Cannabis Hyperemesis Syndrome (CHS): Symptoms, Causes, Treatment

What are the symptoms of cannabis hyperemesis syndrome?

Cannabis hyperemesis syndrome (CHS) is a condition characterized by recurrent episodes of severe nausea, vomiting, and abdominal pain in individuals who use cannabis heavily or regularly. The symptoms of CHS typically occur in three phases:

1. Prodromal phase: This phase is characterized by early, nonspecific symptoms that may precede the onset of vomiting. These symptoms can include nausea, abdominal discomfort, and a fear of vomiting.
2. Hyperemetic phase: The hyperemetic phase is the most characteristic phase of CHS. It is characterized by persistent, severe nausea and repeated vomiting that can occur several times per hour. Vomiting is often uncontrollable and can lead to dehydration and electrolyte imbalances.
3. Recovery phase: After the hyperemetic phase subsides, which may take several days, individuals typically enter a recovery phase. During this phase, symptoms gradually improve, and appetite returns. However, some individuals may continue to experience mild nausea or abdominal discomfort.

Other symptoms that may occur during a CHS episode include:

• Abdominal pain or cramping
• Weight loss
• Excessive thirst
• Decreased or absent sweating
• Compulsive hot water bathing or showering, which is a characteristic behavior of CHS

It’s important to note that the symptoms of CHS can be similar to other conditions, such as cyclic vomiting syndrome or other gastrointestinal disorders. Therefore, a thorough medical evaluation is necessary to diagnose CHS and rule out other potential causes of symptoms.

What are the causes of cannabis hyperemesis syndrome?

The exact cause of cannabis hyperemesis syndrome (CHS) is not fully understood, but it is believed to be related to the long-term, heavy use of cannabis. Several factors may contribute to the development of CHS:

1. Cannabinoid effects: Cannabis contains cannabinoids, such as THC (tetrahydrocannabinol), which can affect the gastrointestinal tract. It is thought that chronic exposure to high levels of cannabinoids may disrupt the normal functioning of the digestive system, leading to CHS.
2. Endocannabinoid system dysregulation: Chronic cannabis use may dysregulate the endocannabinoid system, which plays a role in regulating various physiological processes, including digestion and nausea.
3. Thermoregulatory dysfunction: CHS is often associated with compulsive hot water bathing or showering, which is believed to provide temporary relief from symptoms. This behavior may be related to dysfunction in the body’s thermoregulatory system, which regulates body temperature.
4. Genetic factors: Some individuals may be more genetically predisposed to developing CHS than others. Genetic factors may influence how the body metabolizes cannabinoids and how it responds to their effects.
5. Heavy or long-term cannabis use: CHS is more commonly reported in individuals who use cannabis heavily or regularly over a long period of time. The risk of developing CHS may be higher in individuals who use high-potency cannabis products.

It’s important to note that not all individuals who use cannabis heavily will develop CHS, and the reasons why some individuals are more susceptible than others are not yet fully understood. More research is needed to better understand the underlying causes of CHS and to develop effective treatments.

What is the treatment for cannabis hyperemesis syndrome?

The primary treatment for cannabis hyperemesis syndrome (CHS) involves stopping cannabis use, which can lead to a resolution of symptoms. Other treatments are aimed at managing symptoms and preventing complications:

1. Stop cannabis use: The most effective treatment for CHS is to stop using cannabis. This can lead to a significant improvement in symptoms over time.
2. Fluid and electrolyte replacement: Intravenous fluids may be necessary to treat dehydration and electrolyte imbalances resulting from excessive vomiting.
3. Antiemetic medications: Medications to help control nausea and vomiting, such as ondansetron or promethazine, may be prescribed to provide symptomatic relief.
4. Topical capsaicin cream: Some studies suggest that applying capsaicin cream to the abdomen may help relieve symptoms of CHS, although more research is needed to confirm its effectiveness.
5. Behavioral therapy: Cognitive-behavioral therapy (CBT) or other forms of therapy may be beneficial for individuals with CHS, especially those who have difficulty abstaining from cannabis use.
6. Avoiding triggers: Identifying and avoiding triggers that can worsen symptoms, such as stress or certain foods, may help prevent CHS episodes.

It’s important for individuals with CHS to work closely with healthcare providers to develop a treatment plan that addresses their specific needs. In severe cases, hospitalization may be necessary to manage dehydration and other complications.