By Sarah A. Buckley & Nicholas M. Mark
Faculty Peer Reviewed
An 18-year-old male presents complaining of crampy abdominal pain, nausea, and intractable vomiting for the past year. The symptoms are episodic, lasting several weeks and remitting for weeks to months. The patient states that his abdominal pain is 10 out of 10 in severity, and that he has been vomiting up to 20 times each day. He has been evaluated at multiple hospitals, and he has had numerous upper endoscopies, colonoscopies, swallowing studies, and CT and MRI imaging studies, all of which were unrevealing. He underwent a cholecystectomy, but had no improvement in his symptoms after the surgery. His pain and nausea are unresponsive to antacids and antiemetics. The patient’s only relief is with hot water bathing: he spends hours each day in the shower with the temperature set as hot as he can bear. The patient’s history is otherwise unremarkable, except that he admits to daily marijuana use beginning at the age of 14.
This patient’s story is typical of cannabinoid hyperemesis, a clinical syndrome characterized by intractable vomiting and abdominal pain associated with the unusual learned behavior of compulsive hot water bathing, occurring in the setting of long-term heavy marijuana use. Treatment consists of medication for immediate symptomatic relief and marijuana cessation for long-term relief. Symptoms usually remit within weeks of becoming abstinent.
If this disorder is so easily diagnosed and treated, why were the patient’s past doctors confused to the point of performing what might have been an unnecessary surgery? Cannabinoid hyperemesis is a new diagnosis, first described in 2004, and currently sixteen papers on the subject have been published. Therefore, it is likely that the patient’s prior doctors had never considered this disorder. Second, the pathogenesis of cannabinoid hyperemesis is poorly understood. How can marijuana, which is used in cancer clinics as an anti-emetic, cause intractable vomiting? And why would symptoms abate in response to high temperature? The connection between marijuana, vomiting, and heat is non-intuitive, and a medical team unfamiliar with this syndrome would be hard-pressed to reach the diagnosis.
The largest study of cannabinoid hyperemesis to date was the landmark report by Allen et al in 2004 in an area of Southern Australia where marijuana use is largely decriminalized.[i] The report tracked 10 patients who presented with cyclic vomiting after 3 to 27 years of cannabis abuse and no other history of drug abuse. All but one displayed compulsive hot water bathing; the remaining patient had only experienced his symptoms for 6 months, and the authors theorize that he had not yet learned to associate hot water with symptom palliation. The 9 compulsive bathers reported that this bizarre behavior occupied hours of their days and said that their symptoms were ameliorated within minutes of bathing and returned when the water cooled. All 10 patients were counseled to cease cannabis use, and 7 did so. Within weeks of cessation, the symptoms resolved for these 7 patients; the remaining 3 patients did not cease cannabis use and continued to have cyclic vomiting and abdominal pain. After several years of abstinence, 3 patients resumed cannabis use and were hospitalized again with cyclic vomiting and abdominal pain. Once again, 2 of these patients successfully stopped using cannabis, and their symptoms resolved. The remaining patient continued to use cannabis and continued to experience symptoms at the time of publication.
Following the first case report, further cases have been described on three continents. All patients presented with the classic triad of symptoms described by Allen et al: cyclic vomiting and abdominal pain, an extensive history of cannabis abuse, and palliation with hot water bathing. The fact that this unique triad is preserved in diverse patient populations suggests that there is a pathogenic mechanism that underlies this syndrome.
Several authors have speculated about the pathophysiology of cannabinoid hyperemesis, and though the specifics remain unclear, there is consensus over some of the basic principals: It appears that the high lipophilicity of delta-9-tetrahydrocannabinol (Δ9-THC, the active compound in marijuana) causes cumulative increases in concentration with chronic use, which may lead to toxicity in susceptible patients. The abdominal pain and vomiting are explained by the effect of cannabinoids on CB-1 receptors in the intestinal nerve plexus, causing relaxation of the lower esophageal sphincter and inhibition of gastrointestinal motility.[ii] This finding is supported by gastric emptying studies performed on one of the patients presented by Allen et al, which revealed severely delayed emptying. While cannabis appears to have anti-emetic effects that are centrally mediated,[iii] it is possible that these effects predominate at low doses whereas the gastrointestinal effects predominate at the high concentrations that occur with long-term use.
