Cannabinoid Hyperemesis Syndrome: What You Should Know
Cannabinoid hyperemesis syndrome is a condition in which long-term marijuana users experience stomach pain and extreme, recurring nausea and vomiting that dissipates during a hot shower or bath.
According to the National Library of Medicine, people with cannabis hyperemesis syndrome experience repeated and severe episodes of vomiting and stomach pain. Only people who use cannabis regularly and for a long period of time are at risk of developing this rare condition.
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What Chemicals Are in Marijuana?
There are a number of active substances in marijuana, which are known as cannabinoids. Tetrahydrocannabinol (THC) and cannabidiol (CBD) are two examples of these cannabinoids. These chemicals bind to molecules in the brain and digestive tract, which play a crucial role in regulating a number of physiological processes, such as:
- Mood
- Appetite
- Pain perception
- Nausea
When THC and other cannabinoids bind to the receptors of the endocannabinoid system, they can produce a range of psychoactive effects that are associated with marijuana use, like euphoria, relaxation, and altered perception.
What Are the Symptoms of CHS?
The most common symptoms of CHS include recurrent episodes of severe nausea, severe vomiting, and abdominal pain. These symptoms are often debilitating and can last for several hours or up to a few days.
Some people also experience loss of appetite, weight loss, and dehydration from excessively throwing up.
People experiencing painful CHS symptoms often resort to taking hot showers and/or hot baths to get relief. This isn’t a perfect solution, however, because once they get out of the hot water, the symptoms return.
Three Phases of CHS
There are three phases of cannabis hyperemesis syndrome.
Phase 1: Prodromal
The prodromal phase is most common among adults who have been marijuana users since their teenage years. Abdominal pain and morning nausea are the most common symptoms during this phase.
Phase 2: Hyperemetic
The hyperemetic phase typically lasts between 24-48 hours and is characterized by a number of uncomfortable symptoms, including overwhelming and persistent nausea and vomiting.
These symptoms can be so intense they can make it hard for people to go about their daily routines.
Phase 3: Recovery
In the recovery phase, people stop using cannabis. In this phase, CHS symptoms start to lessen and eventually disappear entirely.
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How is CHS Diagnosed?
You must meet certain criteria to be diagnosed with CHS, including:
- Using marijuana daily or weekly for at least one year
- Severe cyclic vomiting episodes after prolonged cannabis use
- Jabbing stomach pain
- Symptoms stop when you stop using marijuana
- Compulsive bathing in hot water
It’s important to note that CHS isn’t the only health condition that causes repeated vomiting. For example, cyclic vomiting syndrome (CVS) and pregnancy are two conditions that can also cause severe nausea and vomiting. This is why diagnosing CHS can be a bit tricky.
1. Initial Evaluation and Triage
Your healthcare provider will conduct a thorough evaluation if you are experiencing symptoms of Cannabinoid Hyperemesis Syndrome and to rule out other causes. The evaluation typically involves a combination of medical history, physical examination, and diagnostic tests.
In reviewing your medical history, your healthcare provider will ask you questions about your symptoms, including how long you have been experiencing them, the frequency and duration of vomiting, and any other associated symptoms you may be experiencing. They’ll also ask about your drug use history, including the frequency and duration of cannabis use.
During the physical examination, your healthcare provider will look for signs of dehydration, electrolyte imbalances, and weight loss. They may also perform a neurological examination to assess your coordination and reflexes.
2. Confirming a Diagnosis of CHS
To confirm the diagnosis of CHS, your healthcare provider will likely run a series of tests to rule out other causes of recurrent nausea and vomiting, including:
- Blood tests for anemia
- Blood tests for infection
- Tests for electrolyte levels
- Pregnancy test
- Urine drug screen
- CT scan of the head if it seems like the nervous system is causing the vomiting
- CT scan of the abdomen
What Are the Health Complications of CHS?
Dehydration is a side effect caused by repeatedly throwing up and is one of the main complications of CHS. The problem with dehydration is that it can lead to a host of other health issues.
If you lose too many electrolytes and don’t seek medical attention, you could be at risk of the following:
- Shock
- Seizures
- Kidney failure
- Muscle spams
- Muscle weakness
Severe vomiting can also lead to:
- An inflamed esophagus
- Malnutrition
- Tooth decay
- Low potassium
- Aspiration, which can lead to inflamed lung tissue and aspiration pneumonia
What Causes CHS?
Although no exact cause of CHS has been pinpointed, researchers believe there are a few factors that can cause CHS, such as:
- Genetics
- Dysregulation of certain receptors
- Slowed digestion
- Toxic buildup from long-term marijuana use
- Enlarged blood vessels
- Disruption of the body’s temperature regulation
Treatment of Cannabinoid Hyperemesis Syndrome
Some of the treatments for CHS include:
- IV fluid treatment to help restore fluid and electrolyte balance in the body
- Antiemetic medications, like ondansetron and promethazine, to help stop vomiting
- Pain medications to help alleviate the abdominal pain
- Anxiety medication such as benzodiazepines to manage the anxiety or panic attacks that some patients experience
- Heartburn medication to treat stomach inflammation
- Capsaicin cream, which is a topical cream made from chili peppers and has been shown to help decrease pain and nausea
Can I Treat CHS at Home?
If you don’t feel like your symptoms warrant a trip to the emergency department, you may want to stay home and try the following at-home cures:
- Hot baths and hot showers to relieve nausea and help relax your muscles to ease belly pain
- Benadryl and other antihistamines, which can help reduce nausea
- Antipsychotic medications such as haloperidol can also help reduce nausea
- Over-the-counter pain relievers like ibuprofen or acetaminophen
Remember, these remedies may not work for everyone. It’s always best to consult with your healthcare provider before trying any new treatment.
Zinnia Health Can Help You Quit Marijuana
To fully heal from cannabinoid hyperemesis syndrome, you must stop using marijuana. If you need help quitting marijuana or other drug abuse, Zinnia Health can help.
Our team of caring and compassionate addiction specialists works with each client to create a custom treatment plan. To learn more about our process and nationwide treatment centers, call (855) 430-9439.