Cannabis Hyperemesis Syndrome (CHS)

Cannabis Hyperemesis Syndrome (CHS) is a condition of recurring episodes of severe nausea, vomiting, and abdominal pain that is caused by chronic, long-term cannabis use. CHS was first reported in 2004. It’s fairly new to the scene, and research is ongoing to better understand its triggers because most medical marijuana users are not effected by CHS. For those that are, the only cure is to stop using marijuana.

How common is cannabinoid hyperemesis syndrome?

Only a small portion of people who regularly use cannabis develop CHS. Because this is a newly discovered condition, many people may have it and not report it or are misdiagnosed. One study found that up to 6% of people who visited the emergency room for vomiting had CHS.

Being misdiagnosed is an issue. Symptoms of CHS are similar to GI disorders. Someone could possibly suffer for years through treatments, unneccsassry tests and mulitple hospital vists before finding out their issue is CHS. If you’re dealing with recurring episodes of nausea and abdominal pain, be honest with your healthcare provider and report medical cannabis use.

What are the causes of CHS?

Except for the fact that chronic cannabis use is a factor, the scientific healthcare community is also studying how genetics plays a role because most cannabis users are not inflicted. In fact, medical marijuana is frequently used to combat chemotherapy-induced nausea and vomiting so it’s a bit of paradox as to how marijuana could then lead to hyperemsis (prolonged, persistent nausea).

THC, the principal psychoactive component in marijuana, is linked to the activation of CB1 receptors in the brain and nervous system. “Stimulation and blockade of CB1 receptors can inhibit vomiting in a dose-dependent manner.” CCJM

But chronic overuse of cannabis over a long period of time may downgrade the brain’s chemicals, when instead of inhibiting vomiting it actually induces it, resulting in CHS. Keep in mind, it’s not as easy, or simple, to just say that CHS is a case of “too much of a good thing.” It is not prevelant in all medical marijuana patients who have used for a long time. Studies are being done to determine genetic or enivronmental causes.

Symptoms of Cannabis Hyperemesis Syndrome (CHS)

Hyperemesis is a clinical term that means to suffer from severe or prolonged vomiting, persistent enough that the issue leads to weight loss and/or dehydration. So anyone with Cannabis Hyperemesis Syndrome can expect to deal with that. And it is believed to arrive in stages.

The first stage of CHS:

• Days, weeks or months of mild symptoms

Researchers frequently describe the symptoms of this first stage as “similar to the ‘aura’ of migraines because they precede an intense worsening of symptoms. In this phase, patients experience nausea, mild GI discomfort, and anxiety or restlessness. Symptoms are more commonly experienced in the morning but may be felt throughout the day. Patients’ eating habits are unchanged, and weight loss and vomiting are minimal or absent. Many patients continue or increase their cannabis use because they believe it will ease symptoms; they don’t make the connection between their symptoms and cannabis use because the symptoms don’t occur immediately after consumption.” American Nurse

The second stage of CHS:

• Days of intense vomiting, abdominal pain, sweating and flushing
• Vomiting as frequently as four or more times per hour
• Weight loss
• Dehydration

This is when many patients discover that hot showesrs, or baths, relieve symptoms. The hotter the water, the greater the relief. It’s referred to as “washing away” the nausea. It’s important to note that while some individuals with CHS may find temporary relief from hot baths or showers, this does not provide a long-term solution or cure for the condition.

Treatments for Cannabis Hyperemesis Syndrome

What’s with the hot showers? One theory is that cannabis use affects the body’s ability to regulate temperature, and CHS can lead to hypothermia when the body temp drops. The hot water helps raise the body’s temperature and alleviate some of the discomfort. Hot showers may simply be a distraction from the symptoms. Any theories on why hot showers relieve symptoms of CHS is specualtive at this point. It’s definitely not a cure. The only known treatment for Cannabis Hyperemesis Syndrome is cessation – to stop using cannabis.

At this time, only when patients have stopped using marijuana did their symptoms dissolve. “In all studied cases, resumption of cannabis use caused symptoms to recur. This recurrence is compelling evidence that cannabis is the root cause of CHS, making a history of cannabis use essential for diagnosis.” American Nurse

If you, or someone you know, is experiencing symptoms of CHS, it is advisable to consult with a healthcare professional for an accurate diagnosis and appropriate management. And be sure to report cannabis use.