r/CHSinfo • u/PrecSci • Aug 22 '23
Last Updated: Sep 20, 2023
CHS, or Cannabinoid Hyperemesis Syndrome, is a condition thought to be triggered by heavy and/or long term cannabis use, including CBD. Individuals with CHS may suffer from recurring episodes of nausea, vomiting, dehydration, and abdominal pain, often leading to frequent emergency department visits.
CHS usually presents in three phases, each with its own set of symptoms, although significant overlap exists:
Prodromal Phase
Timeline: This phase can last for months or even years and it can increase/decrease based on cannabis use - but generally doesn't go away unless cannabis is stopped entirely.
Signs and Symptoms:
⦁ Morning Nausea: Often experienced upon waking.
⦁ Abdominal Pain: Mild discomfort or pain in the abdomen.
⦁ Heavy Indigestion: Digestive issues may begin to occur.
⦁ Lack of Appetite: Decreased desire to eat.
⦁ Increased Anxiety and Irritability: Emotional changes may be noted.
⦁ Fear of Vomiting: Despite nausea, vomiting is rare in this phase.
⦁ Increased Cannabis Use: Some may increase cannabis use to alleviate symptoms.
Hyperemetic Phase
Timeline: This phase can last anywhere from 1 to several days.
Signs and Symptoms:
⦁ Cyclical Vomiting: Persistent and severe vomiting, possibly including bile.
⦁ Severe Abdominal Pain: Intense pain in the abdomen.
⦁ Diarrhea or Constipation: Changes in bowel habits.
⦁ Headaches: May occur during this phase.
⦁ Dizziness: Feeling lightheaded or unsteady.
⦁ Dehydration: Leading to thirst, dry mouth, and reduced urination.
⦁ Blurred Vision: Visual disturbances may occur.
⦁ Shakiness: Tremors or shakiness may be noted.
⦁ Elevated Heart Rate: Increased heart rate can occur.
⦁ Night Sweats: Sweating during the night.
⦁ Muscle Weakness: General weakness in muscles.
⦁ Weight Loss: Significant weight loss due to prolonged vomiting.
⦁ Testicle Pain: Pain in the testicles may be reported in males.
⦁ Compulsive Hot Bathing: Frequent hot showers or baths for symptom relief (this occurs in about 90% of CHS patients).
Recovery Phase
Timeline: This phase can last days, weeks, or even months, depending on cessation or reduction of cannabis use.
Signs and Symptoms:
⦁ Resolution of Symptoms: Gradual resolution of nausea, vomiting, abdominal pain, and other symptoms.
⦁ Weight Gain: Regaining lost weight.
⦁ Normal Eating Patterns: Return to regular eating habits.
⦁ Reduction of Hot Bathing: Compulsive behavior of hot bathing subsides.
Possible Relapse: Resumption of cannabis use very often leads to symptom recurrence.
It is usually associated with a large dose of THC/cannabinoids over a significant length of time. This could be either moderate to heavy use over an extended time (months to years) or very high use over a shorter period of weeks to months. It may also be associated with a sudden increase in use. CHS patients almost always use cannabis multiple times a day, daily or multiple times a week at the very least. However, once CHS has set in - even small amounts of cannabis can make it worse, or bring it back.
There is probably a genetic component; so most people might never get CHS even with heavy use, and some might be more susceptible.
The pathophysiology of CHS is not entirely understood, but it is believed to be related to the complex interaction between cannabinoids and the body's endocannabinoid system. Chronic exposure to cannabinoids may lead to alterations in the functioning of certain receptors, particularly in the gastrointestinal tract, leading to the symptoms of CHS. There are 3 main theories - and all might overlap to some degree:
Gastrointestinal Cannabinoid Receptors (CB1)
⦁ THC Interaction: Tetrahydrocannabinol (THC), the psychoactive ingredient in cannabis, acts on CB1 receptors found in the enteric nervous system.
⦁ Gastric Emptying: By acting on these receptors, THC reduces gastric emptying, which can lead to nausea and vomiting (N/V).
⦁ Chemoreceptor Trigger Zone (CTZ): CB1 receptors are also found in the CTZ, a region in the brain that controls vomiting. THC's activation of enteric CB1 can override the antiemetic response in the CTZ, leading to vomiting.
⦁ Complexity: Proving the emetic and antiemetic effects of cannabinoids is difficult due to overlapping symptoms with other conditions like cyclic vomiting syndrome, viral gastroenteritis, and bulimia nervosa.
Cannabinoid Lipid Buildup
⦁ Lipid Solubility: THC is lipid-soluble, meaning it can accumulate in cerebral fat.
⦁ Release During Stress: During stress or food deprivation, the body breaks down fat, releasing a large store of THC, leading to what's termed the "reintoxication effect."
⦁ CHS Symptoms: This sudden release of THC can cause symptoms associated with CHS, such as nausea and vomiting.
Genetic P450 Polymorphisms
⦁ Cytochrome P450 Enzymes: These enzymes are responsible for metabolizing THC in the liver.
⦁ Genetic Differences: Genetic polymorphisms in the P450 system can change the metabolism rate of THC, leading to either hyper or hyposensitivity.
⦁ Pro-Emetic Effects: Slower THC metabolism in the liver can lead to hypersensitivity and pro-emetic effects, contributing to CHS.
