Health Library

Cannabinoid Hyperemesis Syndrome

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

The risk of CHS is higher in those who use cannabis more than once a week for more than a year.

Symptoms

Symptoms of CHS may may include:

  • 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 the person uses cannabis again.

Diagnosis

The doctor will ask about symptoms, past health, and use of cannabis. A physical exam will be done. It will focus on the belly. The diagnosis is based on symptoms and cannabis use.

Treatment

The only way to treat CHS is to stop using cannabis. Symptoms will come back if the person continues to use it.

The goal of treatment is to ease symptoms and prevent further problems. Options 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.dynamed.com/drug-review/adverse-effects-of-cannabinoids.

Cannabinoid hyperemesis syndrome. Cedars-Sinai website. Available at: https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/cannabinoid-hyperemesis-syndrome.html.