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Cannabinoid Hyperemesis Syndrome

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This seems like it would be next to impossible to diagnose. I recommend Dr. Meyer in Saginaw. He might be able to figure this out. 


Thanks Restorium :)


I talked to a Paul Meyer maybe 5 years ago at THCF. He seemed smart and friendly. I wonder if it is the same guy.


Edit 9/6: I checked. It WAS him. First mmj doc i saw back in 2009.

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Hey legacy, 

Cannabinoid Hyperemesis is the biggest crock of bunny muffin ever. If you have these symptoms please see a gastroenterologist as it could be a number of other serious issues.


Once in like 2011 had the morning nausea and abdominal pain so I went to the local doc offered by my Medicaid and she told I had this after admitted to using cannabis in the prescreening. I scheduled a second opinion with an actual gastroenterologist through my mothers insurance at one of the top hospitals in the country. When I told him what she said he literally laughed at me and how ridiculous the idea was. He scheduled me for a endoscopy and told me I had bad case of GERD. Prescribed me some pills and after two weeks my stomach was healed and no more pills.


I know cannabis is a med but its not the only kind, sometimes the doc got what you need.


Peace, hope you feel better. If you got any questions ask away.

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From what I've read on this site and grasscity, I recognize most people have doubts about CHS. It's understandable since only a tiny fraction of users seem to be affected. So I'm not looking to preach or change anyone's mind.


I would like to hear back from doctors or patients (if any) who have experienced it. The main thing I want to know is recommended maximum medication rates (other than total abstinence) to avoid CHS symptoms, eg. no more than 1-2 times per week, etc. 

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I've never heard of anyone going psychotic, even though the alarmist media has tried that claim in the past. But if someone starts that thread, I'll be respectful of it since I don't know their situation. I think everyone suspects that even if there were a shred of truth to that, it--like CHS--would only apply to something like 0.0001% of users... nothing to sound an alarm over. Seems to me that a lot of this site is about connecting people to ease suffering. That's why I'm respectful of anyone who swears that mmj treats their condition, even if their doctor, family, friends, and co-workers object to their belief. 


As far as CHS not being a "real" condition, I see Granny Storm Crow referenced here and elsewhere a lot and she uses that very word to describe it...


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Welcome to the site to discuss CHS; glad you're feeling better! 

Yea I been lurking for awhile but I saw this get brought up and figured I finally had something I can contribute. 


The doc basically said that its similar to how people share articles on Facebook without reading them. Docs are not excused from ignorance, and many times reading a study that reaffirms your own perception of something (in this case marijuana) overshadows the actual facts. I'm not a doctor but I looked up the one who told me this before going and he was highly regarded. 


IMO lots of people medicate with marijuana to calm stomach issues but marijuana doesn't cure colitis, IBS, etc they just relieve the symptoms. So if you never treat the underlying issue and only the symptoms eventually the underlying issue gets far worse (i.e. constant vomiting). 



This one has the largest sample size:




Patients were included if there was a history of recurrent vomiting with no other explanation for symptoms and if cannabis use preceded symptom onset. Of 1571 patients identified, 98 patients (6%) met inclusion criteria.



On the basis of the results of that review, patients were included if they had (1) long-term marijuana use before the start of symptoms, (2) a history of recurrent vomiting, and (3) the absence of a major illness that could explain the symptoms.


So that means first they searched through people they had previously diagnosed with CHS, and found 101 people. Then they said well thats not enough people to search through so they went through records and searched for ANYONE that had the words:


cannabinoid OR cannabis OR marijuana AND vomiting OR emesis ORhyperemesis


That gave them 1400 new people to filter through. Out of the combine 1,500+ less than 6% of the people met the inclusion criteria. That means that even less people met the inclusion criteria for the study than were diagnosed with CHS perviously. That also means that 94% of the time people had CHS symptoms they: didn't have recurrent vomiting,  had the symptoms BEFORE they started smoking, or have another major illness. Yet they were still diagnosed with CHS or a notation was made on their record of marijuana vomiting or marijuana emesis.


There so much more in that study that is skewed in my opinion. They use the showers for relief but only 52 patients mentioned it as relief. The other 48 have no mention of hot showers or deny hot showers help. That 50/50 almost, yet it is considered a major feature?


