Cannabinoid Hyperemesis Syndrome (CHS) is a serious condition affecting long-term cannabis users, characterized by severe cyclical vomiting and abdominal pain. Understanding its symptoms and progression is crucial for early recognition and treatment.
The condition progresses through three distinct phases, each with unique characteristics:
During this initial phase, patients experience morning nausea, anxiety about vomiting, and mild abdominal discomfort. This phase can persist for months or even years, with many individuals increasing their cannabis use in an attempt to alleviate symptoms.
This intense phase typically lasts 24-48 hours and includes persistent nausea, repeated vomiting (up to 5 times per hour), and severe abdominal pain. A distinctive feature is the compulsive need for hot showers or baths, which temporarily relieves symptoms.
Symptoms begin to subside during this phase, but only with complete cessation of cannabis use. If cannabis consumption resumes, the cycle typically restarts.
CHS diagnosis relies on several characteristic symptoms and patterns:
Severe cyclical nausea and vomiting occur in all cases, accompanied by abdominal pain in 85.1% of patients. The condition predominantly affects daily cannabis users under 50 years old who have used cannabis for more than one year.
The hallmark symptom of CHS is the compulsive need for hot showers or baths, reported in 92.3% of cases. Another distinctive feature is “scromiting” – the combination of screaming and vomiting due to intense pain.
Untreated CHS can lead to serious complications:
In rare cases, patients may experience muscle spasms, seizures, heart rhythm abnormalities, or kidney failure.
Cannabis cessation is the only definitive treatment, with 96.8% of patients experiencing symptom resolution after stopping use.
Treatment options include:
Traditional antiemetics like ondansetron and metoclopramide often prove ineffective. Opioids should be avoided as they may worsen outcomes.
The only proven way to prevent CHS recurrence is complete cannabis cessation. Symptoms typically return if cannabis use resumes, making abstinence crucial for long-term recovery.
Immediate medical attention is necessary if experiencing:
Understanding these symptoms and seeking prompt medical care can help prevent serious complications and ensure proper treatment for those affected by CHS.
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Early symptoms include morning nausea, mild abdominal discomfort, and anxiety about vomiting. Many increase cannabis use, mistakenly thinking it helps.
CHS is directly tied to chronic cannabis use and resolves with cessation, while CVS can occur without cannabis and responds to preventive medications.
Yes, untreated CHS can lead to dehydration, kidney injury, seizures, and rare complications like brain swelling. Symptoms resolve with cannabis cessation.
Complete cannabis cessation is key. Temporary relief includes hot showers, capsaicin cream, hydration, and light exercise. Professional support aids recovery.
Diagnosis is based on long-term cannabis use, cyclic vomiting, abdominal pain, and symptom relief with hot showers. Normal diagnostic tests and resolution with cessation confirm CHS.
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