The proposed explanation for compulsive hot water bathing is based on the fact that cannabis disrupts autonomic and thermoregulatory functions of the hippocampal-hypothalamic-pituitary system. There is a high concentration of CB1 receptors within the limbic system,[iv] and the hypothalamus in particular is known to be responsible for integrating central and peripheral thermosensory input.[v] Furthermore, Δ9-THC induces hypothermia in mice in a dose-dependent manner.[vi] While this evidence links cannabis to the hypothalamus and to thermoregulation, it does not provide a causal relationship. Two mechanisms proposed by Chang et al are that (1) cannabinoid-induced hypothermia causes the desire for hot water bathing, or (2) hot water bathing is the direct result of CB1 activation in the hypothalamus. The true mechanism underlying hot water bathing remains enigmatic, and further studies are needed to elucidate the relationship between this bizarre learned behavior and the other features of cannabinoid hyperemesis.
A timely diagnosis of cannabinoid hyperemesis is essential not only to effect proper treatment but also to prevent iatrogenic morbidity and mortality from unnecessary diagnostic procedures and surgical interventions. There are, however, several obstacles to effective diagnosis:
First, the legal status of marijuana makes eliciting an accurate drug history challenging. Second, the bizarre hot water bathing is likely often attributed to psychological conditions such as obsessive-compulsive behavior. Third, the knowledge of the anti-emetic effects of cannabis likely disguises cases of cannabinoid hyperemesis, leading to the erroneous belief that cannabis is treating cyclic vomiting rather than causing it. Finally, the fact that this syndrome is so recently described and relatively unknown outside an esoteric subset of the GI literature means that most clinicians are unaware of its existence. The following diagnostic criteria adapted from Sontineni et al[vii] can be used to facilitate a diagnosis of cannabinoid hyperemesis syndrome:
| ESSENTIAL FEATURES | |
| History of chronic cannabis use | |
| Nausea and cyclic vomiting over months | |
| Relief with cessation of cannabis use | |
| SUPPORTING FEATURES | |
| Compulsive hot water bathing with transient relief of symptoms | |
| Colicky abdominal pain | |
| Exclusion of other etiologies (especially gall-bladder and pancreas) | |
In the case of the 18-year-old patient presented above, asking the open-ended question, “What makes you feel better?” followed by more focused questions regarding the temperature of the water and the history of marijuana use were sufficient to suggest the diagnosis of cannabinoid hyperemesis. We propose that these questions be used as a screening tool for all patients presenting with cyclic vomiting. Based on our experience and a review of the literature, we believe that these questions may be both sensitive and specific for detecting this unusual syndrome.
The patient presented in this case was counseled on his likely diagnosis. Though he was initially skeptical, giving him printouts of case reports on cannabinoid hyperemesis syndrome and discussing the etiology of the disease were sufficient to convince him of the diagnosis. He was treated symptomatically in the hospital. Two weeks after discharge, he remains abstinent from marijuana and reports that his symptoms are improving.
Sarah A. Buckley and Nicholas M. Mark both are 4th year medical students at NYU School of Medicine
Faculty reviewed by Robert Hoffman, MD, Director NYU Poison Control Center, Associate Professor Departments of Medicine and Emergency Medicine, NYU Langone Medical Center
References:
[i]. Allen JH, de Moore GM, Heddle R, Twartz JC. Cannabinoid hyperemesis: cyclical hyperemesis in association with chronic cannabis abuse. Gut. 2004;53(11):1566-1570.
[ii]. Izzo AA, Coutts AA. Cannabinoids and the digestive tract. Handb Exp Pharmacol. 2005;(168):573-598.
[iii]. Simoneau II, Hamza MS, Mata HP, et al. The cannabinoid agonist WIN55,212-2 suppresses opioid-induced emesis in ferrets. Anesthesiology. 2001;94(5):882-887.
[iv]. Herkenham M, Lynn AB, Little MD, et al. Cannabinoid receptor localization in brain. Proc Natl Acad Sci U S A. 1990;87(5):1932-1936.
[v]. Egan GF, Johnson J, Farrell M, et al. Cortical, thalamic, and hypothalamic responses to cooling and warming the skin in awake humans: a positron-emission tomography study. Proc Natl Acad Sci U S A. 2005;102(14):5262-5267.
