Cannabinoid Hyperemesis Syndrome (CHS) is a condition affecting individuals who use cannabis regularly and long-term, causing repeated, severe episodes of nausea, vomiting, and abdominal pain. While CHS itself is not directly fatal, severe complications from prolonged vomiting can become life-threatening if not managed. Understanding these risks is important for those experiencing the syndrome.
Recognizing CHS Symptoms
CHS manifests in distinct phases, starting with milder symptoms that can escalate. The prodromal phase involves early morning nausea, abdominal discomfort, and a fear of vomiting. This phase can last for months or even years, and some individuals may mistakenly increase cannabis use, believing it will alleviate their symptoms.
The hyperemetic phase brings severe, cyclical symptoms: intense nausea, repeated vomiting and retching, and significant abdominal pain. Individuals often seek temporary relief by taking frequent hot showers or baths, a characteristic behavior. Vomiting can occur many times an hour and persist for 24 to 48 hours, making it difficult to consume food or medication.
Understanding the Risk of Severe Complications
The danger of CHS stems from severe, prolonged vomiting during the hyperemetic phase. This can quickly lead to dehydration. Dehydration can result in fatigue, dizziness, a rapid heart rate, and reduced urine output, necessitating emergency medical attention.
Persistent fluid loss disrupts the balance of electrolytes like potassium and sodium. These minerals are important for nerve signals, muscle function, and maintaining heart rhythm. Significant electrolyte imbalances can lead to muscle spasms, weakness, seizures, and dangerous heart rhythm abnormalities.
Severe dehydration from prolonged vomiting strains the kidneys, potentially leading to acute kidney injury. In rare instances, this can progress to kidney failure if not treated promptly. Forceful vomiting can also cause physical damage, such as Mallory-Weiss tears (lacerations of the esophageal lining). These tears can result in gastrointestinal bleeding, though they often heal on their own.
Medical Intervention and Recovery
When experiencing severe CHS symptoms, seeking emergency medical care is important due to the risk of complications. Healthcare providers typically focus on managing acute symptoms. Intravenous (IV) fluids are administered to correct dehydration and restore electrolyte balance.
While traditional anti-nausea medications (antiemetics) are often used, they may not always be effective for CHS. Other treatments, such as benzodiazepines or antipsychotics, may be used to alleviate nausea, anxiety, and vomiting. Topical capsaicin cream applied to the abdomen has also shown some benefit in reducing pain and nausea.
Once acute symptoms are controlled, recovery involves addressing the underlying cause. The hyperemetic phase may continue until cannabis use is completely stopped. Symptoms typically begin to resolve within days of cessation, though full recovery can take several weeks to months as residual cannabinoids clear from the body.
Preventing Future Episodes
The most effective way to prevent future Cannabinoid Hyperemesis Syndrome episodes is complete cessation of all cannabis use. Even occasional use after an episode can trigger a relapse of symptoms.
Because cannabinoids, particularly THC, are stored in body fat, it can take an extended period for them to be eliminated from the body. This means symptoms may persist for weeks or even months after stopping use before complete relief is achieved. For individuals finding it challenging to cease cannabis use, support from healthcare providers or addiction counseling services can be beneficial.