Patient education: Cannabis hyperemesis syndrome (The Basics)

What is cannabis hyperemesis syndrome? — Cannabis hyperemesis syndrome ("CHS") is a condition that causes frequent vomiting (throwing up). It can happen in people who have been using cannabis (marijuana) regularly for at least a year. It is sometimes called "cannabinoid hyperemesis syndrome."

CHS is happening more as cannabis products become more potent and legal in more places. It is more likely to affect teen and young adult males. Almost all people with CHS use cannabis at least weekly, and most report daily use.

What are the symptoms of CHS? — The main symptom is repeated, severe episodes of vomiting. A person might vomit up to 6 to 8 times per hour during an episode. These episodes can last for up to a few days. Then, the cycle repeats every few weeks or months.

In addition to vomiting, symptoms can include:

●Nausea

●Belly pain

●Feeling very tired

●Pale skin

●Diarrhea

Lots of vomiting can lead to dehydration. This is when the body loses too much water.

Often, people with CHS take a lot of very hot showers or baths. This sometimes helps them feel better temporarily.

Should I see a doctor or nurse? — Yes. If you have repeated episodes of vomiting or belly pain, call your doctor or nurse. They will ask about your symptoms and do an exam. They will also ask you questions about your cannabis use, including how long you have been using it, what products you use, and how often you use it. It's important to be honest in your answers, since this information helps your doctor or nurse figure out what is causing your symptoms.

You should also call your doctor or nurse if you have any signs of dehydration, such as:

●Feeling very tired

●Being very thirsty, or having a dry mouth or tongue

●Muscle cramps

●Dizziness

●Confusion

●Urine that is dark yellow, or not needing to urinate for more than 5 hours

How is CHS treated? — The long-term treatment is to stop using cannabis products. Vomiting usually gets better within days to weeks of stopping. Symptoms might get worse or return if you start using cannabis again.

If you are dehydrated, you might need to get extra fluids through an IV. (An IV is a thin tube that goes into a vein.)

Sometimes, people with severe symptoms need treatment in the emergency department. This can include:

●IV fluids

●Medicines – Different medicines can help with nausea, vomiting, and belly pain. These are usually given by IV.

●A cream called "capsaicin" – This is rubbed on the belly and might help with pain.

Doctors might also order tests to find out if something else is causing your symptoms. For example, you might get an imaging test like a CT scan. (Imaging tests create pictures of the inside of the body.)

Can CHS be prevented? — The only way to prevent this condition for sure is to avoid using cannabis products at all. Some people can use cannabis once in a while without having problems. But if you have already had CHS, using it at all is likely to cause your symptoms to come back.

If you are trying to stop using cannabis and are having a hard time, tell your doctor or nurse. They can help you get support. This might involve counseling or support groups.

More on this topic

Patient education: Nausea and vomiting in adults (The Basics)
Patient education: Cannabis use disorder (The Basics)
Patient education: Medical cannabis (The Basics)