[vi]. Hayakawa K, Mishima K, Hazekawa M, et al. Cannabidiol potentiates pharmacological effects of Delta(9)-tetrahydrocannabinol via CB(1) receptor-dependent mechanism. Brain Res. 2008;1188:157-164.
[vii]. Sontineni SP, Chaudhary S, Sontineni V, Lanspa SJ. Cannabinoid hyperemesis syndrome: clinical diagnosis of an underrecognised manifestation of chronic cannabis abuse. World J Gastroenterol. 2009;15(10):1264-1266.
Image courtesy of Wikimedia Commons
[...] Cannabinoid Hyperemesis: High on the Differential for Intractable Vomiting By: Sarah A. Buckley and Nicholas M. [...]
Im glad to finally find out what is wrong with me. I’ve been in just about every hosp in the Denver Co area with the same problems as you mention. I am 50 yrs old and have been smoking pot since I was 15. I’ve been going thru this Hyperemesis for about ten years with no diagnosis, except for Unremarkable, and mentioning of everything from Pancreatitis to Cancer. I sure believe now that there is a problem with me smoking pot. Thank You.
I was recently diagnosed with this syndrome.
Thank god it was this and not something more complicated and difficult to remedy.
I had been in the emergency room 11 times in 4 years until I found a doctor who had recently read about it.
Had every test imaginable performed on me without any conclusive results – ct scan, ultrasound, xrays, blood tests, urine tests etc.
So thankful for running into a doctor who had done his job and kept up on the journals.
I would like to find more research and information about this. Very interesting correlation. But is it the vomiting that caused the use of marijuana, or has the marijuana caused the vomiting? I completely agree with the study, however I started smoking regularly at the age of 15 to help with the vomiting. And why the hot water? Obviously not many patients diagnosed with cyclic vomiting feel they need the hot water, why herb smokers? I heard they are trying to find out if it has to do with brain transmitters. I was always told I had gastritis, cyclic vomiting, abdominal migraines, was treated for h-pylori. I also have had just about every blood, CT, MRI and scope tests done, results coming back “normal”. One doctor said it was anxiety and deprssion. Another a breakdown of my centrak nervous system. I have had these reccuring vomiting episodes for 8 years. And for eight years almost every doctor I saw told me smoking could not hurt at this point or suggested it v. anit-nausea meds. Very interesting, and disturbing, to find out it was probably making things worse.
I too TOTALLY believe the study. Some things I have read say that it has something to do with the cannabinoid receptors in the brain (particularly in the hypothalamus) – which regulates the body temperature and digestive system. If this is true it would explain why the patients are unknowingly seeking to warm up their “core body temperature” and keep throwing up. For years my husband has been diagnosed with everything under the sun, ibs, possible parasites etc etc. The first episode I remember was ?19 years ago maybe? I personally believe there is a Gastric Emptying component to this as well. I believe that the cannabis also slows down digestive motility, which causes your supper to sit in your gut all night…rotting…which would also explain why this phenomenon occurs (at least for him) always with onset in the early morning hours. Once I convince him…we can “fix” it.
YES, please spread the word. I have gone through horrendous anxiety over the past few years watching my husband repteat this cyclical vomiting cycle- and then sitting in the bathtub with his bong for hours on end. Listening to your loved one retching and suffering is heart wrenching. Until I pack him up and go to the Emergency Rooms. No conclusive diagnosis after $30,000 worth of tests. To now know that he has been causing this because of his habit/addiction is revelatory. He is in denial at the moment, using the excuse of “why don’t the doctors know about this?” or “I overate-that’s why I threw up”. Once his physician hears about this, I pray that he will listen and get help to quit.
WOW….I just spent the last week in the hospital with all associated syptoms. Usually sick in the morning and HOT water was my best friend. I actually became very nasty with the hospital staff when they would not let me in the shower. Nothing else would work. They were throwing everything at me, anti-nausea, acid-reducers, anti-biotics etc….
Thing is, I don’t smoke weed. I have been making “herbal incense” with the synthetic cannabinoids like JWH-122, 210 etc….I figured it would be no problem at all. I’ts not detectable in general uranalysis, so the doctors, even if aware of CH, would probably not even think once about it.