Their result is my favorite part.:


The major features include (1) severe cyclic nausea and vomiting, (2) resolution with cannabis cessation, (3) relief of symptoms with hot showers or baths, (4) abdominal pain, and (5) weekly use of cannabis. Supportive features include (1) age younger than 50 years, (2) weight loss of greater than 5 kg, (3) morning predominance of symptoms, (4) normal bowel habits, and (5) negative findings on diagnostic evaluation. 


​So basically as long as you have a negative find on diagnostic evaluation for anything else and you use cannabis weekly you are labeled as having CHS. They have no mention of how many people fit major features 1,3,4 and supportive feature 1,2,3,4,5 in the database with out 2,5 major features. We wouldn't know and seems to be important in seeing if this is a cause of correlation =! causation.


Like I said not a professional but this study seems skewed.  Sorry for grammer and spelling errors, tried to make this as concise as possible. 


Remember they let Ben Carson be a neurosurgeon.

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 I think everyone suspects that even if there were a shred of truth to that, it--like CHS--would only apply to something like 0.0001% of users... 


To put that into perspective, the UN estimates that 158M people use cannabis world wide ever year. .0001% of that would be 15,880 ppl would have CHS. The largest study only found >100 people EVER to be "diagnosed" with CHS ever. The average range for "rare illness" would be around 1 per 1,500-2,500 . CHS at a rate of 100 to 150,000,000 would make it one of the rarest things on earth...


Not trying to put anyone down who reads this but I urge you if you believe you have this or have been told by a medical professional that you do seek another opinion.

Edited by twerkle
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Twerkle thanks for the reading. I didn't feel put down and hope I didn't make you feel put down either.


If my math is correct, I wanted to clarify that .0001% of 158M is 158. The point is that it is extremely rare. 


Also, no one told me I have CHS. I have been sick though for months. I've had many tests that all turned out negative. It was when i searched cannabis as a treatment for delayed gastric emptying that I discovered CHS. Last week I quit using cannabis fearing for a hospital test. This week all symptoms stopped. My plan is to gain back 10 pounds then make a decision on reintroducing it into my life. 


Everyone please don't get the wrong idea about my view of cannabis. I 100% support mmj. I don't support descheduling to schedule 2. I am in favor of descheduling it completely. I am in favor of total legalization. This should be pretty clear from all of my older posts condemning prohibitionists. 

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Aha nice! Do you know if he's a member on this site (Saginaw is a bit far from me)? 

No. He's a real doctor with real patients of all types. No time to be contributing here too. It would be worth your time to see a real doctor and get a proper diagnosis because, like I said earlier in the thread, this CHS would be very hard to diagnose. Many doctors might just punt and point at the cannabis use. But Dr. Meyer wouldn't do that. He would use his knowledge of cannabis and holistic medicine to help find a good solution for you. And then maybe we can all learn something real instead of guessing around in circles while you suffer. 

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do you have vomiting or just nausea?


smoke or vape?


do you eat before mj ? empty stomach?


any prescriptions, vitamins, or other products you take on a regular basis?


drink alcohol, pop, caffeine, coffee, beer, tap or well water, what is your water source?.


eat meat? corn? gluten? wheat? canned, spicy, sour or pickled? ice cream, dairy?



I ask, because I want to eliminate variables. I had terrible gas bloating pain for months. eliminated everything from diet until I came to meat. stopped eating meat, stopped getting gas.


.here's what dr google says


The rate of gastric emptying is strongly influenced by both volume and composition of gastric contents, which makes considerable sense.



help us out and document your condition for others.

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Hi t-pain,


thanks for your interest in my condition and this syndrome. thanks for not making me feel like i'm on the receiving end of "you don't look sick" or "why don't you use real medicine"


my symptoms went away earlier this week, but mine were a little different than what i've read online. i didn't have any vomiting. just had severe abdominal cramping / bloating / burning maybe a half hour after each meal. the pain gave me a hunched over look throughout the day. the time it knocked me down to my knees was when i decided it was time to see a doctor. the doctor suggested taking a ppi. then i switched to a h2 blocker for kidney concerns. both worked to stop the pain, but i suspect my weight loss was due to those taking away my appetite. a few times previously i tried stopping the medicine, but within about 60 hours, the pain would return. the delayed gastric emptying was discovered on my most recent hospital procedure. i suspect that the burning may have been due to stomach acid trying to digest the food that was remaining in my stomach. this past week after stopping the h2 blocker (and cannabis a few days prior), i didn't have any pain. it was also the first time i've felt hungry in months. I keep a food journal and the only lifestyle / diet difference between now and the last few months is i haven't used cannabis since last week.


