What is CHS? Symptoms and Signs of “Stoner Stomach”
Cannabinoid hyperemesis syndrome (CHS), also known as cannabis hyperemesis syndrome, is a rare condition that’s seen in people who use cannabis over long periods.[1] As the name indicates, this condition usually involves repeated episodes of vomiting and nausea, along with abdominal pain.
CHS isn’t just an unpleasant side effect of smoking weed. It can be a serious problem that causes health complications like severe dehydration, and with the increasing legalization of marijuana, CHS is on the rise.
Key Points
- CHS is a rare condition prevalent in heavy cannabis users.
- CHS leads to repeated and severe bouts of vomiting, nausea, and abdominal discomfort.
- The most intense phase of CHS can last for 24 to 48 hours.
- Cannabinoids can affect receptors in the esophageal sphincter, which can cause stomach acids to return through your esophagus, leading to nausea and vomiting.
- CHS is connected with marijuana use, so the only true “cure” is to stop using marijuana products.
What Is CHS?
Similar to cyclic vomiting syndrome, which occurs in children, CHS is a rare condition that leads to repeated and severe bouts of vomiting, as well as other gastrointestinal symptoms like nausea and abdominal discomfort. It occurs in cannabis users as a result of long-term marijuana use.
CHS Symptoms and Signs
CHS is a fairly new condition that only began to appear in heavy users over the past few decades, though it’s becoming more common as more people use marijuana.
Some of the symptoms of CHS include:[2]
- Morning sickness
- Intense abdominal discomfort or paint
- Persistent nausea
- Repeated severe vomiting and retching, often without warning
- Loss of appetite
- Weight loss
- A fear of vomiting
People with CHS may feel an overwhelming urge to take a hot shower or bath, which may be due to the soothing effects of hot water for relieving nausea. With CHS, people may take excessive baths or showers, sometimes spending hours in the water.
The symptoms of CHS are spread across three phases:[3]
CHS Prodromal Phase
The prodromal phase is the most common among adults who’ve used marijuana since they were teens. It may include stomach pain or morning sickness, but not necessarily any vomiting. In fact, some people in the prodromal phase feel a fear of vomiting, even if they haven’t.
CHS Hyperemetic Phase
The hyperemetic phase is the most intense and can last for 24 to 48 hours. It may include repeated vomiting and nausea, possibly leading to dehydration from loss of fluids. People tend to avoid eating or become extremely selective about what foods they eat.
CHS Recovery Phase
When you stop using marijuana, the symptoms of CHS typically subside over days or months. This is the CHS recovery phase. Once people quit for good, the symptoms of CHS often go away completely unless they use marijuana again.
What Causes CHS?
People who use marijuana regularly may get CHS, but others may not. The medical community is not yet sure why CHS only affects certain people, but experts believe genetics may be one of the factors.
Marijuana contains cannabinoids that bind to the cannabinoid receptors in the endocannabinoid system in the brain and gut. The primary cannabinoids in marijuana are tetrahydrocannabinol (THC) and cannabidiol (CBD), which give marijuana its psychoactive and therapeutic effects.
Ironically, this includes the cannabinoids in the brain that control nausea and vomiting, which is why cannabis is sometimes helpful for managing the symptoms of cancer treatments.
But over time, using marijuana can change how the cannabinoid receptors in the body respond to cannabinoids.[4] For example, marijuana cannabinoids can affect the cannabinoid receptors in the esophageal sphincter, which is responsible for opening and closing to allow food to pass from the throat to the stomach. If that sphincter no longer works properly, it may cause stomach acids to come back into your esophagus, leading to nausea and vomiting.
Complications of CHS
The primary symptom of CHS is extreme vomiting, which can cause dehydration and electrolyte imbalances in marijuana users. The risks of complications increase with severe dehydration and may include:[5]
- Seizures
- Kidney failure
- Muscle spasms and weakness
- Shock
- Heart rhythm problems
- Though rare, brain swelling
Other complications may arise with CHS, including:
- Inflammation in the esophagus (esophagitis)
- Tears in the esophagus (Mallory-Weiss Syndrome)
- Malnutrition from appetite issues
- Tooth decay
- Low potassium (hypokalemia)
- Low phosphorus (hypophosphatemia)
- Air trapped in the chest cavity (pneumomediastinum)
- Aspiration pneumonia
Can I Treat CHS at Home?
