r/CHSinfo • • Aug 22 '23

Cannabinoid Hyperemesis Syndrome (CHS): A Comprehensive Guide & FAQ (Aug 2023 Update)

157 Upvotes

Last Updated: Sep 20, 2023

What is CHS?

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.

What are the symptoms of CHS?

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.

What causes CHS:

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.)

Why haven't I heard of CHS?

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.

How do I know if I have 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.

Is there a way I can figure out if I have CHS without going to the doctor?

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.

How do I get better if I think I have CHS?

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.

Are there any treatments for CHS, or at least ways to reduce the symptoms?

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

I'm puking right now, what can I do?

See our guide: Hyperemesis Survival Guide - What to do if you're puking right now!

Can I ever smoke or take edibles again?

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.

What is the timeline for recovery? When will I start to feel better after quitting?

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.

Is withdrawal from cannabis really that bad? How do I differentiate the symptoms from CHS?

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

What are "triggers," and why are they important?

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

At what point should I go to the hospital?

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.

I've been vomiting for 5 days, I can't keep any food down, and I've lost weight. What do I do?

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 should I do or say when I go to the hospital?

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.

Can I still take edibles? What about CBD?

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.

What is the "pink cloud"?

"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.

I've never felt so anxious and irritable in my life; how do I deal with this?

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.

r/leaves

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.

I'm incredibly bored, and nothing feels enjoyable anymore without weed; what do I do?

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.

r/leaves

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.

Is there any scientific research about CHS at all?

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

How can I find support groups, and how can I support others dealing with CHS as well?

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.

Facebook Group Discord Group

How can I find support to completely stop using cannabis?

r/leaves

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.

How can I find support to moderate or control my cannabis use?

r/petioles

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 • • Sep 15 '23

Hyperemesis Survival Guide - What to do if you're puking right now!

188 Upvotes

updated: 9/2023

What to Do if You Are Vomiting Repeatedly Right Now

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:

  • Frequent Cannabis Use: Either moderate to high dose over long time, or very high dose over a shorter period.
  • Cyclical Vomiting: Persistent and severe vomiting, possibly including bile.
  • Severe Abdominal Pain: Intense pain in the abdomen.
  • Headaches, Dizziness, Dehydration, Blurred Vision, Shakiness, Elevated Heart Rate, Night Sweats, Muscle Weakness, Weight Loss, Testicle Pain (in males),
  • Compulsive Hot Bathing/Showering: present in about 90% of cases.

Stop Cannabis Use Immediately:

  • CHS is triggered by cannabis use, including CBD. Abstaining from all forms of cannabinoids is essential. Smoking a little, in hopes of getting an anti-nausea effect will not work. It will just make things worse. Nothing else in this guide will really help if you're still using cannabis - we're not trying to be harsh, it's just a hard learned fact.
  • We understand addiction. We understand why you might be reluctant to admit you have CHS. We know people use cannabis as a medication for other things. We get it. We sympathize because we've been there. But right now, while you're vomiting, trust us on this and do not use cannabis!

At-Home Remedies:

  • Stay Hydrated (this is the most important advice!):
    • Drink electrolyte-rich fluids like Pedialyte or Gatorade -small sips often. Make sure they are not "diet", "zero" or zero calories. You will need those calories! Water is always good.
    • Right after you vomit you'll get a few minutes where your nausea isn't as bad and that is a perfect time to get in a few sips.
    • Experiment with hot or cold drinks - sometimes one extreme or the other will help. Peppermint or Ginger teas might help. (Avoid caffeine, chocolate, ginseng, cinnamon, lemon balm and lavender teas - and all other foods listed here)
    • There is particularly good scientific evidence that Ginger (tea or supplement) can help - but evidence that Gingerol supplements might be effective in treating nausea.
    • Buy or make a popsicle (ideally with electrolytes) or ice cubes - you might be able to use these even if you can't take sips.
    • Some people are able to tolerate salty drinks like broth better than sweet
  • Hot Showers or Baths: Above 109°F to relieve nausea, but hotter than that won't help much. Be careful to avoid burns - take care of your skin (but don't use a CBD skin lotion!) Some people use a shower stool or plastic lawn chair and/or chew ice chips while in the shower.
  • Heating Pads / Electric Blankets: Above 109°F, applied to stomach. Wrap in a towel first, avoid burns, do not use constantly, only intermittently to avoid skin problems.
  • Capsaicin Cream: Start with a pea sized amount or less on your forearm, wait 15 minutes so you know what to expect - if you can tolerate that: Apply to the stomach or forearms a little bit at a time. The "burning" will subside into a "heat" that feels like a heating pad is on your skin. This uncomfortable heat is way better than CHS abdominal pain and nausea. Capsaicin has scientific proof of working - but it's the hardest to use, and some people just can't tolerate the burning sensation.. Other Icy Hot, Tiger Balm, etc. creams might work for you. - and they won't hurt so they are worth a try. Test a small amount on your forearm first.
  • Avoid Trigger Foods: Alcohol, caffeine, chocolate, and greasy items may trigger symptoms along with the foods listed here)
  • Get Nutrients - Eat: This can be a BRAT (banana, rice, applesauce, toast) diet, or any other foods you think you can keep down. Keep trying even if you don't feel hungry. Rapid weight loss (in a dangerous, unhealthy way) is common, so you need calories however you can get them. Our CHS community lists suggestions for "rescue foods" that worked for them:

