Marijuana has a lot of active chemical compounds called cannabinoids. When you use weed, these compounds bind to cannabinoid receptors found in your brain, digestive tract (gut), and certain cells in your body. Tetrahydrocannabinol (THC) and cannabidiol (CBD) are the main cannabinoids in marijuana products.

• When cannabinoids bind with brain receptors, they tend to prevent nausea and vomiting.
• In two case reports, doctors used lorazepam (Ativan) to manage CHS-related nausea and vomiting.
• Because of this possible complication, it’s important to use caution with marijuana and other cannabis products.
• Preventing dehydration and stopping nausea and vomiting are the treatment goals during the hyperemesis stage of the condition.
• The top reason marijuana users seek help in ERs is a malady known as cannabinoid hyperemesis syndrome, or CHS.
• In the 1970s, THC concentration in most marijuana would be about 7%, Lapoint said.

When should I call my health care provider?

After stopping cannabis use, symptoms generally resolve within days or months. Reusing cannabis again often leads to a reoccurrence of CHS. The prodromal phase can last for months, or even years in some cases. Symptoms are most common in early middle-aged adults who have used cannabis regularly since adolescence.

Hyperemetic phase

Nausea and vomiting tend to return if they start using marijuana again. If you need help quitting, speak to a healthcare provider or connect with your local addiction treatment services. Most people with CHS who stop using cannabis have relief from symptoms within 10 days. It’s important to be honest about your marijuana use if you have symptoms of CHS. Without knowing this background, providers often misdiagnose CHS as other conditions, like cyclic vomiting syndrome (CVS).

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However, you might research the cannabis strains you use to determine their reported effects on digestive and related systems. Some people recovering from severe bouts of CHS will resume cannabis use. If their unique constitution does not restart the CHS episodes, they might continue with more moderate and less frequent cannabis use. “We give patients IVs to hydrate them. We do basic testing, just to make sure their kidneys aren’t failing, that their electrolytes are not very disturbed,” he said. “But really, to cure them of this condition, they need to stop smoking.” Erica Hagler was diagnosed with cannabinoid hyperemesis syndrome.

CHS is a condition caused by chronic and repeated cannabis use that leads to severe nausea and vomiting. In one 2018 study, a group of researchers surveyed 2,127 U.S. adults between the ages of 18 and 49 at an emergency department in New York. Of those surveyed, 155 met the criteria of smoking cannabis at least 20 days per month. Some people with conditions like epilepsy, multiple sclerosis, chronic pain and nausea believe that marijuana helps them. Heard and other physicians say the lack of solid, peer-reviewed research on cannabis’s effectiveness remains reason for skepticism.

Cannabinoid Hyperemesis Syndrome (CHS) and the Cyclic Vomiting Syndrome (CVS) in Adults

Also, it’s possible there are more cases than have been reported, since not everyone chs smoking with the illness will seek medical help or tell their doctor they use cannabis, the Cleveland Clinic notes. Doctors at the hospital ran tests and ordered scans but could not name the source of her unrelenting nausea and vomiting. It was so bad she thought it might be a recurrence of her severe pancreatitis, the illness for which she once had been hospitalized and put on life support.

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

Typical antiemetics such as ondansetron, commonly known as Zofran, have often been found ineffective at suppressing nausea Sobriety caused by CHS. There are some drugs that may help, such as amitriptyline, Camilleri said. What was causing this intense stomach pain, Brittany wondered as she rode in an ambulance one late night in February. As the laws regarding the possession and use of marijuana change, CHS may become more prevalent because more people will have legal access to the drug.

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• Cannabinoid hyperemesis syndrome (CHS) is a very unpleasant — and potentially dangerous — complication of long-term marijuana use.
• Some people recovering from severe bouts of CHS will resume cannabis use.
• What distinguishes CHS is the severity of the pain and vomiting.
• What was causing this intense stomach pain, Brittany wondered as she rode in an ambulance one late night in February.

The pain is usually around the belly button and can get better with hot shower/baths. Some patients use hot water bags across the center of their belly and can burn the skin if done a lot. He also warned that people with serious mental illnesses, such as schizophrenia, should be cautious about marijuana use, as studies show cannabis can exacerbate the effects of those illnesses. Experts also aren’t clear on what causes CHS, or why some people develop it while others don’t.