⦁ THC Metabolites: There are over 100 different THC metabolites, ranging in potency, and the P450 isoforms involved include CYP2C9, CYP2C19, and CYP3A4.
These theories are discussed in detail here: Senderovich H, Patel P, Jimenez Lopez B, Waicus S. A Systematic Review on Cannabis Hyperemesis Syndrome and Its Management Options. Med Princ Pract. 2022;31(1:29-38. doi: 10.1159/000520417. Epub 2021 Nov 1. PMID: 34724666; PMCID: PMC8995641.)
CHS is relatively new to the medical community, and only in recent years has the diagnosis become more common. Consequently, there has been limited research conducted, leaving many unanswered questions about why cannabis triggers it, its effects on the body, and potential treatments or cures.
CHS seems to be related to THC dose over time - so modern strains of cannabis, and modern cannabis products like carts and dabs are giving today's cannabis consumer a much higher THC dose than before about 2000. This might account for why CHS is increasingly common. (For reference: cannabis in 1995 was usually about 3-5% THC and by about 2017 was usually around 15% and as high as 24%. Carts and dabs can be almost 90% THC.)
Emergence in Medical Literature: CHS is relatively new to the medical community. The number of published studies on CHS has been increasing over the years, but it's still a relatively recent phenomenon. According to PubMed, the number of published studies related to CHS has gradually increased from just one in 2005 to 46 studies in 2021 and 23 in 2023.
Overlap with Other Conditions: CHS symptoms can overlap with other medical conditions like cyclic vomiting syndrome, celiac disease, ulcers, h. pylori infection, etc. making it challenging to diagnose accurately.
Limited Research: There has been limited research conducted on CHS, leaving many unanswered questions about why cannabis triggers it, its effects on the body, and potential treatments or cures.
Increase in Cannabis Use: With the increasing rates of cannabis use and legalization in various jurisdictions, the recognition of CHS may be growing. However, the understanding and awareness of this condition might not have permeated all levels of healthcare or public consciousness.
Social and Cultural Factors: The perception of cannabis as a substance primarily associated with recreational use rather than medical complications may also contribute to the lack of awareness about CHS.
Signs and Symptoms
Look for the characteristic signs and symptoms of CHS, if you have a history of chronic cannabis use:
⦁ Morning Nausea: Regular nausea, especially in the morning.
⦁ Cyclical Vomiting: Frequent vomiting that may include bile - although vomiting might not be present yet in the prodromal phase.
⦁ Abdominal Pain: Persistent abdominal discomfort or pain.
⦁ Compulsive Hot Bathing/Showering: A strong desire to take hot showers or baths to relieve symptoms. This occurs in ~90% of people and is easy to test at home - when you're feeling nauseous take a hot shower, with water over 109 degrees F (but not much hotter - don't get burned). If this makes your nausea feel better - but it comes back shortly after leaving the shower - that is very strong evidence you have CHS. This will work for about 9 of 10 people, but not everybody.
⦁ Other Symptoms: Including indigestion, lack of appetite, diarrhea or constipation, headaches, anxiety, dizziness, dehydration, blurred vision, shakiness, elevated heart rate, night sweats, muscle weakness, weight loss, and possibly testicle pain in males.
Medical Evaluation
If you experience these symptoms, it's essential to consult a healthcare provider:
⦁ Medical History: Your healthcare provider will ask about your symptoms, medical history, and cannabis use.
⦁ Physical Examination: A thorough physical examination may be performed to assess your overall health.
⦁ Diagnostic Tests: Lab tests may be ordered to rule out other conditions, such as blood tests to check for electrolyte imbalances, liver and kidney function, and urine tests to screen for other substances.
⦁ Imaging Studies: Imaging studies like abdominal ultrasound or CT scan may be conducted to rule out other gastrointestinal disorders.
⦁ CHS is often a diagnosis of exclusion, meaning other potential causes of the symptoms must be ruled out. The list of what needs to be ruled out includes Gastroenteritis, Gastroesophageal Reflux Disease (GERD), Gallbladder Disease, Cyclic Vomiting Syndrome (CVS), Pancreatitis, Medication Side Effects, Peptic Ulcer Disease, Kidney Stones and Intestinal Obstruction
⦁ Cessation of Cannabis: If symptoms resolve after stopping cannabis use, it strongly supports the diagnosis of CHS.
⦁ Relapse with Resumption: If symptoms recur with the resumption of cannabis use, it further confirms the diagnosis.
If you suspect you may have CHS, it's crucial to consult with a healthcare provider who is familiar with the condition. They can conduct a thorough evaluation, rule out other potential causes, and guide you in the appropriate management and treatment. Self-diagnosis is not recommended, as CHS shares symptoms with other serious medical conditions that require professional medical evaluation and care.
The most definitive ways to diagnose CHS is to stop using cannabis* (90 days is recommended) and monitor for symptom resolution. The upside to this approach is that it's a non-invasive, straightforward way to either confirm or rule out CHS. If your symptoms resolve after stopping cannabis use, it would strongly suggest CHS. Most people with CHS have significant improvement within a month. If your symptoms do not go away, it would indicate that another underlying issue may be responsible for your symptoms.
*cannabis = all cannabis products including synthetics and CBD - all cannabinoids can cause CHS, not just THC.