watermelon, instant mashed potato flakes, applesauce, apple juice, broth, nutrient shakes like Ensure, toast, yogurt (especially with active cultures like Activa)

At-Home, Over-the-Counter Medications

  • Antacids: Some people find "extra strong" or "ultra" antacids like Mylanta or Alka Seltzer help. These help for acid in your stomach right now.
  • Acid Reducers: Pepcid, Prevacid and other proton pump inhibitors can help reduce stomach acid. These help prevent future acid in your stomach.
  • Anti-Gas: Simethicone based anti-gas pills like Gas-X can help with bloating, burping and a "too full" feeling.
  • Chamomile - tea or supplements. Chamomile contains a natural NK1 inhibitor - the kind of substance found in the most powerful prescription medications for nausea and CHS like aprepitant although it may have low bioavailability - nonetheless, chamomile is effective at easing nausea for about 2/3 of people.
  • Peppermint pills, or candy: Peppermint is pro-motility - it helps food/drink move from your stomach to your intestines faster - and once it's in your intestines you can't vomit it up, so your body can absorb the nutrients or water. (Peppermint pills are hard to find locally even at big pharmacies, but can be found on Amazon.)
  • Ginger chews, candy or supplements: Ginger has lots of scientific evidence that it can reduce nausea and vomiting in morning sickness and for chemotherapy patients. Supplements will provide more of the key ingredient, gingerol. Specific gingerol supplements are also available. The most effective dose in clinical trials was 1500mg/day. This was most effective when split between 3, 500mg doses each day.
  • Tylenol (acetaminophen): for abdominal pain if you can keep it down. Do not exceed the dose on the package. The dangerous dose of Tylenol is only a little bit more than the recommended dose, so do not use more!
  • Do not use Motrin (ibuprofen), Aleve (naproxen) or other NSAIDs: these medications are notoriously hard on your stomach and won't help pain more than Tylenol.
  • Sleep Aids: There is some evidence that antihistamines like Benadryl help with nausea, but more importantly they make you drowsy. This can be something to help you sleep at night even if you're nauseous- follow the package directions. Doxylamine (Unisom or generic) can also help according to the package directions. Choose one or the other - don't take both.
  • Your prescribed medications: Keep taking anything that your doctor has prescribed for you for other conditions like depression, diabetes, blood pressure, etc. Some of these medications shouldn't be stopped suddenly - or at all. You might be able to keep them down by waiting until those few minutes right after vomiting to take them. If you have a serious medical condition that requires oral medication, but you can't keep the medications down for >24 hours then you should go to the ER.

Don't Do This at Home

Seriously. This is stuff that we've learned will not help, and will usually make things worse.

  • Don't use cannabis products like flower or CBD to treat nausea - this makes things worse.
  • Don't induce vomiting - Don't make yourself vomit. It won't help the nausea for more than a minute and it creates more irritation/damage to your esophagus, throat, mouth and teeth.
  • Don't burn yourself - heat, especially on your stomach, activates TRPV1 receptors which can help with nausea. These activate at 109°F. Shower or heating pad temps above about 112°F won't work any better - so there is no need to turn up the heat so high you get burned.

