Cannabinoid hyperemesis syndrome (CHS) is recurrent nausea, vomiting, and crampingabdominal pain that can occur due to prolonged, high-dose cannabis use.[4][5] These symptoms may be relieved temporarily by taking a hot shower or bath. Complications are related to persistent vomiting and dehydration which may lead to kidney failure and electrolyte problems.[2]
Weekly cannabis use is generally required for the syndrome to occur; synthetic cannabinoids can also cause CHS.[6][5] The underlying mechanism is unclear, with several possibilities proposed.[2][5] Diagnosis is based on the symptoms, as well as the history of cannabis use (including a urine screen test if necessary).[6] The condition is typically present for some time before the diagnosis is made.[6]
The only known curative treatment for CHS is to stop using cannabis.[7][2] Two weeks (or possibly up to 3 months) may be required to see a benefit.[6][8] Treatments during an episode of vomiting are generally supportive in nature (e.g., hydration). There is tentative evidence for the use of capsaicin cream on the abdomen during an acute episode.[2]
Another condition that presents similarly is cyclic vomiting syndrome (CVS).[3] The primary differentiation between CHS and CVS is that cessation of cannabis use only resolves CHS. CVS does not resolve with the cessation of cannabis use.[5] Another key difference is that CVS symptoms typically begin during the early morning; predominant morning symptoms are not characteristic of CHS.[9][10] Distinguishing the two can be difficult since many people with CVS use cannabis, possibly to relieve their symptoms.[5]
The syndrome was first described in 2004, and simplified diagnostic criteria were published in 2009.[11][12]