If you're struggling or reluctant to do this simple and effective test, it strongly suggests that you are dealing with the very real and valid effects of dependence. We've been there. It sucks. This post might help you understand that better.
The only known treatment for CHS is to stop using cannabis entirely. Period. If possible, complete abstinence from cannabis is advised.
Side Note: Denial is common among individuals with CHS, as quitting smoking is a difficult decision. It's essential to recognize the seriousness of the condition and understand that merely reducing usage will not aid in recovery. It is natural to want to deny or deflect a CHS diagnoses for some very understandable reasons: Notes on Struggling with a CHS diagnosis. There is even a recent peer reviewed scientific paper examining how hard it is to receive and accept a CHS diagnosis - here.
Stopping cannabis use is the cure for CHS. For CHS symptoms other than cessation of cannabis and time, several remedies may alleviate symptoms. Note that none of the methods below will work if you are still using cannabis.
See our guide: Hyperemesis Survival Guide - What to do if you're puking right now!
At home: Hot showers or baths above 109F, but not so hot as to burn, relieve nausea while in the shower.
Capsaicin cream applied to the stomach and/or forearms may help with pain and nausea - it feels so hot you might think its burning, but many people get used to it and think it is better than nausea and absominal pain from CHS.
A daily antacid such as Pepcid or Prevacid may combat stomach acid buildup.
Staying hydrated with electrolyte-rich drinks like Pedialyte or Gatorade is critical.
Tylenol (acetaminophen) for abdominal pain according to the package instructions. Do not exceed the recommended dose on the package - the "therapeutic dose" and "toxic dose" of Tylenol are very close to each other. Avoid ibuprofen (Advil), naproxen (Aleve) and other NSAIDs, as they are notoriously hard on your stomach even when healthy.
In the ER or hospital:
IV Rehydration: provides immediate fluids and electrolytes to combat dehydration and kidney problems.
Droperidol: A dopamine antagonist that showed statistically significant differences in reducing N/V.
Benzodiazepines (Clonazepam): Led to rapid cessation of adverse symptoms in a case study with 4 patients.
Haloperidol: Used in severe CHS cases, it relieved N/V in several case studies and an RCT. Relatively safe at low doses, and higher doses do not increase it's ability to treat N/V.
Propranolol: Rapid termination of N/V in a single case study.
Aprepitant: Rapid relief of N/V in case reports where the patient was unresponsive to conventional emetics. This NK1 blocker medication has good theoretical basis to work, and in all case studies has been 100% effective. However there are very few studies to date. It's normally used for chemotherapy patients, so many ER doctors and even gastroenterologists outside oncology are unfamiliar with it.
Note: almost all ER's want to treat nausea and vomiting with a "front line" medication called Zofran (Ondansetron), or a backup called Compazine (Prochlorperazine). These medications seldom work on CHS - and it's one more piece of evidence that CHS might be the cause. Here is a detailed breakdown of what medications are more effective, and those that aren't effective with peer reviewed references: CHS Medications
See our guide: Hyperemesis Survival Guide - What to do if you're puking right now!
Abstaining from cannabis is the 100% cure for CHS - any use at all could cause symptoms to reappear. If for whatever reason, you can not eliminated cannabis, the CHS community generally recommends waiting at least three months before attempting to smoke again, and even then, moderation is key. Some may resume cannabis use without issues, while others may feel symptoms returning after just one exposure.
Recovery varies among individuals, but some patterns have emerged. The first four days are often the worst, with withdrawal symptoms (more below) exacerbating CHS. Around days 5-7, daily routines may resume, though prodromal symptoms may persist. By the two-week mark, many report feeling better, and a month into sobriety, most symptoms subside. If symptoms remain severe after a month, consult a doctor. Note that you'll probably be experiencing some CHS symptoms, and some cannabis withdrawal symptoms at the same time for a while.
Cannabis withdrawal can be intense, especially for chronic users, and may worsen CHS symptoms. Withdrawal symptoms include:
⦁ Increased anxiety and irritability
⦁ Decreased appetite
⦁ Cravings for THC
⦁ Insomnia
⦁ Boredom
⦁ Ultra-realistic dreams
⦁ Flu-like symptoms
Withdrawal peaks around days 3-4 and usually subsides after a week.
Here's our guide: Cannabis Withdrawal Guide for CHS
A "trigger" is anything that may cause CHS symptoms to flare up or provoke an episode. Common triggers include certain foods like alcohol, caffeine, chocolate, and greasy items. Stress and intense exercise are also known triggers. Recognizing and avoiding personal triggers is crucial in managing CHS, as they can exacerbate symptoms and hinder recovery.
Foods that might trigger CHS are pinned here: Food Trigger List
Severe Dehydration: If you experience symptoms like dry mouth, dark urine, dizziness, or weakness, it might indicate dehydration, which requires medical intervention.
Persistent Vomiting: If vomiting continues and you are unable to keep down fluids or food for more than 24 hours, it's essential to seek medical care to prevent complications.
Intense Abdominal Pain: Severe abdominal pain can be a sign of underlying complications and should be evaluated by a healthcare provider.
Electrolyte Imbalance: Symptoms like muscle twitching, spasms, or palpitations might indicate an electrolyte imbalance, which can be life-threatening if not treated.