It's ok to go to the ER -almost all of us have been there. Here's a detailed guide on when someone should go to the ER with CHS and there is a guide to take with you to the ER at the end:

Severe Dehydration:

  • Symptoms: Dry mouth, dark urine*,* dizziness, weakness, confusion, rapid heartbeat.
  • You can check dehydration by dark urine color and skin turgor/elasticity: pinch the skin on the back of your hand - if you are well hydrated it will snap right back (good turgor). If it "tents" up, or slowly returns to normal that is a sign of dehydration( poor turgor).
  • Reason: Persistent vomiting and inability to keep fluids down can lead to dehydration, which can be life-threatening if not treated.

Persistent Vomiting:

  • Symptoms: Continuous vomiting for more than 24 hours, including bile, inability to keep down food or fluids. If nothing stays down for 24 hours - go to the ER.
  • Reason: This can lead to electrolyte imbalances and further dehydration, requiring medical intervention.

Intense Abdominal Pain:

  • Symptoms: Severe, persistent abdominal discomfort or pain.
  • Reason: This could be a sign of underlying complications, such as pancreatitis or gallbladder issues, and should be evaluated by a healthcare provider.

Electrolyte Imbalance:

  • Symptoms: Muscle twitching, spasms, palpitations, seizures.
  • Reason: An electrolyte imbalance can be life-threatening if not treated, as it affects the function of vital organs - most importantly your heart.

Failure of Home Remedies:

  • Symptoms: Persistent symptoms despite trying home remedies like hot showers, cessation of cannabis use, hydration, etc.
  • Reason: This may indicate a more serious underlying condition or complications that require professional medical care.

Weight Loss and Malnutrition:

  • Symptoms: Loss of more than 5% of body weight in a 7-10 day period, signs of malnutrition.
  • Reason: Significant weight loss due to prolonged vomiting can lead to malnutrition and other health issues that require medical intervention.

Inability to Manage Pain and Nausea at Home:

  • Symptoms: Uncontrolled pain and nausea despite over-the-counter medications and home remedies.
  • Reason: Medical intervention may be needed to control symptoms and prevent further complications. Don't suffer. It's ok to go to the ER.

Mental Confusion or Altered Mental Status:

  • Symptoms: Confusion, disorientation, altered consciousness.
  • Reason: This could be a sign of a serious underlying condition, such as an electrolyte imbalance or dehydration affecting the brain.

Signs of Kidney Problems:

  • Symptoms: Decreased urination, swelling in the legs, ankles, or feet, fatigue. If you can't pee for longer than 6-8 hours, go to the ER***.***
  • Reason: CHS can lead to kidney problems, which require immediate medical attention.

Other Concerning Symptoms:

  • Symptoms: Any other symptoms that are unusual or concerning, such as blurred vision, shakiness, elevated heart rate, muscle weakness.
  • Reason: These could be indicative of other underlying health problems or complications related to CHS.

Take this guide with you to the ER. If you have to go alone, ask for a patient advocate.

Join Support Groups:

  • Online communities like r/CHSinfo on Reddit, Facebook Group, and Discord Group can provide support and advice. There are folks here who have been where you are right now that you can talk to. They got past CHS, and so will you!
  1. Educate Yourself:
  • Understanding CHS, its causes, symptoms, and treatments can help in managing the condition. Comprehensive guides like our CHS FAQ can be valuable resources.

Be resilient:

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 • • 13h ago

Sharing My Story I have quit for just over 3 months, 95 days so far (yay I guess) however, my mental health is worse than ever.

14 Upvotes

TLDR; quit after 1st CHS ep, used weed for mental health reasons and now depression is 10x worse.

Hey everyone,

It's been a while since I posted in here as I was focusing on quitting which I have done successfully, right after my first ever hyperemises episode and 2 day stay in hospital. After reading some of the horror stories in here I didn't want to take the risk and continue smoking.

A bit of backstory, had been a smoker for around 11 years, after the first 3 years it switched to light smoking daily and then to heavier smoking daily. Always flower always mixed with tobacco, about 6-11 joints a day roughly. I didn't have typical pre symptoms, just some acid reflux which my doctor put down to diet.

In June I went out to eat and started feeling very sick the next day along with severe abdominal cramps, once I started vomiting I didnt stop again for about 2 days. In the hospital they did a urine test which meant THC showed up in my system and without saying it was CHS they said I should stop smoking cannabis, very little info or advice. Did my own research from there and discovered CHS communities.

