If you think you have CHS or cannabis use disorder, talk to a healthcare provider. A 2025 systematic review and meta-analysis of 64 studies (mostly 2015–2025) looked at health-related quality of life in patients using medicinal cannabis (published in Quality of Life Research). This condition can cause recurring episodes of severe nausea, abdominal pain, and vomiting among certain individuals who are long-time cannabis users. This confusion often leads to a delay in treatment, with diagnosis often delayed several years. Cyclic vomiting syndrome is the most common misdiagnosis, but the key distinction lies in the compulsive bathing behavior. If you find yourself spending hours in hot baths or showers to relieve nausea, that is a strong clinical indicator of CHS.

Increased Identification In Recent Years

This phase can last for several days and can be debilitating, with vomiting and dry heaving up to five times an hour and requiring emergency room visits. The only known cure for CHS is sustained abstinence from all cannabis products. The recovery phase can take days or even weeks as the cannabinoids clear from your system, but symptoms usually vanish once you stop using. It’s important to know that this is a permanent sensitivity; resuming use, even after a long break, carries a high recurrence risk of the symptoms returning. In hospitalized patients with CHS during the hyperemesis phase, a “nothing by mouth” regimen and IV hydration are typically alcoholism employed until symptoms improve. As recovery progresses, patients are initially given clear liquids and gradually advance to a regular diet as tolerated.

F. Anorectal Disorders

Cannabis has over 100 cannabinoids in it and has varied effects and toxicity dependent on the THC-to-other-cannabinoids ratio 16. Cannabinoids like anandamide (AEA) and 2-arachidonoylglycerol (2-AG) have shown anti-emetic effects in animals that can vomit (e.g., ferrets and shrews) and in those that cannot (e.g., rodents) 17,18. In rodents, indirect measures such as taste aversion and facial expressions are identified to confirm the anti-emetic properties of cannabinoids 18. Cannabis may interact with blood thinners, sedatives, antidepressants, anti-anxiety medications, and certain anti-epileptic drugs. However, some patients are able to reduce their opioid dosage when cannabis is added to their treatment plan. Reported cases of CHS in the medical literature are quite rare, but there is a growing school of thought that believes CHS could be more common than first thought.

Treatment for Cannabinoid Hyperemesis Syndrome

The prevalence of cannabis CHS is expected to rise as legal restrictions on its recreational use decrease in several states. Education and awareness are vital in diagnosing and treating CHS as its prevalence increases. This comprehensive review explores the ECS’s involvement, CHS management approaches, and knowledge gaps to cannabinoid hyperemesis syndrome enhance understanding of this syndrome. Failure to recognize this disorder can result in multiple E.R. Visits and extensive recurring serum testing and imaging evaluations with increased healthcare-related costs. It is crucial to exclude other entities such as Addison’s disease, migraines, hyperemesis gravidarum, bulimia, and psychogenic vomiting, which can mimic CHS symptoms and may also occur alongside it.

Several previous studies have described the characteristics of frequent and prolonged hot shower use common among patients with CHS. Patients often adopt this behavior to alleviate nausea, vomiting, and abdominal pain symptoms of CHS, and some reports have referred to this symptom as CHS as “cannabis hot shower syndrome”. It is hypothesized that hot showers help stabilize the thalamic thermostat, which is frequently disrupted by chronic cannabis use, including CHS.

H3. FUNCTIONAL DEFECATION DISORDERS

• In a recent survey-based preprint, about 18% of daily cannabis users reported symptoms consistent with CHS.
• Lipolysis from elevated ACTH triggers the release of THC from fat cells.
• Carnett’s sign refers to pain elicited by tensing the abdominal muscles or performing a straight leg raise.
• Symptoms can be managed with intravenous fluids for dehydration and medications to help with nausea and pain.
• Alternative TCAs such as nortriptyline and doxepin may be used when amitriptyline is not tolerated well, owing to its excessive sedative nature in certain patients.

Cannabinoid hyperemesis syndrome is a misunderstood condition linked to long-term cannabis use. Learn what CHS is, how rare it really is, why it’s often misdiagnosed, and when ongoing nausea and vomiting may signal something https://ecosoberhouse.com/ more serious. For frequent users, the idea of quitting marijuana can feel overwhelming, especially if you’ve been using it to try to cope with stress or the very nausea it’s now causing.

Anxiety

• This activation leads to the emetic reflex, which includes increased salivation, deep breathing, glottis closure, pyloric sphincter relaxation, retroperistalsis, and abdominal muscle contraction.
• Cannabis leads to upregulation of CB1 receptor activity in the hypothalamus, which enhances the hypothermic effects of THC.
• Cannabis has over 100 cannabinoids in it and has varied effects and toxicity dependent on the THC-to-other-cannabinoids ratio 16.
• They may order an abdominal ultrasound or a pregnancy test to rule out other causes.

Public health can aid in creating safe consumption guidelines on lower dose usage for patients using it for medicinal reasons. Policy emphasizing mandatory labeling of high-potency cannabis products with information on their risk, including CHS, will benefit chronic users. Cannabis legalization should include balanced details on its benefits and potential risks. As cannabis becomes legal in more places, it is essential to monitor CHS cases across the country, which can help with public health strategies and policy decisions. To be considered for the study, the CHS patients had to have experienced two or more episodes of severe vomiting in the past year and have used cannabis at least three times a week for the last six months. Anyone reporting concurrent synthetic cannabinoid use, opioid use, or alcohol abuse was excluded from the study.

It occurs almost exclusively in chronic cannabis users who have consumed cannabis products daily or near-daily for several years. Researchers think CHS may involve dysregulation of the endocannabinoid system affecting gut motility and nausea pathways, but the exact mechanism isn’t fully understood. Cannabinoid hyperemesis syndrome (CHS) happens when you have cycles of nausea, vomiting and abdominal pain after using cannabis (marijuana) for a long time.