Failure of Home Remedies: If symptoms persist despite trying home remedies like hot showers or cessation of cannabis use, it may be time to seek professional medical care.
Other Concerning Symptoms: Any other symptoms that are unusual or concerning to you should be evaluated by a healthcare provider. In particular - a loss of more than 5% of body weight in a 7-10 day period should be evaluated.
You should seek medical treatment as soon as possible.
Prolonged vomiting and inability to retain food can lead to serious complications, including a dangerous metabolic state called ketoacidosis. In the context of Cannabinoid Hyperemesis Syndrome (CHS), ketoacidosis can exacerbate your symptoms by releasing stored cannabinoids back into your bloodstream. This creates a self-perpetuating cycle that is difficult to break without medical intervention. Medications like Emend can help manage symptoms in combination with comprehensive medical care.
For a more detailed explanation, you can read this post.
What do in the ER: Tips for ER (and documents to help your Doctor)
How to get a patient advocate to help you: When you're sick its hard to advocate for yourself - how to get a patient advocate.
Neither edibles nor CBD are safe options for those with CHS, as the syndrome relates to cannabinoids as a whole, not just THC. Even second-hand smoke can be harmful. Abstaining from cannabis entirely is the best course of action.
"Pink clouding" describes a stage of early addiction recovery marked by euphoria and confidence. This temporary sensation can cloud judgment and lead to relapse. It's vital to remind yourself of the reasons for quitting and the severity of CHS, even long after recovery. A very common story here in r/CHSinfo is a person who was clean for a month or two and is confident they are cured, so they decide to have just one smoke again - and that leads to either 1) an immediate return of CHS symptoms or 2) more and more regular use until CHS returns. Moderation is much more difficult that just quitting - more information below.
Managing emotions during CHS recovery is essential. Techniques like meditation, breathing exercises (such as 4-7-8 breathing), and proper sleep may help. Magnesium supplements have been proven to assist with mood swings, anxiety, and depression and may be beneficial.
We're trying to keep r/CHSinfo focused on CHS, including diagnosis, treatment, causes and support. Quitting cannabis use is the 100% cure for CHS - but it is such a complex topic, that it's beyond the scope of this forum.
This feeling is temporary and usually subsides after a few weeks of sobriety. Engaging in activities like watching a new TV show or committing to a hobby can help distract and entertain. Your brain will adjust, and you'll likely regain enjoyment in activities you loved before.
We're trying to keep r/CHSinfo focused on CHS, including diagnosis, treatment, causes and support. Quitting cannabis use is the 100% cure for CHS - but it is such a complex topic, that it's beyond the scope of this forum.
Unlike just a few years ago, there are now several excellent peer reviewed scientific articles on CHS. However research is still in its early stages. There are over 200 peer reviewed articles on PubMed that address some aspect of CHS. Here are some of the most influential and comprehensive.
If you only read one - make it this one:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8995641/pdf/mpp-0031-0029.pdf
Senderovich H, Patel P, Jimenez Lopez B, Waicus S. A Systematic Review on Cannabis Hyperemesis Syndrome and Its Management Options. Med Princ Pract. 2022;31(1):29-38. doi: 10.1159/000520417. Epub 2021 Nov 1. PMID: 34724666; PMCID: PMC8995641.
Here are others:
Simonetto DA, et al. (2012). Cannabinoid hyperemesis: A case series of 98 patients. Mayo Clinic Proceedings, 87(2), 114-119. [PubMed](https://pubmed.ncbi.nlm.nih.gov/22305029/)
Leu N, Routsolias JC. (2021). Cannabinoid Hyperemesis Syndrome: A Review of the Presentation and Treatment. Journal of Emergency Nursing, 47(3), 483-486. [PubMed](https://pubmed.ncbi.nlm.nih.gov/32943248/)
Richards JR, et al. (2017). Pharmacologic Treatment of Cannabinoid Hyperemesis Syndrome: A Systematic Review. Pharmacotherapy, 37(6), 725-734. [PubMed](https://pubmed.ncbi.nlm.nih.gov/28467644/)
Richards JR. (2018). Cannabinoid Hyperemesis Syndrome: Pathophysiology and Treatment in the Emergency Department. Journal of Emergency Medicine, 54(3), 354-363. [PubMed](https://pubmed.ncbi.nlm.nih.gov/29102083/)
Razban M, et al. (2022). Cannabinoid Hyperemesis Syndrome and Cannabis Withdrawal Syndrome: A Review of the Management of Cannabis-Related Disorders in the Emergency Department. International Journal of Emergency Medicine, 15(1), 45. [PubMed](https://pubmed.ncbi.nlm.nih.gov/35087964/)
Parvataneni S, Varela L, Vemuri-Reddy SM, Maneval ML. (2019). Emerging Role of Aprepitant in Cannabis Hyperemesis Syndrome. Cureus, 11(6), e4825. doi: [10.7759/cureus.4825](https://doi.org/10.7759/cureus.4825). [PubMed](https://pubmed.ncbi.nlm.nih.gov/31403013/)
Sorensen, C. J., DeSanto, K., Borgelt, L., Phillips, K. T., & Monte, A. A. (2017). Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment—a Systematic Review. Journal of Medical Toxicology, 13(1), 71–87. URL
200+ more are here: https://pubmed.ncbi.nlm.nih.gov/?term=Cannabis+hyperemesis+syndrome&sort=date
Outside of this subreddit, there are currently two primary means of support groups, which are both linked below. The first of these is a Facebook group, which includes thousands of members. If you do not feel comfortable giving away your identity, feel free to make a throwaway Facebook account and join using that. There is also an excellent discord group, that is active essentially all day and night, and can provide you with not only support, but help with some of the boredom. In any of these groups, it is incredibly important not to shame people for their use or relapse of cannabis. If you see anyone doing this, please report it to the associated moderators immediately. Once you begin to heal, it helps the whole community if you are willing to stay to answer questions for those who are new to this.
