Cannabinoid Hyperemesis Syndrome
(CHS)
How to say it: Can-ah-bin-oyd Hi-perr-emm-ih-sis Sin-drom
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.
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.dynamed.com/drug-review/adverse-effects-of-cannabinoids. 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
