Cannabinoid Hyperemesis Syndrome (CHS) is a rare condition that occurs in some people who use cannabis regularly and long-term, typically weekly or daily use over months or years. It is characterized by cyclical episodes of severe nausea, vomiting, and abdominal pain

. Key features of CHS include:

• Symptoms: Intense nausea, repeated vomiting (sometimes up to five times an hour), abdominal pain, dehydration, weight loss, and fear of vomiting. Symptoms often come in cycles and can be severe enough to require emergency care

• Phases: CHS usually progresses through three phases:
  • Prodromal phase: Mild nausea, abdominal discomfort, and increased thirst, sometimes lasting months or years.
  • Hyperemetic phase: Severe and persistent vomiting, abdominal pain, and dehydration, often leading to hospital visits.
  • Recovery phase: Symptoms resolve after stopping cannabis use

• Unique symptom relief: Many patients find relief from symptoms by taking frequent hot showers or baths, which is a distinctive diagnostic clue for CHS

• Cause: The exact mechanism is unclear, but CHS is linked to chronic cannabis use and possibly genetic predisposition. THC, the main psychoactive component of cannabis, accumulates in fat stores and may be released during stress or fasting, triggering symptoms

• Diagnosis: Based on clinical symptoms, history of cannabis use, and ruling out other causes of vomiting. It can be difficult to distinguish from cyclic vomiting syndrome (CVS), but CHS symptoms improve only with cessation of cannabis

• Treatment: The only known cure is complete and sustained abstinence from cannabis. Supportive care during acute episodes includes hydration and symptom management. Capsaicin cream and hot water hydrotherapy may provide temporary relief

In summary, CHS is a paradoxical syndrome where long-term cannabis use causes severe vomiting and abdominal pain, relieved temporarily by hot showers, and resolved only by stopping cannabis use