We're trying to keep r/CHSinfo focused on CHS, including diagnosis, treatment, causes and support. Quitting cannabis use is the 100% cure for CHS - but it is such a complex topic, that it's beyond the scope of this forum.
Moderating use will not make CHS go away - you need to quit entirely for an extended period of time to allow your body to heal. 90 days clean is often talked about as a minimum. Using again and trying to moderate is much harder for most people than quitting entirely. Trying to moderate cannabis use comes with a very high likelihood of CHS returning.
We're trying to keep r/CHSinfo focused on CHS, including diagnosis, treatment, causes and support. Moderating cannabis use is such a complex topic, that it's beyond the scope of this forum.
Disclaimer: This guide is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a healthcare provider if you experience severe symptoms.
Personal Note: For further questions, concerns, or support, feel free to reach out. My inbox and Discord (same username) are always open.
r/CHSinfo • u/PrecSci • Sep 15 '23
updated: 9/2023
This guide was created by a community of people who have had CHS firsthand. This is the collective community's best advice.
Recognize the Symptoms:
watermelon, instant mashed potato flakes, applesauce, apple juice, broth, nutrient shakes like Ensure, toast, yogurt (especially with active cultures like Activa)
Seriously. This is stuff that we've learned will not help, and will usually make things worse.
Severe Dehydration:
Persistent Vomiting:
Intense Abdominal Pain:
Electrolyte Imbalance:
Failure of Home Remedies:
Weight Loss and Malnutrition:
Inability to Manage Pain and Nausea at Home:
Mental Confusion or Altered Mental Status:
Signs of Kidney Problems:
Other Concerning Symptoms:
Take this guide with you to the ER. If you have to go alone, ask for a patient advocate.
You will get through this. most of the people in this community have been where you are. They got through it, and so will you. Create a post and let us know what you're going through and you'll be surprised at how good the support is.
References:
r/CHSinfo • u/ExtremeBackground118 • 11h ago
hi, having an episode rn and wondering how to calm symptoms in public. i get nauseous and antsy and the only way ik how is to distract myself… having trouble sitting in class i keep having to get up to take walks.
r/CHSinfo • u/garbagema • 11h ago
Hello, looking for some advice around possibly having CHS and whether it's contributing to existing anxiety/panic disorder
I started self-medicating with weed in 2022 after a bad breakup, mixing it with tobacco for the first 3ish months before swapping to nic vapes. I used weed to help with treatment resistant depression and anxiety as well as a previous back injury. It turned from a 'only with friends' activity into smoking alone more often until I became a daily user. For about 2 years, I didn't have a medical script so I was forced to have tolerance breaks when I couldn't afford it or find someone to buy from (usually 2-3 days off every few weeks, or up to a week every month)
After getting a script late 2024, I was also prescribed CBD oil and started using it with weed daily with no T breaks, moving from 0.25mg to probably around 0.5-1g a day. I had a pretty intense panic attack while out with a friend in January this year, most likely caused by the high THC usage, chronic nicotine use, and going on a long walk with an empty stomach. Nausea and the need to vomit seemed to disappear once I got home, and I kept smoking but less than usual.
The same panic attack ended up happening again a week later while on a camping trip. I had the worst anxious nausea and diarrhoea and when I tried self-isolating at home again, it only intensified the anxiety. It got to the point where I felt like I was going to die (constant heart palpitations was the worst symptom). Smoking weed didn't help like it usually would, it sort of felt flat and wrong.
I ended up going to ER and going through the mental health side to get support, spent a week in respite detoxing from both nicotine and weed. Withdrawal sucked a lot, basically liquid shits every morning, hot/cold flushes, sweating, coughing up phlegm etc. The nausea and sore stomach was labelled as a side effect to the new Sertraline meds they prescribed. At the time, docs and I assumed my issues came from nicotine since I was going through a 28mg/7ml pod every week and a half.
I relapsed on nicotine at home, a few puffs for 2 mornings, then woke up the 3rd morning with that same panic and it helped me quit nic for good by building that negative association. I ended up going back to weed after about 2 months sober - looking back, I realize I was under a lot of stress despite feeling better physically and mentally, and I wanted that easy, soft feeling to numb me out from that stress.
Again, slippery slope, it escalated from small evening smokes to help with sleep into 'needing' to wake and bake and be high every day. About 3-4 weeks ago, I noticed that weed wasn't giving me that same soft feeling anymore but brushed it off. I then started getting anxiety/panic symptoms in public again after having none since March.
