It may seem paradoxical that cannabis — which is often used to treat nausea and vomiting — can cause Cannabinoid Hyperemesis Syndrome (CHS) in some users. Yet some chronic cannabis users may develop Cannabinoid Hyperemesis Syndrome (also sometimes called “Cannabis Hyperemesis Syndrome,” a condition that causes persistent vomiting, seemingly endless vomiting episodes, and severe abdominal pain. In this article, you’ll learn more about what the symptoms are, why CHS only occurs in some individuals, how to determine if you have CHS, and what the stages of the condition are.
What Are The Symptoms of CHS?
Cannabinoid Hyperemesis Syndrome is an episodic condition, meaning it comes and goes. The most obvious symptom of CHS is vomiting sessions lasting between 24 and 48 hours, followed by asymptomatic periods that can last weeks or months.
During an episode, patients will experience any or all of the following symptoms:
- Abdominal pain that can’t be relieved with conventional treatments (e.g., ondansetron, promethazine, and metoclopramide)
- Extended periods of nausea and vomiting — up to 20 times per day
- Severe nausea and intractable vomiting
- Unintentional weight loss
According to a 2017 study published in the Journal of Medical Toxicology, researchers identified the major diagnostic characteristics of CHS patients:
- Abdominal pain (85.1%)
- At least weekly cannabis use, but usually much more (97.4%)
- Chronic cannabis use for more than a year (74.8%)
- Severe nausea and vomiting (100%)
- Symptoms go away after patients stop using cannabis (96.8%)
- Men are more likely to suffer from CHS — men represented 72.9 percent of patients in the study
The answer to this question remains a mystery, although there are a few proposed explanations:
- Genetics: Individuals who get CHS may have a genetic or immune vulnerability;
- Long-Term Excessive Use of Cannabis: With rare exception, most everyone who develops CHS have been using cannabis for a long time, and often;
- Digestive Tract: Our digestive tract contains many molecules that bind to THC that cannabis use can affect. In some people, long-term cannabis use may alter the way their molecules respond, which could lead to CHS.
There are two indicators that suggest a person has CHS:
- Nausea and vomiting that go away (temporarily) after the patient takes a hot bath, shower, or medicates with capsaicin (an active component of chili peppers). No other vomiting condition we know reverses itself due to heat;
- Symptoms cease and don’t recur after a sustained period of abstinence. If cessation of cannabis use doesn’t eliminate CHS, the patient may have a different type of cyclic vomiting condition.
Keep in mind that the severity and length of time a patient suffers from symptoms can vary dramatically among those with CHS.
There are three stages of CHS symptoms:
This phase can last anywhere from months to years. During this phase, a patient will generally experience nausea and abdominal pain when they wake up in the morning.
During this phase, most patients can still maintain their regular eating patterns. However, many patients up their cannabis use, thinking the cannabis will cure their nausea and vomiting. It’s obviously paradoxical that cannabis (which many patients use to get rid of nausea and vomiting) could cause it others.
During the hyperemetic phase, patients will experience persistent nausea, abdominal pain, reduced appetite and food intake, dehydration, and ongoing vomiting episodes. Vomiting during this phase can be overwhelming and may persist until the patient stops their cannabis use.
During this phase — which can last between days to months — the patient’s appetite goes back to normal, and they no longer experience symptoms. Symptoms will likely return if the patient resumes cannabis use.
Clearly, Cannabinoid Hyperemesis Syndrome is no joke for those suffering from it. Fortunately, it can be treated. Unfortunately, the only long-term solution is for a patient to stop using cannabis, permanently. Also, as we noted earlier, patients can find short-term relief by taking a hot shower, a bath, or by using a topical capsaicin cream.
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