All I know at this point, is that I will no longer be partaking in any “sessions”. Last week was the worst I have ever felt in my life and I am sure as heck not going to purposely hurt myself.
I’ve been smoking marijuana for 14+ years and everything mentioned in this article is exactly what is happening to me. I’ve had colonosopy, CT scans, ultrasounds, endoscopy, and stomach emptying test and am now realizing that I’ve been keeping myself sick this entire time by continuing to smoke MJ. I have also become obsessed with taking hot showers for relief.
STOP SMOKING AND YOU WILL BE AMAZED! 2-3 weeks and all your problems will be gone.
I am very glad to hear everyone else’s story. I have been dealing with this condition on and off for about three years now. This year has by far been the worst. Since January, I have been hospitalized over 20 times, had my gallbladder removed, CT scans, xrays, blood tests, endoscopy, you name it, I’ve done it and with no real diagnosis. I was diagnosed with exclusionary IBS at the hospital, then I went to a homeopathic dr who thought I had parasites. I also had to drop out of my classes at school and miss lots of work. It was awful.
I have been smoking weed on and off since I was about 14 and before a couple years ago I had never experienced anything like this. I am very glad that I finally found a reason for why I get sick all of the time. I always thought that smoking would make me feel better when I was nauseous, but now I found out that it was just hurting me more. I will miss smoking because I love to be high, but my health comes first and I don’t wanna be sick anymore. Thank you all who shared ur stories.
I am a 26 year old female and have also been suffering from numerous “episodes” of nausea, vomiting, stomach pain…im not 100% on the hot showers, though i do find it helps sometimes when i first start getting flushed-hot/cold flashes… I have not been diagnosed as of yet, but am convinced this is what i am suffering from at this point. They have done ultrasounds/ct scans/xrays/bloodwork/urine..the works..heck i even just got a laparotomy done where they cut my stomach open to examine it…nothing wrong found, everything looks healthy or comes up ok… Met with a stomach specialist today and will be going for a colonscopy and endoscopy but in the meantime was advised to lay off the weed. I hope it is just as simple as quitting smoking….thanks for the article and all the best to any other sufferers of this, it sucks.
Just a few questions that I hope can be answered by the experts.
Does this have anything to do with smoking before the brain is fully developed? i.e. becoming dependent on a substance before the brain is fully functioning or is able to decipher the properties of certain substances? Perhaps the hypothalamus is underdeveloped or perhaps it damaged the synchronization of the hypothalamus? Interval issues due to the use before the brains parts are fully developed?
At what point/age is the hypothalamus acting at full capacity? On the average.
Do alternate brain functions develop at alternate intervals with respect to functioning? i.e. parts of the brain could develop much quicker than the brain parts of others? Obviously but I would prefer your opinion and analysis.
Since a small percentage suffer from this why doesn’t everyone else who smokes suffer from the same symptoms?
Is this only found in those who smoke chronically?
Is it different for those who consume the substance other than by purely smoking it? i.e eating, vaporizing, etc. This could be used as a controlled experiment eating vs smoking. Vaporizing vs smoking. Etc.
Could this occur from an inhalation or consumption of contaminants that are easily dissolved in the body’s system while the substance that stays in the system longer is the culprit? Tainted?
I’ve never heard of this until recently and I do acknowledge it’s importance in understanding it completely. I’m trying to gather more information for my own hypothesis. Thank you and good day. My email is Calcula7ed@hotmail.com
I have been suffering from this syndrome for 4 years now. I spent a lot of time in denial that my smoking (typically about 5x/day) was the problem but over time the patterns never changed. Cyclic episodes of severe nausea and vomiting along with hours upon hours spent in the bathtub and shower to get relief. I spent weeks upon weeks in the hospital on over a dozen occasions in the time period having every test done imaginable as well as had a completely unnecessary surgery performed on me. I encourage anyone who even THINKS they or someone they know might be suffering from this condition to take a closer look at your symptoms and talk to a doctor. I am thankful to have discovered the root of the problem.
