Cannabinoid Hyperemesis Syndrome

Cannabinoid hyperemesis syndrome (CHS) is a condition that leads to repeated and severe bouts of vomiting. CHS is rare and only occurs in daily long-term users of cannabis.

Cannabis has many active components. The one being most prominent and well know is THC (tetrahydrocannabinoid). THC binds to cannabinoid receptors located throughout the body and can produce a variety of effects depending on where the receptors are located. In the brain, THC has shown to help with the prevention of nausea and vomiting symptoms. For patients who suffer from CHS, however, cannabis seems to have the opposite effect in the digestive tract and subsequently induces nausea and vomiting. Experts are still trying to understand why CHS occurs in a small percentage of daily long-term cannabis patients.

CHS was only recently discovered.  Because many healthcare workers are unaware of this condition, diagnosis is not always straight forward. Diagnosis of CHS is based on the symptoms that occur, resulting in additional tests being performed to confirm a diagnosis. A gastroenterologist trained in diseases of the digestive tract may ultimately make the diagnosis.

Treatment for CHS can include IV fluids for hydration, prescription medication to treat the nausea and vomiting, and the use of proton-pump inhibitors to reduce the level of acid production in the gastrointestinal tract.  Ultimately, stopping the use of cannabis will assure the elimination of CHS. Although CHS occurs in only a small percentage of patients, it is important to be mindful that cannabis users can suffer from CHS, and healthcare workers should be ready to recognize the symptoms early on to treat and counsel patients effectively.