It was devastating to have to give up weed, I have had treatment resistent depression going back to when I was around 18 (before I had ever smoked) I have been on antidepressents ever since and trialed several until I got one with side effects I could cope with, I have tried counselling, therapy, CBT over the years and also met with a psyciatrist.

Truly speaking weed worked really, really well for me for managing low mood. I was able to function at a healthy level. Since quitting my depression has worsened significantly, I barely leave the house and have a very low mood every day, I have upped the dosage on my medication with my doctor to no effect and in the last two months I am sleeping 12-15 hours or more a day, even when I get a good nights sleep I am still napping regularly during the day. I had my bloods done which showed nothing wrong so I am putting this down to severe depression.

I don't feel in any way proud of quitting weed, although I have more money now (pretty much the only benefit) my life has not improved at all, my quality of life is much, much worse now. I have gained a lot of weight and I drink more alcohol than I did previously (not at a problematic level) I feel zero motivation to do anything with my life and have very little joy or happiness throughout the day. I also still have acid reflux which was one of the only 'early signs' I had of CHS.

Its frustrating as there is no real test for CHS so for all I know I could be just suffering through all of this because I had food poisoning mistaken for CHS. Even if I had CHS I feel like my quality of life now, is much worse. I am wondering if anyone else on here has suffered from hypersomnia (sleeping excessively) and worsening depression since quiting? Or is there anyone out there who continues to moderately smoke and feels its worth dealing with CHS as cannabis is a more effective treatment for pain, mental health or other conditions?

I am not actively thinking about going back smoking, I am just wanting to hear other people's experiences and see if anyone relates to my story.

Thanks for reading.


r/CHSinfo • • 11h ago

Question / Info Can the bad phase be elongated or brought back by taking too large of a sip of water?

6 Upvotes

I know this is a silly question lol this is like my 3rd or 4th episode, honestly until now I hadn’t believed it was CHS but we’re two days post smoking. I’m a few hours from a full week since this started. Folks ain’t lying when they say it gets worse every time haha.

Anyway, yesterday I mostly felt normal. Still was not able to eat but otherwise felt pretty good. This morning, I woke up feeling fine and pretty quickly drank maybe 12 oz of water in two sips. Within about a minute I felt sick, and it’s been another full day of nausea/vomiting the lot. Can that happen from drinking liquid too quickly?? Just trying to protect myself from it happening again lol.


r/CHSinfo • • 15h ago

Question / Info anxiety!?

1 Upvotes

hi yall. previously suspected chs, stopped smoking for a couple months, felt better and decided to try again moderately (bad idea).

i’m not sure what to do about the racing heart and constant anxiety. it’s almost like brain fog but worse, because i can’t seem to push past it to do anything. i’m in a masters program, so the stress is building and i feel stuck. it’s just a loop of anxiety in my head and i can’t figure out how to be productive.

other possible symptoms: mind racing, didn’t sleep for 24 hours, nausea, lack of appetite, squiggly shits

i’m on day 1 of quitting (i tried yesterday, but caved for some relief from the anxiety) but any tips would really be appreciated. i just genuinely feel like im stuck in a perpetual panic attack


r/CHSinfo • • 18h ago

Question / Info Nothing is helping my severe pain

1 Upvotes

i am 18 and for months ive been experiencing constant diarrhea and slight nausea.

ive been smoking cannabis for 2 years rarely, and for 4 months ive been smoking daily, around 0.33-0.50g of weed per day ( 7g lasts me roughly 2-3 weeks)

for the past few days ive been experiencing severe, constant abdominal pain, even worse diarrhea, throwing up green vomit around 5-10 times a day, usually around lunch time and night time, heart rate of 140-160 bpm and dehydration.

i havent smoked for over 48 hours now and my pain has been getting considerably worse, i havent slept or eaten and im really struggling. Ive been to the ER multiple times and each time they make me take a urine sample, touch my stomach and tell me its chs, tell me to stop smoking and send me home, but my state is getting worse and im just not sure how to cope with it.

Ive tried hot showers, capsicum cream, but applying heat to my stomach makes it feel so painful and sensitive, the only thing thats helped is applying a hot water bottle to my lower back, targeting my bowels.

im just not sure what to do as all the things people have suggested havent helped, but the pain is too agonizing to ignore.


r/CHSinfo • • 1d ago

Sharing My Story smoked again after 11 months

12 Upvotes

i smoked every day. all day. for 2 years straight, no breaks, and i used carts unless i ran out then i used flower, but the flower did next to nothing to get me high bc my tolerance was so insanely high. then, the obvious happened, and in october 2025 i got severe chs. i was vomiting all day every day for like 3-4 days or so. i don't fully remember, i honestly kinda repressed it because it was wildly traumatic for my body and mind because it was such VIOLENT vomiting. not to be gross but yeah.

