What is CHS? Symptoms and Signs of “Stoner Stomach”

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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 the receptors in the gastrointestinal tract, which can contribute to symptoms like 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 nausea
Intense abdominal discomfort or pain
Persistent nausea
Repeated severe vomiting and retching, often without warning
Loss of appetite
Weight loss
Anxiety about vomiting

People with CHS may feel an overwhelming urge to take a hot shower or bath, which may provide temporary relief from 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 often occurs in adults who have used marijuana for an extended period. It may include stomach pain or morning sickness, but not necessarily vomiting. 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 lasts 24 hours to days. It may include repeated vomiting and nausea, possibly leading to dehydration from fluid loss. 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 return to 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

CHS Diagnosis and Treatment

CHS is a relatively recently recognized condition, so it’s still being researched. Some doctors aren’t familiar with the condition or its symptoms, so you may need a gastroenterologist or another specialist to diagnose it.
Typically, a lot of questions about your cannabis use and the types of products you use are valuable to the diagnostic process. Be sure to be honest with your doctor about your use and symptoms.

Your healthcare provider may want to rule out other causes of vomiting with diagnostic tests like:

Blood tests
Urine tests
Radiographs
MRI
Head or stomach CT
Pregnancy test
Electrolyte test
Liver and pancreatic enzyme tests
Endoscopy

During the hyperemetic phase, it may be necessary to stay in the hospital for supportive care to avoid complications. This may include intravenous fluids to stay hydrated, antiemetic medications to reduce vomiting and pain medications.
CHS is connected with marijuana use, so the only true “cure” is to stop using marijuana products. Though CHS’s side effects and symptoms may last for weeks, they typically subside with cessation of marijuana use.

Can I Treat CHS at Home?

Though supportive care and medical supervision are recommended for severe cases of CHS in the hyperemetic phase, some home remedies, like hot baths, can provide temporary relief for symptoms. However, be cautious about excessive sweating, leading to further dehydration.

Some over-the-counter medications may help with the symptoms until the CHS subsides, including:[6]

Antihistamines
NSAIDs like ibuprofen or pain relievers like 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 by 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, 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 frequently smoke too much weed, you may experience stomach issues like nausea, vomiting, diarrhea, and indigestion. This is colloquially referred to as “stoner stomach.” A 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 how to get rid of a stoner stomach or CHS is to quit consuming weed.

Amanda Stevens, B.S.

Medical Content Writer

Amanda Stevens is a highly respected figure in the field of medical content writing, with a specific focus on eating disorders and addiction treatment. Amanda earned a Bachelor of Science degree in Social Work from Purdue University, graduating Magna Cum Laude, which serves as a strong educational foundation for her contributions.

Collaborating with esteemed organizations like Epiphany Wellness and Ocean Recovery, Amanda has produced valuable and enlightening content that empowers individuals on their path to recovery. Her work with these organizations exemplifies her exceptional expertise and unwavering commitment to providing accurate and reliable information to those seeking assistance.

Sources

[01]

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.

[02]

[03]

[04]

[05]

Cannabinoid hyperemesis syndrome – statpearls – NCBI bookshelf. (n.d.-a). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK549915/ on 2023, June 20.

[06]

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