For the past two years I’ve been suffering with gastrointestinal issues that have gotten worse and worse. I’ve had test after test (all of which were normal except for gallbladder which was removed) but still my symptoms persisted and worsened. Finally, right before my gastroenterologist was going to run a battery of more tests, he asked me if I smoked marijuana and if I took a lot of hot showers. Embarrassed, I admitted that I smoke every day, all day, and yes I’ve noticed I’ve been taking a lot of hot showers, even this summer. He told me he knew what was wrong with me and printed off info about Cannabinoid Hyperemesis Syndrome. At first I didn’t want to believe it. I cried so hard in his office. I have smoked pot for 18 years because I suffer from Bipolar Disorder and pot stops my manic episodes. It also relieves my anxiety (but I have noticed in recent years that it sometimes CAUSED more anxiety). Well, since I had been suffering so much and had lost 36 lbs in 2 months because I couldn’t eat solid food, I stopped smoking pot to see if it was true. Unbelievably, within 2 weeks I was completely cured. After two years of horrible stomach pain and all these invasive tests, I can now eat whatever I want with out a problem. Like the rest of you suffering from this syndrome, I will miss pot A LOT. Since stopping it I’ve gone into a pretty serious manic episode and I’ve had to go on Lithium to even me out, but I’m so happy to not be vomiting and having excrusiating pain, so it’s worth it. Good luck to all of you who have this. I know it will be hard to let go of smoking, but you will see its way worth it in the end.
This is the dawning of the age of new illnesses, and shall I say, the discovery of some of them. Cannabinoid Hyperemesis seems to be very reel although there may be quite a few factors that run hand in hand with its symptoms and diagnoses.
Long term THC consumption will definitely lead to gastrointestinal issues at some point. The trouble here for doctors is identifying this problem. Many doctors are unaware and limited in their scope. Too many things for people to have to avoid. By choice or not; like poor diet, STRESS, lack of exercise, dangerously improper food staples, chemical poisoning by doctor prescribed drugs, farm field pesticides, and general water & air pollution,,,, and now even THC!
All things in moderation,, something a lot of us chronic users never considered when it came to getting high. I started up with MJ at 13 years old and I thought it was the best relaxing thing ever,, now almost 40yrs old, I have had a number of very serious health problems related to my long term use.
My problems became worse than just vomiting and pain after about 15 year of chronic use. With very heavy daily use my gastro-system can become confused and began clamping off certain sections of the GI tract where many CB-1 & CB-2 receptors are concentrated. These areas of the gut may also include many immune system cells that respond (hyperactivacte) when THC is absorbed. The worse part in a modern sense is, if there are allergic components (toxic food debris) in the intestine at the time of this intestinal spasming,, that’s when the confusion begins.
When your bodies immune system activates it uses existing sugars to charge the immune response. The intestines hold sugar/energy by means of food/waste sources and will use any means nessecary to obtain the glucose that is vital to its task.
Stressed or unfit intestines don’t act well & normal under the persure of THC’s annonomus immune system command. Chronic use of THC means an overused exhausted and confused immune system attempting to operate with often horribly dangerous and improper energy sources.
In a nut shell, Cannabinoid Hyperemesis is going to become a real problem and mystery to the rapidly growing number of THC users in the next several years.
Doctors are starting to take notice of this syndrome although they will be thrown way off the mark if they don’t consider the lifestyle, whole body health, the whole person, and the THC too!
All things must be considered, we must start on the first page in order to finish and understand the book.
We’re on to something here!!
I have been dealing with every symptom listed for the last two years. I have smoked anywhere from 1/8 to a 1/2 ounce a week for the last 15 years. Last monday I woke in the morning, smoked a bowl and had three seizures in a row. I then was violently ill for the next day throwing up over 20 times. I have cronic abdomenal pain on my right side and serious temperature control problems. After a day of vomiting I went to the emergency room and was admitted to the hospital. I had a ct scan, ultrasound and many blood tests. My blood pressure and heart rate was completly out of wack. At first they thought I had an infection but after a day on antibiotics they found that to be wrong. Zofran was given to me for the nausua while I was there but did not help at all. They told me that for some reason my kidneys where over run with toxins which was very serious. I was given around 10 bags of fluids over the next week at which my kidneys slowly began to recover. I have never felt that sick in my life. I would find myself shaking from being cold and also I had bouts of anxiety and depression like feelings that would take me over completly. The doctors in the end speculated that the seizures had released the toxins from my muscles into my kidneys causing the illness but admitted to me there was many unanswered questions. The could find no reason for the abdomenal pain. I was urinating fine the whole time and bowl movements where normal other than they were few and far between due to me not eating for five days. I lost about 10 pounds during this time.