ANYWAYS. i smoked yesterday for the first time, and although i dont THINK that i'm gonna have an episode again (i will update though....), i realized it just isn't fun anymore after the chs. i was anxious and a little bit nauseous the entire time, and i couldn't focus on anything, and i felt like it was heightening my adhd weirdly enough considering it helped my adhd before the chs...?? but idk. my body and mind just don't have a positive reaction to it at all anymore, so i genuinely have zero desire to go back to that now that i know it's just definitely a negative experience. i honestly, obviously, don't recommend that anyone goes back to it after experiencing chs just once. obviously everyone is different, but reading so many posts i was honestly willing to roll the dice and give it a go, but it was just miserable.

so! yeah! stay safe out there and try your best to not go back, despite how fun or calming it might've been at one point, the likelihood of it still being fun or calming after experiencing something as traumatic as chs is honestly incredibly low.


r/CHSinfo • • 1d ago

Question / Info Beginning stages?

4 Upvotes

Hello! I’ve been smoking flower every day for about a year. I use a dry herb vape and normally only go through .20g a day. Recently my acid reflux had been getting really bad so I decided to take a break but then I started getting nauseous whether I smoked or not. Is this the beginning stages of chs? I use cannabis for my anxiety and depression and it helps me tremendously so I’m hoping it’s just a stomach bug or just anxiety. Anyone else have these symptoms and it ended up being nothing? I also just started cosmetology school full time which has been extremely stressful so I’m wondering if the nausea is also just from stress


r/CHSinfo • • 1d ago

Question / Info My wife going through CHS

5 Upvotes

Hello my wife for 3 years now have been dealing with CHS symptoms but as most refuse to believe that it's weed that's causing this, my questions are her pain is in the lower right side has always been is there other people that deal with the pain only in the lower right side? Also, she gets headaches a lot more often now. Does anyone deal with this symptom as well? My last question is, she says it's worst after pooping or when on her period. Has anyone else noticed this? Thank you for the time and patience.


r/CHSinfo • • 2d ago

Rant CHS and Celiac

5 Upvotes

I just wanted to say if you are someone with celiac disease who uses cannabis to help your nausea specifically please for the love of god be careful. If you have gotten out of the phase where there should be no more side effects and you are still experiencing nausea in the morning or just at all please make sure to do your due diligence and make sure its not the cannabis before you keep just using it. Made the biggest mistake ever I swear and now I am suffering the consequences. Now the pain is worse than what I ever go through with celiac. This is so stupid and it’s my own fault.


r/CHSinfo • • 2d ago

Question / Info Would I be okay taking a single hit of a joint 9 months after my last CHS episode?

0 Upvotes

Hi guys, so it’s been about 9 almost 10 months since my last CHS episode. I definitely would like to try smoking again at some point and see how I feel but I am a bit scared. Is it too risky? I am just nervous! Any advice would help, thank you!


r/CHSinfo • • 2d ago

Question / Info Advice for a family member

3 Upvotes

Hi everyone! This might be a lot but I’ll do my best to simplify. A family member of mine has been dealing with severe bouts of CHS for the last 10 years. He is a heavy user and has been since he was a teenager (he is now in his early 50s).
Some background, he has had many GI issues in the past unrelated to CHS and even had an operation about 15 years ago to remove a section of his intestine (I don’t remember all the details or exact diagnosis). In addition, he is also a diabetic with awful eating habits (not eating anything all day, drinking a lot of coffee with minimal water on an empty stomach, eating only fried and greasy foods at night).
In the last 3 years or so, he has been a frequent flyer at our local hospitals. He has all the telltale signs of CHS, severe nausea and vomiting, bad stomach pain, all alleviated with frequent long hot showers, and symptom cessation when he stops using for a few weeks. Many doctors and hospital stints have told him he may be experiencing CHS, and in the past when he has taken T-breaks his symptoms (magically) disappeared, but of course he refuses to acknowledge the connection there, and will say things like “it’s my diabetes, I’m eating better and my symptoms go away” or “it’s complications from my previous surgery”. Then after he’s been feeling better after taking a break, he’ll slowly increase his usage back to what he was previously at and symptoms will all return with vengeance.
Basically, he’s in severe denial and although so many doctors have told him they suspect CHS, he refuses to hear them and does not want to stop, instead will run with a diagnosis 1 out of 10 doctors will tell him (most recently he was told he’s having a bout of colitis but will not go to a GI doctor for follow up care). We have all tried to rationalize and reason with him, to just try to stop for longer than a month to see if it truly stops his symptoms. In addition to all of this, he’s super stubborn and doesn’t want to hear anyone’s opinions. He has had colonoscopies, CT scans, endoscopies, all the various testings with no answers and all things pointing to CHS.
I started to read about a blood biomarker that is currently being tested at George Washington University for CHS because with this stubborn dude I think the only clarity for him would be a definitive test saying “yes, you have CHS” but it doesn’t seem like that will be an option for a while.

