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What is Cannabinoid Hyperemesis Syndrome?
cannabinoid hyperemesis syndrome

Cannabinoid hyperemesis syndrome (CHS) is a rare medical condition that affects some marijuana users.

It’s well known that marijuana can help reduce nausea and vomiting and put your stomach more at ease. But what many don’t know is that, in rare cases, it can have the opposite effect.

Indeed, a small percentage of marijuana users seem to suffer from sudden bouts of severe nausea and vomiting caused by a rare condition known as cannabinoid hyperemesis syndrome.

While only discovered in the past decade, this unique disorder is becoming more common as the use of marijuana becomes more widespread. If you’ve ever used marijuana and felt a bit queasy, you might want to do yourself a favor and read on.

What is cannabinoid hyperemesis syndrome?

Cannabinoid hyperemesis syndrome is a relatively new disorder that is characterized by brief periods of severe nausea and vomiting lasting 24-48 hours. In many cases, symptoms are so severe that patients require hospitalization.

During these nauseous episodes, patients are known to develop an odd habit of taking hot baths or showers multiple times per day. Patients often find bathing in hot water to be the only effective way of managing their symptoms.

The cause of CHS is paradoxical and not well understood, since marijuana is known to have anti-emetic effects and is often used to treat nausea and vomiting.

CHS can be confused with cyclic vomiting syndrome (CVS), which causes similar symptoms but is not related to cannabis use. As a result, patients with CHS are often misdiagnosed.

How common is cannabinoid hyperemesis syndrome?

If you’ve never heard of cannabinoid hyperemesis syndrome before, that’s no surprise. There’s a good chance your doctor hasn’t either. The condition was first described in 2004 by a group of Australian researchers who based their report on only 19 patients.

Since then, individual cases of CHS have been recorded in hospitals around the world but the overall population of sufferers remains small. The prevalence of the condition among marijuana users and the general public is presently unknown.

CHS only seems to affect people who have used cannabis regularly for many years. Interesting enough, sufferers of CHS often report years of symptom-free cannabis use prior to the onset of the condition.

At the time of onset, patients usually report using cannabis frequently (more than 3-5 times) throughout the day.

It isn’t clear what causes CHS to affect such a small portion of marijuana users. However, some researchers believe the disorder may have an underlying genetic component.

What are the symptoms of cannabinoid hyperemesis syndrome?

Cannabinoid hyperemesis syndrome is a reoccurring condition that causes symptoms to appear and disappear suddenly without warning.

However, the cycle of symptoms in CHS is known to occur in three phases: pre-emetic (or prodromal), hyperemetic and recovery.

1) Pre-emetic Phase

The pre-emetic phase is when mild symptoms start to appear and can span months or even years. During the pre-emetic phase, patients begin to develop symptoms of nausea, a fear of vomiting and abdominal discomfort. Patients generally maintain normal eating habits and will often increase their marijuana use due to the belief that marijuana can help relieve their nausea.

2) Hyperemetic Phase

The hyperemetic phase is the shortest and most severe phase, usually lasting 24-48 hours. During this phase, symptoms become obvious and most patients seek treatment.

The hyperemetic phase is characterized by sudden periods of intense nausea and vomiting, which are often described as overwhelming and incapacitating. Patients cannot tolerate solid food and may vomit up to 5 times per hour. The vomit usually consists of white, watery secretions.

Other symptoms that commonly occur include abdominal pain, dehydration and weight loss. It is during this phase that patients display the characteristic behavior of bathing multiple times per day. Hot baths or showers often provide temporary relief from symptoms and quickly become a compulsive habit for many patients.

3) Recovery Phase

The recovery phase is a symptom-free period that can last for days, weeks or months. During this phase, patients seem to recover their health and will usually regain weight and return to normal eating habits. Without medical intervention, most patients will return to using cannabis, which often triggers a relapse in symptoms.

What are the treatments for cannabinoid hyperemesis syndrome?

Most patients with cannabinoid hyperemesis syndrome seek treatment during the hyperemetic phase, when symptoms are the most severe. Strangely enough, hot baths seem to be the most effective treatment known to help manage symptoms of CHS.

Patients often report a reduction in nausea and vomiting, abdominal pain and appetite loss after taking a hot bath or shower. However, symptoms usually return in full force soon afterwards, leaving most patients with an urge to bathe again.

Despite such an unconventional method of treatment, researchers are still not sure how hot water baths work to reduce symptoms of CHS. One popular theory points to the presence of cannabinoid receptors in an area of the brain (hypothalamus) that regulates the body’s temperature.

Patients that are hospitalized may also be given supportive therapy and IV fluid replacement during their stay.

Ultimately, the most effective long-term treatment for CHS is cessation of cannabis use. Patients with CHS are generally instructed to stop using cannabis completely, and those who do usually experience a full recovery.

But many CHS sufferers choose to continue using cannabis, causing the cycle of symptoms to reappear weeks or months later.