I still can’t believe what I’m reading. I guess it’s really that I don’t want to believe it. At the same time I’m so incredibly happy though. I’m a 29 yr old female who has smoked pot everyday, usually several times a day for 16 years now. For the last 12 years I have battled with extreme stomach pain/ upset/ discomfort everyday and until now thought that pot was the only thing that alleviated my symptoms at all. I have been to the ER and been admitted into hospitals so many times now I couldn’t even make an accurate guess. I had my gall bladder taken out 10 years ago, was diagnosed with cyclic vomiting syndrome 8 yrs ago, and have been blaming my agonizing symptoms on this unknown “disease” ever since. To finally discover that I’ve been doing this to myself all these years is almost more than I can absorb.
I just got done with another two week stay at the hospital with my kids and family at my bedside wondering if I was gonna pull out of this round again or not. Been in this particular hospital so many times they don’t put me through the extensive tests anymore, but don’t think I haven’t been through them all, scoped 3 times, CT scans, MRI’s, etc., etc.. I just happened to get my least favorite ER Dr again this time (this being because he has no sympathy for me when I’m there in complete agony because of my pot habit). He told me again of how they’re finding out how chronic marijuana use can actually cause the symptoms I’ve come in there with so many times. I, like every other time, just denied that I smoke much pot and acted like he didn’t know what he was talking about. After laying in the hospital for 2 weeks afterwards (after returning to the ER to have a different Dr admit me) I decided to Google “cyclic vomiting syndrome” and “marijuana” and I’ll be damned if he wasn’t right.
Going to have a very hard time giving up my all-day, everyday habit, but if it makes me quit getting sick and feeling as crappy as I do all the time, maybe it wont be so hard. I haven’t read any comments about anyone having near as many “episodes” as I have had yet, but I know in my case, if I have to be hospitalized many more times, well, they’re running out of good veins to even be able to hydrate me through. They’re past trying to put them in my thumbs, wrists, feet, and other painful places. This last time they managed to get IV’s going in my shoulders, but did I mention, I’m 29 yrs old! And in otherwise very good health. All this rambling I guess is just in case anyone is reading this who might still be trying to be in denial like me and might
Has any one experienced any of this but without the temperature? Have experienced many of same symptoms but not the bathing thing. In fact it is just like food poisoning when it happens. Could be same thing? And answers?
Hey, just reading these comments and now truly believe that I too have this. Can a person just cut back on their pot intake and cure themselves or is stopping it all together the only answer. I love coming home on a Friday after a long hard week and having a beer and a joint to unwind. It’s like my treat. Just wondered if anyone has had any luck with just cutting back?
I recently (less than 2 months ago) was in the ER twice in three days with this condition. I had been smoking pot every day, multiple times per day, for over 4 years. For myself, I cannot smoke pot at a decreased level; I am addicted to it, and over 12 years, my use has only increased. I was able to lower my use for small amounts of time, two weeks to a few months, but inevitably always regained my previously highest level of use, and then surpassed it. I have known I have a problem with pot for 10 years (since I was 16), and have been in rehab 11 times attempting to get clean and sober. Until I experienced hyperemesis, though, I could not bring myself to honestly see the severity of my marijuana addiction. Had it not been for the love of my family and girlfriend, I probably would have just let myself die of dehydration. I am now 38 days sober, 40 days off of pot. My stomach no longer hurts, and I no longer have the pre-episode feeling in my stomach that I came to learn would lead to hyperemesis if I ate solid food with it. Today, I can eat breakfast, lunch, and dinner, without fear of triggering an episode. My life is exponentially better without marijuana in it.
I view weed as one of the truly insidious drugs on the planet, as in the rooms of recovery, most people think it benign and harmless, and non-addictive. In fact, I’ve been in the rooms of a 12-step program on and off for 10 years, with probably over a thousand meetings attended, and I’ve never met a single person who’s heard of hyperemesis, much less experienced it. Weed addiction is real!
