What is Cannabis Hyperemesis Syndrome?

Cannabis Hyperemesis Syndrome

Cannabis is a common remedy to promote appetite in patients with anorexia and wasting associated with HIV/AIDS. Cannabis may also relieve chemotherapy-induced nausea and vomiting. But while cannabis is a good treatment for nausea and vomiting, it may also cause a paradoxical syndrome of nausea and vomiting known as cannabis hyperemesis syndrome (CHS). CHS is a clinical diagnosis that results from chronic cannabis use (2). A well-known symptom of CHS is cyclic nausea and vomiting that usually responds to hot bathing (3)(2). These symptoms don’t respond to standard antiemetic therapy but respond to compulsive hot bathing.

What is Cannabis Hyperemesis Syndrome?

Cannabis hyperemesis syndrome (CHS) is a condition that prompts severe vomiting that lasts for a long time. This condition is rare, and it mostly affects long-term cannabis users.

Marijuana contains many active compounds including CBD and THC. These compounds interact with receptors found in the brain, which is why users feel high after using cannabis.

The digestive tract also contains several molecules that interact with THC and other compounds. This means cannabis can also influence the digestive tract. For example, cannabis can increase appetite by making the stomach empty. 

Cannabis also affects the esophageal sphincter which is the tight band of muscle that allows food from the esophagus into the stomach. Long-term cannabis use can influence the way our body’s molecules react, leading to the symptoms of CHS.

Marijuana is a popular drug in the US even among Young adults. This group of people small commonly develop CHS. This condition commonly affects long-term cannabis consumers. CHS can also affect individuals who use cannabis daily.

What are the symptoms of cannabis hyperemesis syndrome?

CHS sufferers experience repeated bouts of vomiting; These episodes also come with periods without any symptoms. The symptoms of CHS come in 3 stages: the preemetic phase, the hyperemetic phase, and the recovery phase (2)(5).

  1. Preemetic phase: This phase usually lasts for months to year and it comes with nausea, vomiting and abdominal pain (2)(5). The primary symptoms of this phase include early morning nausea and belly (abdominal) pain. Most people maintain their normal eating patterns during this time. Using high amounts of cannabis is believed to treat nausea but not in this case. Cannabis may stop nausea in non-frequent users but increases it in long-term cannabis users. 
  2. Hyperemetic phase; This phase last 24 to 48 hours and is characterized by symptoms including (6).
  • Repeated nausea
  • Constant episodes of vomiting
  • Stomach pain
  • Low food intake and weight loss
  • Symptoms of fluid loss (dehydration)

This phase is also characterized by intense vomiting. Many people find that taking hot showers during the day reduces nausea (6). That may be partly due to the way high temperature affects a brain area known as the hypothalamus. This brain area also controls temperature regulation and vomiting.) This is the phase where you need to seek medical advice.

The hyperemetic phase may continue as long as the person is still consuming cannabis. Afterward, the recovery phase starts.

3. Recovery phase: During this phase, the symptoms start diminishing. Users can eat normally again. This phase can last days or months. Symptoms usually manifest gain if the individual tries marijuana again (6).

How to potentially prevent Cannabis Hyperemesis Syndrome?

Preventing CHS means you have to stop using marijuana in any form. Since cannabis is the underlying cause of your symptoms you must part ways with the drug. Consuming cannabis daily for several years makes the syndrome develop. CHS sufferers will need to completely stop using cannabis otherwise their symptoms will likely come back.

  • Abstaining from cannabis may prompt other health benefits, including:
  • Better lung function
  • Improved memory and cognitive functioning
  • Enhanced sleep
  • Low chance of depression and anxiety

History of Cannabis Hyperemesis Syndrome

The first report documenting CHS was in 2004. (1) This report analyzed nine patients in Australia. These patients were chronic cannabis users before presentation, and they experienced symptoms including nausea and vomiting. Most patients acknowledged bathing in hot water to relieve symptoms. Abstaining from cannabis use led to a reduction of illness, whereas patients who still used cannabis remained ill. Since then, there have been additional case reports of CHS sufferers. Many studies relating to CHS have been published that further describe CHS; Nonetheless, there is yet to be a randomized, controlled study evaluating or defining CHS.

(4) In Colorado, the legalization of cannabis has led to increased rates of CHS since 2009. However, keep in mind that CHS is not a condition easily recognizable by clinicians. Some physicians usually misdiagnosed for other disorders, such as cyclic vomiting syndrome (CVS). CVS and CHS have different meanings. CVS is hereditary and comes when your family has a history of migraines, psychiatric disorders, and a lack of compulsive hot bathing.

How to live with it/ What to avoid if you have it

Living with CHS is not the easiest of tasks but there are several ways to break through its symptoms. You can reduce the symptoms of CHS by:

  • Bathing with hot water
  • Staying hydrated with water
  • Communicating with your friends and family or speaking to a counselor
  • Avoiding cannabis

If you fear the symptoms, visit a physician. If you are experiencing bouts of nausea and vomiting, you may need medicine or have intravenous (IV) fluids to relieve the symptoms. You may also need to reduce the fear of vomiting. It is essential to know what causes your symptoms to get better or become worse. This is essential in living with CHS.

The main thing to avoid is cannabis. Using cannabis regularly makes increases dependence. This may prompt symptoms of withdrawal when you stop taking it. Feelings of nervousness, anger, and depression are common withdrawal symptoms. You may find difficulties relaxing and have trouble sleeping or concentrating. You may experience chills, shake, high temperatures, migraines, and stomach pains. You may also lose weight due to loss of appetite. However, not using cannabis is the only way to prevent CHS.

The permanence of Cannabis Hyperemesis Syndrome?

CHS is a recurrent disorder and the permanence will depend on whether the patient stops smoking cannabis. Vomiting episodes may last for a few days. 

When an individual stops using cannabis, cyclic vomiting and other symptoms subside.

Doctors believe that the best way to stop CHS is by completely abstaining from smoking cannabis.

Nonetheless, CHS doesn’t last long and the symptoms begin to dimmish when a person stops cannabis use.

Final thoughts 

It’s important that cannabis consumers be aware of cannabis hyperemesis syndrome. This is a rare condition which only affects cannabis consumers. Being aware of this condition is useful to get help for you or anyone suffering from the condition.


  1. https://gut.bmj.com/content/53/11/1566
  2. https://pubmed.ncbi.nlm.nih.gov/22150623/
  3. https://pubmed.ncbi.nlm.nih.gov/26921970/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3251168/
  5. https://pubmed.ncbi.nlm.nih.gov/26185942/
  6. https://pubmed.ncbi.nlm.nih.gov/26445382/