What Is CHS: Cannabinoid Hyperemesis Syndrome? 


Cannabis is pretty common nowadays. You might have tried smoking weed or eating a cannabis gummy, even if you’re not a regular user. Depending on your state’s laws, the act is usually harmless. Plus, it doesn’t present any side effects in most people.

Of course, there are always exceptions out there. You may suffer from some problems if you take heavy doses of cannabis over a prolonged period. One of these problems is CHS. 

Cannabinoid Hyperemesis Syndrome, CHS, is a rare condition that affects chronic cannabis users. Depending on the intensity of the symptoms, it can land you in the emergency department. So let’s see what it is!

What Is CHS?

CHS stands for Cannabinoid Hyperemesis Syndrome or Cannabis Hyperemesis Syndrome. The syndrome usually affects people who are chronic long-term users of cannabis. Severe nausea, vomiting, and abdominal pain are common CHS symptoms.

Doctors only discovered it during the 2000s, so they don’t know everything about it. Still, CHS isn’t a minor problem. If you have CHS and don’t get treated, it could cause severe complications later. 

Who Does CHS Affect? What Are The Risk Factors?

Even if chronic marijuana use isn’t the same as substance abuse, it is bound to leave some nasty side effects. CHS just happens to be one of those effects. CHS may affect people who use cannabis regularly. Even one a week is too much in such cases.

If the person has been using cannabis from a very early age, they are at a higher risk of developing CHS. Unfortunately, we don’t know that much about other risk factors. More studies are needed to determine if certain genetic or environmental factors contribute to the disease’s occurrence. 

What Causes CHS?

Excessive and prolonged cannabis use causes Cannabinoid Hyperemesis Syndrome. Of course, it doesn’t happen to everyone. According to our information, only a few avid marijuana users are affected. 

Other than that, we don’t have much to go on. There simply haven’t been enough studies to identify why high amounts of cannabis cause CHS. Of course, there are a few theories in the medical community. 

Cannabis has cannabinoids that react with the cannabinoid system in your body. As a result, you get relief from nausea, increased appetite, and other benefits. However, chronic overstimulation of these receptors can cause all these effects to be reversed. 

Thus, it affects the temperature regulation in the hypothalamus. That leads to lower body temperatures and nausea hence why hot showers can alleviate the symptoms for a while. Additionally, it slows digestion which may cause nausea and vomiting. 

Alternatively, genetics may play a role as well. Some people are predisposed to CHS because they develop mutations in their genes. Like we said before, these are all theories. More research needs to be conducted before we find the actual cause of CHS.

Does Every Regular Cannabis User Get CHS?

Nope. If we look at the statistics, only a small percentage of chronic marijuana users develop CHS. However, you must remember that CHS is a relatively new disease. That means people don’t know much about it. 

It is quite possible that it may be misdiagnosed as Cyclic Vomiting Syndrome (CVS). CVS, called Cyclical Vomiting Syndrome, is also characterized by severe vomiting and persistent nausea. It’s a manifestation of psychological problems instead of a disease. 

Researchers have been trying to determine the frequency of the syndrome. However, the results are quite contradictory. Some papers say it is quite common and may occur in as many as 33% of the population. However, other studies have shown that it’s rare and only affects some people. 

What Are The Common Symptoms Of CHS?

Cannabinoid Hyperemesis Syndrome symptoms can be very severe, depending on the person. Furthermore, you likely won’t feel all the symptoms at once. Some of the more common symptoms of the condition are:

  • Severe vomiting (Can last a few hours)
  • Morning sickness
  • Persistent nausea
  • Stomach pain
  • Dehydration
  • Weight loss
  • Fear of vomiting
  • No appetite

These are the general symptoms. You don’t need to feel every one of them. Alternatively, you could have symptoms, not on this list.

What Are The Phases Of CHS?

The symptoms are usually spread out over a period. According to a paper in the Current Drug Abuse Reviews, there are three phases of the syndrome’s onset:

  • Prodromal Phase

The prodromal phase is characterized by morning sickness and abdominal pain. It’s more common among marijuana users who have been using it since their teenage years. People may try to use more marijuana to relieve pain and decrease nausea. Since many believe that weed helps with pain.However, that doesn’t help. The person’s appetite remains the same. Some people can stay in this phase for months or years. 

  • Hyperemetic Phase

Hyperemesis means severe vomiting. So during this phase, the person will suffer from extreme vomiting. They may vomit several times during an hour, and the phase can last up to two days. 

People may resort to hot showers to alleviate the symptoms. They’ll also start avoiding food and drinks, leading to dehydration and weight loss. Taking cannabis or cannabinoids during this phase will just make things worse. 

The patient may have to visit the ER during this phase as the condition can get quite severe. However, the symptoms won’t completely stop unless they stop using marijuana. 

  • Recovery Phase

Once the person stops using cannabis, the recovery phase begins. After the symptoms subside, they regain their appetite. The patient regains all the weight they lost. The symptoms probably won’t return unless they start using marijuana again. 

How Do Healthcare Professionals Diagnose CHS?

There are no dedicated tests for Cannabis Hyperemesis Syndrome (CHS). Since it’s newly discovered, your health provider may not even know about it. They’ll ask about your history and do a physical exam. 

Inform your health provider about your cannabis use. They’ll dig into that and might order a few tests to rule out other diseases. These tests include but are limited to:

  • Blood tests
  • Electrolyte tests
  • Pregnancy tests
  • Liver and pancreas tests
  • Drug tests
  • Urine tests

They might use imaging techniques like X-rays, CT, MRI, and endoscopy to rule out blockages and other issues. If your doctor can’t figure it out, you may have to consult with a gastroenterologist to get a diagnosis.