Though supportive care and medical supervision is recommended for severe cases of CHS in the hyperemetic phase, you can alleviate some of the symptoms with home remedies like hot baths. You have to be careful that you don’t sweat excessively and cause further dehydration, however.
There are some over-the-counter medications that may help with the symptoms until the CHS subsides, including:[6]
- Antihistamines
- NSAIDs like ibuprofen or acetaminophen
- Topical capsaicin cream, which can relieve nausea and vomiting when rubbed on the abdomen
CHS Prevention
The only way to prevent CHS or reduce your risk of getting it is to avoid marijuana completely. Even if you’ve used marijuana for months or years without any symptoms, CHS can happen at any time.
If you already have CHS, the only option is to quit, as your symptoms may persist as long as you’re using marijuana.
If you or a loved one is struggling to quit marijuana, treatment options are available for marijuana use disorder. Treatment for marijuana addiction often includes similar treatment modalities as other substance use disorders, such as individual therapy, group therapy, and behavioral therapies like cognitive behavioral therapy (CBT) on an inpatient or outpatient basis.
Frequently Asked Questions
Can Weed Make Your Stomach Hurt?
Yes, weed can make your stomach hurt with CHS, but stomach pain can be caused from any number of unrelated conditions, such as gastritis, gastroparesis, or irritable bowel. It’s important to seek medical attention if you have severe stomach pain.
Can You Get Sick from Weed?
Though marijuana is considered safe for most people, it can cause you to get sick. Along with CHS, you can have an allergy that leads to respiratory issues or an allergic reaction, stomach upset, nausea, and vomiting from overconsumption, or psychological symptoms like anxiety or panic attacks.
In rare cases, marijuana can make you sick not from the marijuana itself, but due to contamination from pesticides, heavy metals, or mold. Depending on the nature of the contaminant, you can have serious health effects.
What Is Stoner Stomach?
If you’re frequently smoking too much weed, stomach issues like nausea, vomiting, diarrhea, and indigestion. This is colloquially known as “stoner stomach.” Stoner stomach is more noticeable with edibles, but it can happen regardless of how marijuana is consumed.
How Can I Stop Stomach Pain from Smoking Weed?
If your stomach is upset after smoking or eating marijuana, the best solution for how to get rid of stoner stomach or CHS is to quit consuming weed.
WebMD. (n.d.-a). Cannabinoid hyperemesis syndrome (CHS): Causes, symptoms, treatment. WebMD. Retrieved from https://www.webmd.com/mental-health/addiction/cannabinoid-hyperemesis-syndrome on 2023, June 20.
WebMD. (n.d.-a). Cannabinoid hyperemesis syndrome (CHS): Causes, symptoms, treatment. WebMD. Retrieved from https://www.webmd.com/mental-health/addiction/cannabinoid-hyperemesis-syndrome on 2023, June 20.
WebMD. (n.d.-a). Cannabinoid hyperemesis syndrome (CHS): Causes, symptoms, treatment. WebMD. Retrieved from https://www.webmd.com/mental-health/addiction/cannabinoid-hyperemesis-syndrome on 2023, June 20.
WebMD. (n.d.-a). Cannabinoid hyperemesis syndrome (CHS): Causes, symptoms, treatment. WebMD. Retrieved from https://www.webmd.com/mental-health/addiction/cannabinoid-hyperemesis-syndrome on 2023, June 20.
Cannabinoid hyperemesis syndrome – statpearls – NCBI bookshelf. (n.d.-a). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK549915/ on 2023, June 20.
WebMD. (n.d.-a). Cannabinoid hyperemesis syndrome (CHS): Causes, symptoms, treatment. WebMD. Retrieved from https://www.webmd.com/mental-health/addiction/cannabinoid-hyperemesis-syndrome on 2023, June 20.