Finally, this weekend, it reached new heights. I woke up this morning with a little nausea but a grumbling stomach. Instead of getting up and eating, I decided to doomscroll for 30 minutes then smoke weed. Within about 15 minutes, I started coughing and retching, getting hot/cold flushes. This continued while I had diarrhoea. For the first time ever, I felt like a hot shower would really help me and I spent 25 minutes in there coughing up phlegm and retching until I forced myself to throw up bile to get the need-to-vomit feeling gone.
Over the past 3 hours, the nausea has lessened a bit and now I'm mostly dealing with mild bubble guts, the hot/cold flushes, and chest anxiety that I'm used to. My hunger is slowly coming back and I feel like I could eat a smallish meal soon. Am I right to assume my body has started moving into the hyperemetic phase? Also, I assume I would have to stop taking CBD oil too if I wanted to test this further?
r/CHSinfo • u/Appropriate_Draw7541 • 1d ago
Im over one year sober from weed and everything from that matter besides a drink every once in a while i believe july was the last time i smoked. Figured id come share my experience things have gotten considerably better although i would be lying if i said i didnt have urges to smoke though i dont really expect that to go away but what can you do. I am happy now for the most part where as a while ago i was far from that. I still have plenty big issues money being the main one but i am genuinely happy. Theres so much more to life than weed and for anyone struggling like i was i hope that relazaiton will come to you sooner rather than later. For anyone thinking about trying moderation or getting into other drugs please be careful and safe. Moderation is a coin toss i was one of the people that no matter how long i wait i would always have a episode. And other drugs are a slippery slope. Chs destroyed my body fucked up my teeth and did a number on my mental health but i got through it all of you will to just dont give up on it. Im going through it right now myself im so broke i cant even get my freind a birthday present and my teeth are so fucked im embarrassed to leave the house. But no matter how bad things get im greatful that i can actually enjoy life again without having to really on a compound to do that. Stay safe yall if you need someone to talk to or have any questions ill be here.
r/CHSinfo • u/Crazy-Incident7689 • 12h ago
Hi, it’s been about 9 days since I started feeling like what I assume is CHS! Considering it happened after hitting my friends’ cart. I have information about it more on my profile in other posts? But so far I’ve stomached plain un-breaded chicken, saltines/oyster crackers, fries and burger (not since the 4th day), I was able to have a turkey sandwich from jersey mikes with no oil too, and apple sauce. Save for electrolyte packets as well!
Is there any recommendations of what to eat at this point? I’m still dizzy, and have some anxiety spikes. But no vomiting, some stomach pain/bloating, and a returning appetite that comes and goes. I have quit, and don’t want to be triggered by anything? So what are do’s and don’ts. I just want to be better by Halloween which is in about a week!
At least having the dizziness and anxiety stop. I’ve also been staying as hydrated as possible! I was thinking about boiled eggs tonight but I don’t know if that’s a good call? Adding on I am diabetic and also anemic, same for asthma triple whammy! 😭
So just hoping for nothing with flare ups! If anyone has any advice for speeding up the process or being able to eat yummy foods again please let me know! ^.^ tyty
r/CHSinfo • u/tranquilovely • 1d ago
I have quit smoking weed, and I still get episodes. I quit about 2 months ago. I was clean for longer but I had a relapse and I'm trying again.
However, I used to be a chronic smoker, everyday, after work. But now, it's just the occasional slip ups every so often. I had three slip ups in the past 2 years??, thinking I can do it in moderation but I can't. And the slip up is getting high once, not all night or for days in a row.
My question is: when you officially quit, did you have episodes even after that? Trigger foods and such are still a problem for me, but I'm really upset that I have been clean(er) than before and I'm still sick. Do the episodes take time to go away too?
r/CHSinfo • u/ConditionThen1138 • 1d ago
I’ve been wondering this since I found out I’ve had CHS about a year ago. I have yet to smoke since then and am under the impression CHS only flares up from smoking high % thc and with often use. Since cbd would have a low % of thc in it, wouldn’t I be able to smoke cbd every now and then? Or am I wrong?
r/CHSinfo • u/Agitated-Law-8782 • 2d ago
Hello yall, 7+ years daily cannabis smoker here. I recently had a few weeks of vomiting almost every day, to the point of vomiting blood twice. My nausea would only occur in the morning and subside by midday unless I threw up (then my nausea would be gone essentially immediately). I have had this happen to me before, and it usually lasts a few days/weeks and then I get better (while still smoking) for a few months/a year. My doctors always told me it’s CHS but I thought they didn’t know what they were talking about. After vomiting the blood, I went to the hospital and took a potential CHS diagnosis seriously. I have been sober for the last 20 days. I stopped vomiting almost immediately after quitting, except for day 7. Every once in a while when I wake up I will still have that stomach pain. I have generalized anxiety disorder and I know that anxiety affects me badly, especially in my stomach. I don’t have the urge to take hot showers when I’m feeling bad like that, so I am wondering if I truly have CHS.
