Cannabinoid Hyperemesis Syndrome: Symptoms and Treatment - Step To Health

Cannabinoid Hyperemesis Syndrome: Symptoms and Treatment

There are many disorders caused by chronic cannabis use. Unfortunately, cannabinoid hyperemesis is new to medical knowledge and tends to be underdiagnosed.
Cannabinoid Hyperemesis Syndrome: Symptoms and Treatment

Last update: 30 November, 2021

Excessive marijuana or cannabis use causes many systemic conditions in people. Unfortunately, there are some little-known repercussions, such as cannabinoid hyperemesis syndrome, which are very uncomfortable for those who suffer from it.

Cannabinoid hyperemesis is a syndrome observed in chronic marijuana users. Some professionals define it as recurrent episodes of vomiting, nausea, and abdominal pain that subside with hot water baths. In addition, the symptomatology is characterized by disappearing when consumption ceases.

Phases of cannabinoid hyperemesis

Experts say that the syndrome in question is divided into 3 major phases, which have very specific differences between them. These are the prodromal, hyperemesis and recovery phases.

1. Prodromal phase

This is the initial stage of the condition; the clinical manifestations are mild and don’t limit daily activities. The prodromal phase is characterized by morning sickness and abdominal pain.

The patient may remain in this stage for many months or years without an accurate diagnosis. The delay is due to the fact that people don’t admit that they use marijuana and the symptoms are associated with other pathologies.

On the other hand, one of the best known medical applications of marijuana is the reduction of nausea and vomiting, as well as the relief of chronic pain. This fact causes people to increase cannabis use to improve symptoms, which accelerates the progression of the disorder.

2. Hyperemesis phase

This phase is characterized by the presence of obvious clinical symptoms. Vomiting and abdominal pain worsen suddenly and can even be incapacitating. The symptoms are cyclical, lasting between 24 and 48 hours.

The syndrome improves after bathing in hot water. In this sense, people feel a strong need to take constant showers.

A man with cannabinoid hyperemesis syndrome showering.
Hot showers improve the symptoms, so patients resort to them frequently.

3. Recovery phase

The main characteristic of this phase is the disappearance of the symptomatology. Those affected reduce their frequency of daily showering considerably, returning to their usual routine. In addition, vomiting and abdominal discomfort disappear completely.

The duration of this phase is very variable, ranging from months to years. However, it should be noted that people can relapse if they start using cannabis again.

Symptoms of cannabinoid hyperemesis syndrome

The main symptoms of cannabinoid hyperemesis syndrome are vomiting and abdominal discomfort. The intensity of the signs will depend on the stage of the disease.

People may also experience the following:

Most of these symptoms last for the same length of time as the hyperemesis phase, i.e. 1-2 days. However, the duration may be longer if constant marijuana use continues.

Possible complications

The main complication of cannabinoid hyperemesis syndrome is dehydration. The constant vomiting causes a significant loss of fluids and electrolytes, resulting in a variety of systemic manifestations.

The loss of water and electrolytes throws the body out of natural balance. Thus, the following complications are possible:

  • Involuntary muscle contractions
  • Seizures
  • Generalized weakness
  • Shock
  • Severe arrhythmias
  • Kidney failure

Causes of cannabinoid hyperemesis syndrome

Unfortunately, the precise cause of cannabinoid hyperemesis syndrome hasn’t yet been established. It’s important to note that this is a syndrome that was only discovered in 2004, so more research is needed.

Some studies have established different theories that may explain why the condition occurs. All of these theories involve the interaction of tetrahydrocannabinol (THC) and other active ingredients with receptors in the gastrointestinal system.

One of the most widely accepted theories states that THC interacts with the CB1 receptor. The constant interaction generates changes in the digestive tract and causes the onset of the syndrome. However, genetics must play a key role, as not all users develop the disease.


The diagnosis of cannabinoid hyperemesis syndrome is a real challenge for specialists. People often hide the fact that they use marijuana on a recurrent basis, making an accurate and timely approach impossible.

Laboratory tests aren’t too helpful in identifying the condition, so doctors often rely on clinical and consumption history. Nowadays, criteria have been established that facilitate the detection of the alteration, among which the following stand out:

  • Frequent marijuana use for more than 1 year
  • Cyclical nausea and vomiting after use
  • Compulsive hot baths that relieve vomiting
  • Disappearance of the symptomatology when not using cannabis

Young men under the age of 50 are the most affected by this condition, so age should also be taken into account. Cannabinoid hyperemesis syndrome can be confused with cyclic vomiting syndrome and other similar disorders. Thus, a history of marijuana use can be used to make the differential diagnosis.

Some cannabis.
Cannabis use is a clue that can guide the diagnosis when in doubt.

Treatment and prevention of cannabinoid hyperemesis syndrome

Treatment of cannabinoid hyperemesis syndrome during the vomiting phase consists of relieving symptoms and avoiding dehydration. Individuals should consume plenty of fluids to avoid complications. In addition, the use of antiemetics can reduce the intensity.

Hospitalization will be necessary in the most severe cases or when there are many complications. However, the definitive treatment is to stop using marijuana. The symptoms go away within 1 or 2 days after cessation of use.

The real problem lies in the fact that marijuana generates dependence, so it can be very difficult to give up the substance. As a result, people tend to use again, so the symptoms return immediately.

Prevention of cannabinoid hyperemesis is similar to definitive treatment. People should stop using marijuana to avoid relapse. However, symptoms can recur abruptly upon contact with the substance.

A recent and under-diagnosed disease

Cannabinoid hyperemesis syndrome is a pathology characteristic of many chronic marijuana users. The active ingredients of this plant alter the functioning of the digestive tract, causing the appearance of vomiting and intense abdominal pain.

Unfortunately, it’s a little known syndrome with very general symptoms, so it can be confused with other conditions. Thus, the disease is underdiagnosed in most cases. The ideal thing is to go to the doctor in the presence of the characteristic symptoms and not to hide information from the health personnel.

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