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Cannabinoid Hyperemesis Syndrome

(CHS)

How to say it: Can-ah-bin-oyd Hi-perr-emm-ih-sis Sin-drom
by Cynthia M. Johnson, MA

Definition

Cannabinoid hyperemesis syndrome (CHS) is severe nausea and vomiting in people who use a lot of cannabis (marijuana). It is rare.

Causes

The cause of CHS is not known.

Risk Factors

You have a higher risk of CHS if you use cannabis more than once a week for more than a year.

Symptoms

People who use cannabis may have:

  • Attacks of nausea and vomiting
  • Belly pain
  • Fear of vomiting
  • Weight loss
  • Symptoms that ease after taking a hot bath or shower

Symptoms often get better in 1 to 2 days when cannabis is stopped. They return when you use cannabis again.

Diagnosis

You will be asked about your symptoms and health history. You will also be asked about your use of cannabis. A physical exam will be done. It will focus on your belly. The diagnosis is based on your symptoms and cannabis use.

Treatment

The only way to treat CHS is to stop using cannabis. Your symptoms will come back if you continue to use it.

Talk with your doctor about the best treatment plan for you. Some choices are:

Hot Baths or Showers

Hot baths and showers can ease nausea and belly pain. It can also help you feel hungry again. It is not known why it is helpful. The relief only lasts a short time.

Fluids

You will need to replace fluids lost from vomiting. This can be done by drinking plenty of water or an oral rehydration solution. People who have lost a lot of fluids may need them replaced more quickly. This can be done with IV fluids.

Medication

Medicines used to treat CHS are:

  • Antiemetics to control nausea and vomiting
  • Proton pump inhibitors to reduce stomach acid
  • Capsaicin cream put on the belly to cause a feeling of warmth

Therapy

Therapy can help if there is misuse of cannabis. This includes use that interferes with relationships and day-to-day life.

Prevention

You can prevent CHS by not using cannabis.

RESOURCES:

DrugFree.org
https://drugfree.org
National Institute on Drug Abuse
https://www.drugabuse.gov

CANADIAN RESOURCES:

Canadian Centre on Substance Use and Addiction
https://www.ccdus.ca
Health Canada
https://www.canada.ca

References:

Adverse effects of cannabinoids. EBSCO DynaMed website. Available at: https://www.dyname.... Accessed April 5, 2020.
Cannabinoid hyperemesis syndrome. Cedars-Sinai website. Available at: https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/cannabinoid-hyperemesis-syndrome.html. Accessed April 5, 2020.
Last reviewed April 2020 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD
Last Updated: 4/5/2020