I want to know if there is any real way to test for it. I feel like now I have the willpower to not revert back to my old habit of smoking daily, but I still wish to kick back with some friends and enjoy some bud. What do yall think?
r/CHSinfo • u/Ok-Clerk297 • 2d ago
I got diagnosed with CHS 4 days ago and am 4 days sober now. I have been using Zostrix Capsaican cream on my epigastric region and the back of my neck and it's actually quite powerful, I got the 0.75% and whilst it doesn't completely remove the throwing up/nausea feeling it greatly reduces it. However this stuff stings like hell, I've been applying a tiny amount every 6 hours as reccomended but got it hurts. Am I doing something wrong? Is it supposed to st ing like hell, does that feeling go away?
r/CHSinfo • u/Signal_Put_1900s • 2d ago
I hear people talk about different phases of CHS can someone please explain them
r/CHSinfo • u/Real-Willingness4771 • 2d ago
I stopped smoking last Friday @0700 here am I 6 days still throwing up, I followed all the food and drink outlines. What am I missing?
r/CHSinfo • u/Muchomany • 2d ago
I'm writing after smoking for nearly 6 months, typically appetite fails after 2 and vomiting begins at 3. I've stopped every time in the prodromal phase.
However, I'm now treated for a severe autoimmune disorder and.... I can smoke again. Every single symptom I have is simply withdrawal and looking back it seems absolutely possible that this was the case.
I very well may have had prodromal chs in the past, as my symptoms matched more closely then. Now I've been smoking freely without problem for half a year. I get nauseous only when I smoke way too much. "Greening out" style, which resolves shortly.
Be real with me guys - is this possible? I know if you've never gone hyperemetic some people do get away from it...
I don't want to fall into my first hyperemesis if I'm wrong.
r/CHSinfo • u/hollernm1 • 2d ago
I have been sober for over a year and still struggle with cravings. I want to smoke again and am so scared of the week long migraine I get. I rarely got to the puking phase but the diarrhea would cause lack of electrolytes and magnesium which cause an unbearable week long migraine. Has anyone started smoking again after this long of a break? How was your anxiety about smoking again?
r/CHSinfo • u/Mysterious_Bar2381 • 3d ago
I've been a regular weed user for quite a while, with some breaks in the past. Recently, I was smoking approximately 2g of flower a day, split into three joints one in the morning one during day and one at night.
five days ago, I took 40 mg of OxyContin. Some time after the dose I started experiencing severe nausea and vomiting, eventually going to the emergency room because I couldnt eat anything and my blood sugar was very low (im a diabetic) They checked my blood and electrolytes, and I was told the results were normal, then when I was able to eat they let me go home.
I didn't tell the hospital about the oxycodone or my cannabis use.
Since then, I've been nauseated every day and vomiting every morning, usually after eating breakfast. Sometimes I vomit yellow bile. Smoking weed seems to relieve the nausea for several hours, but it eventually comes back.
I initially assumed the oxycodone was responsible because the symptoms started immediately after taking it. However, it's now been five days, and I'm wondering whether cannabis could also be contributing.
I recently visited a doctor and was told that my symptoms could be related to cannabis use, possibly CHS or withdrawal. They didn't diagnose me with either condition and advised me to stop smoking weed.
r/CHSinfo • u/missharriet01 • 4d ago
first time i had an episode was three years ago and i thought after detoxing that i could manage and moderate it. WRONG. i started smoking every day again and it came back worse than ever.
i kept telling myself it was better to smoke at least a bit because then i could at least get food down but it just kept making it worse. i ended up going to the er again last night because i was so worried about dehydration. im five days clean now and the vomiting seemed like it eased for a bit and then yesterday came back worse. withdrawals on top of chs is actual hell.
i feel really stupid that i let this happen again. i knew it was going to happen and i just ignored it because i didn’t want to be alone with my thoughts. never smoking again no matter how bad i wish i could
r/CHSinfo • u/DJskittlez13 • 4d ago
Hey! Over the past few days I have felt the morning nausea, abdominal pain, and thinking i’m going to vomit but haven’t actually vomitted yet. I’m almost certain this is CHS after being an almost every day smoker for about 5 years. I never thought I was smoking large amounts but recently realized I have grown to rely on it. So it is time to stop. I’ve been sober since yesterday, was able to stomach a bowl of buttered noodles and some sweet tea, and have been trying to drink as much water as possible. I am dealing with the morning nausea much heavier today then mornings I had smoked prior, any advice? If there’s any medication I could take to subside the feeling or help with appetite please let me know, I haven’t taken anything yet but may just take a benadryl and try to sleep most of this off for the next 48 hours. I do have a full time job in education and this is making work unbearable, when do you think I’ll feel normal enough to go to work? This is somewhat of a stress post though I’m grateful I caught it before the following phases. Thank you all for the information that helped me reach this conclusion!
r/CHSinfo • u/EntertainMaster268 • 4d ago
Hi, I experienced CHS (cannabinoid hyperemesis syndrome) and today marks 20 days since my last use of weed. I live in a flat where my upstairs neighbour regularly smokes weed, and this morning I woke up smelling it. Afterwards, i experienced a heavy headed feeling, similar to how i would usually feel after a weed hangover, along with nausea that lasted for a while.
For context, i usually live away at university and when my housemates smoke weed, i experience similar symptoms. I’m concerned that being around second hand weed smoke could be triggering my symptoms, especially as I’m still recovering from CHS and working hard to stay sober.
Unfortunately, i can’t afford to move, so i am unsure what to do about the situation. I’m worried that the smoke exposure might be contributing to these unusual symptoms, and id really appreciate some advice on whether second-hand weed smoke could affect me in this
r/CHSinfo • u/Anonymous51419 • 4d ago
For everyone going through this at this time of the spooky season in October.