How Can CHS Be Treated?

Quitting cannabis is the only definitive treatment available at this time. There’s no other cure. After a while, your symptoms will disappear, and you’ll return to normal. However, relapse may cause the symptoms to reappear.

During the second phase, you will need to treat CHS symptoms to relieve pain and vomiting. To do so, your healthcare provider may recommend: 

  • Antihistamines for reducing stomach inflammation and pain. Common antihistamines include Benadryl.
  • Antipsychotic medicines to alleviate the fear of vomiting. Alternatively, they may recommend it if they think you have CVS.
  • Capsaicin cream for belly pain relief. They may also offer over-the-counter pain relievers like Advil or Tylenol.

The doctor will also provide IV fluid replacement if you’re severely dehydrated. Of course, all these approaches only alleviate the symptoms for a little while. For a long-term effective relief, you will need to quit cannabis use. 

Once you stop using cannabis, you can use the meds and hot showers to keep the symptoms at bay while you recover. Afterward, eat well to regain all the weight you lost. Get a physical exam to see if the vomiting caused any additional damage.  

Are Hot Showers And Baths Really Effective Against CHS?

Some people resort to hot showers and baths to try and relieve their symptoms. This form of self-medication might work. However, if the condition isn’t treated, the person may develop a habit of compulsive showering. 

Here’s how hot baths help relieve CHS symptoms like nausea and pain:

  • By Affecting the Hypothalamus

When you take THC,in different forms including THC cartridges, gummies and vapes. It affects your hypothalamus. The THC interacts with the cannabinoid receptor in the thalamus and regulates it. The hypothalamus controls temperature regulation and vomiting, and nausea. 

When THC interacts with it in low doses, it causes your body temperature to increase. Generally, this is how your nausea is relieved. Alternatively, it can interact with the receptor in high doses and cause the opposite reaction. Your body temperature falls, and you start feeling nauseous. That’s what happens when you have CHS.

In such cases, when you take hot showers, it raises your body temperature, easing nausea. You also vomit less. However, it only works for a little while. You’ll need to quit marijuana for actual relief.

  • By Activating Vanilloid Receptors

When your body is under hot water, it activates the Vanilloid receptors too. These receptors cause transient itching and burning. As a response, the body gives rise to an analgesic reaction. This analgesic reaction desensitizes the cells, which eases your pain and nausea. That’s also the reason why capsaicin cream is effective in treating the pain from CHS. 

Are There Any Long-Term Complications of CHS?

If left untreated, you will keep vomiting. That will lead to dehydration and weight loss. It can also cause tears and inflammation in your esophagus. Excessive vomiting may also lead to tooth decay and low potassium and phosphorus levels in your blood. 

Air may become trapped between your lungs if things get even more serious, causing pneumomediastinum. That’s even more painful. Alternatively, you can get the vomit into your lungs and airways, causing aspiration pneumonia.

Even if the other complications from vomiting don’t occur, dehydration can do much damage. These include:

  • Shock
  • Seizures
  • Heart rhythm problems
  • Kidney failure
  • Muscle spasms
  • Brain swelling or cerebral edema

Of course, if you go to the hospital when the vomiting is severe, they’ll provide first aid to avoid these complications. 

What Precautions Help Prevent CHS?

The only precaution you can take is quitting cannabis. It’s helpful in small doses for treating insomnia, pain, and nausea. However, it can cause problems like CHS in the long run. Since CHS takes a long time to develop, you may not even feel it at first. 

Unfortunately, once you develop CHS, you must quit marijuana. That’s the only way your symptoms will resolve. Furthermore, you must do it permanently because the symptoms will return if you relapse. 

Withdrawal can be hard if you have been using cannabis for a long time. However, there are rehab centers and organizations that can help you. If you need help quitting, you can call the Substance Abuse and Mental Health Services Administration. They’ll give you all the information you need. 

When To Visit The Emergency Department Or ER?

If you’re suffering from prolonged vomiting and abdominal pain, it may be time to head to the hospital. They’ll provide first aid, but you will have to quit cannabis too. Once you get to the hospital, you must inform them of your cannabis use. Providing all the information will make diagnosing you easier for the doctors.

Once you quit cannabis, the symptoms will start going away. While the symptoms are subsiding, use complementary and integrative health approaches to treat your symptoms. That means combining the medications your doctor gives you with occasional hot showers for maximum relief.

If you’re using marijuana for medical purposes, you can work with your doctor to find alternative medications. If you have been abusing marijuana and can’t quit, contact a rehab center for help. Do not use CBD to alleviate symptoms, as that will only worsen things.

Conclusion: Cannabinoid Hyperemesis Syndrome Is Dangerous? 

Cannabinoid Hyperemesis Syndrome (CHS) is a syndrome that develops in chronic cannabis users. People suffering from the syndrome have severe vomiting that can last two days, nausea, and abdominal pain.

Its always important ensure that while buying weed online you must research about the brand to check if the brand is offering legitimate products. If things get severe, they can lose weight and dehydrate, which is dangerous. 

These people usually learn to self-medicate by using hot showers and baths. However, the solution is only short-term, and the symptoms return. If the vomiting doesn’t stop, they’ll have to go to the ER to receive medical aid. Unfortunately, this aid only alleviates the symptoms for a while.

For a permanent solution, the patients need to stop using cannabis. Once they do that, the symptoms go away. However, if the patient relapses, the symptoms will return. We don’t know the exact mechanism through which CHS develops. Thus, the only choice is to quit using marijuana.


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