My son is 17 years old and has been in and out of the hospital multiple times over the past year and a half. He started out smoking pot for the first couple years but switched to spice so he could pass a drug test. (I’m 100% against drug use) He is in CHKD as I type this. He has been diagnosed with this illness. I’m here to tell you SPICE can cause this and it can kill you. My son lost soo much weight he looked like a skeleton and he cried to God because he wanted to die because he was in so much agony. He is 5’11″ and was down to 120, originally weighed 160ish. He had a ton of tests done and they found yeast in his GI track. They treated him for that and he got better. We didn’t know it was not just the yeast that made him sick. My son was living with his dad when he got sick for the first few times. He has had episodes of vomiting and not being able to keep water down let alone food. He has a pain in his stomach that center around his belly button. He has taken several hot baths in the hospital which ironically started because I recommend it to him. He does feel better after a hot bath but I have not seen him feel any relief from hot baths to the extent that some of you are talking about. However, I think HTC affects people differently and he definitely has this illness. So even if you’re not getting total relief from hot showers or baths I think you can still have this illness. After he got better the second time I took him straight home from the hospital and he lived with me for a year (and only had smoked two times a small amount). He recently went to stay at his dad’s house and picked up his spice smoking again. The week before he got sick he was smoking it every day this time. On Wednesday he vomited so hard he fell and hit his head on the toilet and blacked out. He was admitted to the CHKD 3 days later on the following Saturday at 8am and released 3 days later on Tuesday after getting the patch for nausea behind his ear and keeping down a cup of water. He was admitted back in to the hospital (after a day and half) Thursday with the same symptoms. I want to note that second endoscope test (one year apart) reviled that he now has ulcer that have developed in his esophagus (but the yeast is gone) I can only wonder if the poisons in the spice eroded parts of his esophagus. The doctors said it is definitely possible.
After searching the web for 4 weeks to figure out what was wrong with me I finally found Cannabinoid Hyperemesis Syndrome today – bingo! I am a daily pot user of 20 years – never had a problem until a month ago. I have many of symptoms described in this thread – stomach pain, burping, bloating, occasional nausea, heartburn, chest pains. I instinctively took warm showers to feel better. When I walked outside, I felt pain, most likely because it was a few degrees colder outside. Now it all makes sense.
I suspected initially that I have H Pylori (the bacteria that causes ulcers) so I stopped smoking pot and cigarettes and ordered Matula Tea – great stuff – kills H Pylori and made me feel better immediately. Then a few days later I smoked a joint – I had slight stomach pain within 1 hour of smoking, but it went away quickly. Then I did not smoke for 2 days – felt good. Then I smoked 2 joints and had another relapse – this time I had a stomach ache for the whole day and half the night. The pot seems to have a cumulative effect, not
necessarily immediate in my case.
Part of my problem, and possibly your problem, is H Pylori. 2 3rds of people have this ulcer-causing bacteria, but most do not get ulcers. I suspect I have a small ulcer. If you have H Pylori, with or without ulcers, and you smoke pot, I suspect that you will be more susceptible to Cannabinoid Hyperemesis Syndrome – just my theory.
While I am disappointed that I must give up pot, possibly forever, I am happy to have pinpointed the cause. For those sad to give up pot, as I am, perhaps this will help; I will tell myself when I am craving a pot buzz, that the best buzz is being healthy, pain free, knowledgeable, free of fear, and in control of my life again. : )
Well, I have a 17 year old son who, six weeks ago suddenly started cyclic vomiting, lost 17 pounds and couldn’t eat until noon every day. After a battery of blood tests that came back normal, and a scope down his stomach that showed everything normal, I happened to be at the front door one evening as he walked in with bloodshot eyes. He admitted to smoking marajuana 3 times a day for the last few weeks since the symptoms started and occasionally before that. That night I googled” cyclic vomiting, smoking marajuana” and BINGO! I found this condition, which I’m pretty convinced he had. It’s now been 3 weeks of no smoking and he feels almost back to normal! I’m hoping he continues to improve so as to avoid a CT scan of lower abdomen and head.
