upon coming to the hospital, the woman had been suffering from intractable nausea and vomiting for a week and recurring symptoms had persisted over an 18-month period. At the time, doctors also found that she was unable to tolerate oral intake and her abdomen had skin discolouration.
Although her symptoms were initially attributed to acute cholecystitis, recurrence of the symptoms and three gastrointestinal endoscopies at different hospitals showed that was not the issue.