your elimination method and the food journal were helpful to me a few years ago to figure out i was lactose intolerant.


the past 5 years i mostly vaped, occasionally smoked. never dabbed. for the past few years i've been medicating maybe 4-6 times per week. friends typically say that i use small amounts. started cannabis 22 years ago. this high times article on chs says the typical chs patient used for 16 years.


i have a hypothesis on a possible method to prevent chs. ironically it is mmj. from what i've researched, it is suspected that chs is caused by the long term (THC) stimulation of the CB1 receptor. CBD is a CB1 antagonist. so maybe CBD can be used to interrupt the symptoms. maybe something like THC day 1, CBD day 2, repeat.



some people including the article recommend total abstinence, which sounds unacceptable to me. others have said they can use cannabis 1-2 times per week. the reason i recently brought up chs was not to say A causes B... I am NOT saying that. As twerkle and i noted above it might be like 1 in a million. the reason was that i wanted to find out the maximum medicating cycle, eg. 1-2 times per week or whatever. i've gained 2 pounds since earlier this week. once i get up to +10, i'm gonna try experimenting with CBD. 

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it is suspected that chs is caused by the long term (THC) stimulation of the CB1 receptor.


That would be counter intuitive. Long term use would diminish the side effects not magnify them. Never eat right before or right after you use cannabis. It can slow down digestion and cause you to see more side effects from intolerance issues from the food. This really is right up Dr. Meyer's ally. I believe he would get you totally straightened out. He has some really great ideas. He would get you to stop eating some grains, for an example.  

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I don't do extractions, and i don't think that they are compatible with my equipment. I'm curious though, what is the connection between lactose intolerance and sensitivity to fats?


Are you saying that THC relieves CHS?

I too find it odd that cannabis could cause CHS since there is so much evidence that it relieves chemotherapy induced nausea. The quote about long term THC stimulation on CB1 is taken from multiple online sources including a Temple Univ study shown on leafly, and a different study on cannabisclinicians.org.



Regarding my future test plan, I read somewhere that low doses of CBD can calm nausea, while higher doses can aggravate it. Anyone know what would qualify as a low dose? Maybe start with 10-30mg/day?

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most cannabis nausea is caused by two things


smoke itself,tobacco smokers also can get nausea




head spinning from marijuana affecting the inner ear.



I'm glad my idea to eliminate foods allowed you to find out you were lactose intolerant.


Unfortunately, when you cut milk out of your diet, you may have made your stomach problem worse.milk has long been known to be a treatment for stomach ulcer and other pain , providing temp relief.


it's my non medical. layman opinion that if you went back to drinking milk, you would be back to where you started a year ago...


would be interesting to see if I am right haha.


Have you ever tried milk of magnesia? some people use it for stomach pain, although large doses can cause cramps and stomach pain...


you definitely have something wrong with your stomach if you are doubled over in pain. cannabis does not cause that. this is not to say that cannabis isn't aggravating your condition of course.

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my opinion..


you don't have this cannabis hyper emesis condition.


because you never got cyclic vomiting


Cannabinoid Hyperemesis Syndrome is characterized by chronic cannabis use, cyclic episodes of nausea and vomiting


but it is possible marijuana aggravates your tummy.

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so, my recommendation is get to a gastro enterologist.


google says there are many conditions that cause stomach pain after eating. such as


Hiatal Hernia




Hydrochloric acid Deficiency, Gastritus, celiac disease, Biliary Bile Duct Cholecyst. 


And many forums say the diseases are quite difficult to diagnose accurately



at least a couple of the diseases said to stay away from beer and smoking.


there's a couple patients here on this forum with intestinal problems that were extremely difficult to diagnose, or the drs gave up and just said it was ibs.


anyways, continue to document your stomach issues and that info may help you find the correct diagnosis.


good luck.

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Ginger is good for settling upset tummies too. I also cannot drink store bought milk, but friends of mine milks Jersey cows, we get unpasteurized milk, cream and butter from them, not only is it really yummy, but if the mj does not sttle my belly down, usually the raw milk will. For those of you that are bacteriophobics, I have been drinking raw milk steady for the last twenty years and off and on previous to that ( according to where I lived when I was younger, am now 62).

                                  Farmer Brown

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One more thing, I,of course, would not drink raw milk from just any dairy, you could die from some of the swill that is being produced out there. In my opinion, most store bought milk is chemical and puss laden crapola!! 

                                  Farmer Brown

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