Prior to this discovery, I had only googled “vomiting at at the same time every morning” and I found loads and loads of people with this same problem who have no idea whats wrong. The only thing they think that helps them is smoking marajuana! This needs to be put on Facebook or something. People need to know. There are lots of people out there who, in my opinion, have the same thing! Good luck to all of you!
For those of you who have had success in abstaining and are cured any helpful tips/ coping mechanisms that helped you make it through the first few weeks until symptoms are relieved… my husband is currently on day 3 after receving his diagnosis. he is in agonizing pain also crying to god to end his suffering and pain. Any suggestions on how I can comfort him through this would be appreciated. Thank you and good luck to anyone else who is suffering
God bless all of you for fessing up to your problem and being honest about this. Had I not found the articles on this I would still be smoking and going to doctors to try and figure out why I can’t eat. I’m currently recovering from my second bout of this (the first time wasn’t enough to convince me), and there is no doubt. Just three days after quitting I’m already feeling better again. I smoked about a gram a day for two years, but was a frequent smoker for two years before that. Recently I smoked all day every day. I have vaporized and used bongs for the most part, and, no, vaporizing doesn’t keep you from developing CHS. That was my last theory, and now I’m suffering from testing it. I should have learned my lesson the first time around. I also tested another common question, as to whether cutting back can be enough. I found that taking a hit would temporarily make me feel better, but after an hour or less I would be much worse. So, it appears to be an issue of toxicity, not withdrawl, or at least that the effect of the withdrawl is minor compared to that of the toxic effect of the cannabinoids. Being high all the time will eventually lead to problems. I have friends who have mild symptoms on and off, but most are not willing to even have this conversation. One friend even accused me of spreading “propaganda.” I’m sorry, I love pot, but this is simply too airtight, and I must reach the conclusion that it’s not for me. What is it they say about the definition of insanity and expecting different results for the same actions? I guess in that regard cannabis causes a little insanity in its users. I think the main thing here to note is that cannabis is the only drug that sticks around for so long, and chronic use will essentially cause an “overdose-like” effect where the body reaches a toxic state and tries to get rid of the toxic compound. We need to realize that after the psychoactive effects are gone that it still has long-lasting secondary effects. Fittingly, cannabis resembles all compounds in that its secondary effect is the opposite of its primary effect. It makes me a little nauseous right now just to think about something hanging around in my body for that long. I’ll bet there’s resin in my tissue from months ago! Yuck! I mean, honestly, would you ever eat something if I told you it would still be in your gut three weeks later? We need to be proactive in getting this information out there. As we sit here, there are probably hundreds of people out there unwittingly smoking medical marijuana for its anti-emetic effect. Had I known these things ten years ago I never would have touched the stuff and been much better off for it. At the same time, though, we all need to count our lucky stars that chronic marijuana use is something we can recover from, which is not the case with any other drug, especially alcohol. Let’s face it, if we had abused other drugs or alcohol to the point we have abused cannabis we would all be dead ten times over, or, even worse, wishing we were… I hope this is something I can look back on as a learning experience without too much regret, though I will always lament losing so much of my youth to this addiction. I hope that in the future we can be more realistic about the effects of cannabis and stop telling lies to our children that will cause them to distrust our advice and do something harmful they might not have even thought about had we been honest with them. It won’t kill you outright, but it will have a negative impact on your life.
I am so pleased i found out about this.
I found info on this after googling male morning sickness.As a mother of 3 the nearest illness i have experienced to this is extreme morning sickness.
my symptons come on suddenly always at 6am. I am woken out of my sleep with the urge to be sick,then i get extreme epigastric pain like a constant pluse.
This goes on for exactly 12 days, no food or water can stay down,no meds help.All i can do is lie still between vomiting praying for health.
As noted by others the only relief is hot water,one time after using all the hot water in my tank i walked to my mums house with a sheet wrapped round me at 5am because i just couldent wait for my own supply to heat up thats how desperate you become.
I have had every test known to man all say im healthy.
Im in Scotland and the docs have prescribed amitryptaline for 6months.
I havent told them im a smoker,its illegal here.At leasti now know im not dying.
I find i can smoke solid (hash) with no problems. On thinking about it, its every time i smoke a bit of green(grass etc)that the symptoms begin.
It truly is a terrible thing to suffer, for the sufferer and their families.