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Cannabinoid Hyperemesis Syndrome

Carl Bryce, MD Reviewed 06/2021
 


BASICS

DESCRIPTION

  • Cannabinoid hyperemesis syndrome (CHS) is defined by cyclic nausea, vomiting, and abdominal pain typically relieved by hot showers or baths in the setting of chronic cannabis use.

  • Eas...

DIAGNOSIS

HISTORY

  • CHS occurs in three phases: prodromal, hyperemetic, and recovery phase.

    • Prodromal phase: early morning nausea and abdominal discomfort with normal eating patterns—can last for months o...

TREATMENT

GENERAL MEASURES

  • Acute treatment includes fluid replacement, antiemetics, benzodiazepines, electrolyte replacement if necessary, and cessation of cannabis to control symptoms (3)[C].

  • Admissio...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Referral for outpatient or inpatient treatment for cessation of cannabis such as cognitive behavioral therapy and rehabilitation programs 

Patient Monitoring

  • Monito...

REFERENCES

1
Substance Abuse and Mental Health Services Administration. Results from the 2018 National Survey on Drug Use and Health: detailed tables. Rockville, MD: Center for Behavioral Health Statis...

ADDITIONAL READING

  • Sorensen  CJ, DeSanto  K, Borgelt  L, et al. Cannabinoid hyperemesis syndrome: diagnosis, pathophysiology, and treatment—a systematic review. J Med Tox...

SEE ALSO

Cyclic Vomiting Syndrome; Marijuana (Cannabis) Use Disorder; Substance Use Disorders, Pediatric 

CLINICAL PEARLS

CHS is a syndrome characterized by bouts of nausea, emesis, and abdominal pain. 
Sufferers often take multiple hot baths or showers daily to relieve symptoms. 
Treatment focuses on elimi...

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