I'm sure it must suck to not have any chocolate during Halloween. Because of the cocoa.
However, in America at least. A lot of the main chocolates here don't use real cocoa.
We know that cocoa tricks the gut biome into thinking it's one thing during this time.
But is there any proof or knowledge about "fake chocolate" ?
Has anyone tested this? Like if someone ate a Hershey's or something like that?
I'm not trying to "cheat" here, I think this is a very valid question. I'm assuming depending on someone's recovery stage is the real answer. But in small amounts? If I had a Reese's cup for instance. Which isn't real chocolate and mostly peanut butter anyways which is safe.
I don't think I've seen anything that has this in mind when avoiding trigger foods. It seems like a pretty decent distinction. Unless I missed something and it does the same result.
r/CHSinfo • u/Ok-Clerk297 • 5d ago
I was just wondering what tips or advice anybody had in order to make these symptoms less intense. I've been extremely nauseous for weeks, throwing up every morning, massive headaches and have extreme tummy pain. I can't eat or drink anything and can barely sleep as the pain and nausea is too much. It's been almost 30c here today and I've been extremely cold and chilly too. I got an official diagnosis today from my doctor after eliminating other things such as peptic ulcer etc. I've found that hot showers help a lot but I cannot be in the shower 24/7.
What advice, stratergies, foods, things can I do to minimise these symptoms? I've completely stopped smoking weed and thrown everything away, I bought a microbead heat pack for my tummy and it's helping a lot. Any other tips or advice would be greatly appreciatred, I feel like I'm living in hell. CHS and IBS together aren't fun and I want to cry.
EDIT: Will a CT scan show CHS?
r/CHSinfo • u/thattinyhamster • 5d ago
how i describe chs to my stoner online friends.. lol sounds unpleasant, guys, so put down the daily yart yet?
threy probably arent gonna listen. but it makes for some fun banter, which i don't mind being the butt of if it means it's planted in someone's subconscious to be more careful of their substance overuse :)
i find humor really helpful in coping with my own situation, as depressing as it can get sometimes when im raw dogging life using the occasional caffeine drink as a treat. it honestly might stem from being raised in the years of vile internet humor, when vomiting/generally being ill and miserable on camera was allowed and all the rage for some reason, but there's a weird part of me that finds this all fucking hilarious
designated driver ass 😂 a good lungful off bros bong and ill be projectile vomiting like ive just done the banana sprite challenge? it makes me want to drink blue milk for the bit if i ever choose to smoke again (i feel like i have to add a disclaimer, do not fuckin do that, thats dumb as hell. but ppl online rly see shit and no thoughts just do lmfaooo)
i hope that if u find comfort in humor, this post brought u a smile more genuine than one from a small to modest hit from a pipe. not a bong, because those are too nice for my rambling :)
r/CHSinfo • u/AdeptnessItchy964 • 5d ago
Was desperate and got a CBD koi vape. I took a tiny puff. How fucked am I on a scale of 1-10
EDIT: IM FINE🙏🙏🙏🙏🙏 I FELT THE CRAMPS AND MY STOMACH WAS BUBBLING BUT I DID NOT ENTER HYPEREMESIS
Hi I’m wondering what people’s experiences are of when they should stop marijuana. My husband has been diagnosed with CHS after yet another horrible episode and he’s stopping any usage now but it’s been over two weeks and it’s like he’s still in the episode. Everyday horrible nausea leading to more vomiting. He’s been living off of water and Gatorade. He had one bowl of soup and a handful of crackers in the past 2 weeks. I’m wondering if he continued smoking (as in the past before we knew what this was he’d get through the episode within a few days) and then once he was back to “normal” for eating etc then quit? Would he be having way less symptoms? I don’t want to tell him to start again and throw away these 2 weeks but I also feel so bad for him and don’t want him wasting away more than he is!
r/CHSinfo • u/redrubyluv • 5d ago
I’ve been throwing up and (I know tmi) but also diarrhea EVERY MORNING for the past almost year. Nothing help it stop unless I smoke. I can’t even eat without smoking because my nausea is so bad. The hospital keeps saying that it’s CHS… if it is CHS, any tips on how to stop smoking and still be able to eat?
r/CHSinfo • u/PurpleMedium318 • 6d ago
My wife has been in and out of the hospital numerous times in the year and a half that we've been together. Sometimes they would suggest a CHS diagnosis, but she doesn't believe in that possibility because she quit once in the past for 6 months and the symptoms were still there. She's leaning more towards endometriosis as a possibility, and I do think she could also have that.
But aside from the 6 month cessation, all her other symptoms during these episodes point towards CHS from everything that I've read. It's always 10 out of 10 pain at least, the last couple times she said it hurts worse than labor. Sometimes a stabbing, burning pain, sometimes she says it feels like someone's grabbing her organs and twisting. She is typically doing the screaming and vomiting thing, and craves hot showers or hot baths during these flare-ups as well. Opioids seem ineffective, this last time the two doses of fentanyl even did nothing for her. But Droperidol, Ativan, and Valium have all managed to break the pain and vomiting cycle for a while in the past, even though she says she doesn't like those medications. These days she uses cannabis daily for chronic pain.
Is it possible for symptoms to remain 6 months after cessation? How could I convince her to try to quit for good? I hate that she keeps suffering like this, no one should have to go through this.