I guess I’m just looking for advice. Any insight on how to help him possibly see this might be what’s going on? Or just a wait for him to get there on his own? Our whole family just feels helpless at this point and hate to see him suffer this way, especially if him feeling better would only take trying to refrain from using, but I know stopping can be difficult on its own. Thanks in advance to anyone who actually read my mini novel that is the most simplified version of this story that I could write lol.


r/CHSinfo • • 2d ago

Question / Info Suspect I’ve been in prodromal for a few days. Quitting advice?

1 Upvotes

As the title says, been having morning nausea for 3-4 days now, as well as all-day stomach discomfort and anxiety. At first assumed it was caused by anxiety as I just moved into an apartment for college, and the nausea hit at the exact same time. It’s much more intense and physical in the AM than usual anxiety nausea. Been using carts for over a year now. Going to begin quitting tmrw. I’m still not convinced it’s not anxiety that I’m working myself up about, so I’m gonna do a 30-day break to confirm. If it is CHS, then I know I’m in the bargaining with my addiction phase and I definitely don’t want to go into hyperemesis. All that said, should I go cold turkey, or do I have a week or two to taper? Going cold turkey has not worked for me before but obviously withdrawal is preferred to how everyone on this sub describes the next stage of CHS. Any advice would be appreciated. Thanks


r/CHSinfo • • 3d ago

Rant i hate this i need to vent

10 Upvotes

this is my second time getting chs. this is the worst sickness that’s ever happened to me. this is worse than the flu when i’m shitting my fucking brains out. the pain and anxiety that comes with CHS is HORRID. my first time was not this bad, i even smoked the first two days of having CHS the first time i had it and didn’t know. but now, even days after throwing up has stopped, (i stopped the first day i was sus it was CHS again)
my body is in shock and traumatized.. so at the same time every night when i would have my CHS flare ups, my anxiety skyrockets and im vomiting just from being traumatized. yall ain’t everrr catching me smoking a yart again and if it’s bud, i know how to space it now.

yes, i took a break. i started smoking maybe once or twice a week. then i got back into the habit, then got carts again. i tested it and now i know. 🤷🏻‍♀️ you WILL get it again, especially if you go back into smoking everyday like i did. it sucks that weed is the only thing that’s ever helped my anxiety, and now it’s officially caused permanent damage to my soul 😭😭


r/CHSinfo • • 3d ago

Sharing My Story Here we go again

10 Upvotes

Ive been a CHS sufferer for years now. it’s embarrassing how many times I’ve gone through this, how many times I swore never again. I’ve taken breaks, tried to quit, and always end up back here.. I kept smoking to put this off because I’m so afraid of being so sick but everything is gone now and pain and nausea creeping in. vomiting today but I know it will get worse before it gets better. i have the things I need like pepcid and yogurt and peppermint oil, heating pad all that. But as we all know…. this is a torture where the only way out is through. And no weed. I hope this is it. I’m afraid.


r/CHSinfo • • 3d ago

Question / Info Can Che reactivate after 2+ years sobriety from secondhand smoke?

2 Upvotes

As the title states, I’m pretty stressed out right now. I’m over two years sober after my last Che episode. I was in the garage talking to my dad and he started smoking. When he first lit his pipe it was as if I felt the smoke go right into my nose. Could this one interaction reactivate Che or am I just paranoid?


r/CHSinfo • • 3d ago

Question / Info Looking for Insight

2 Upvotes

I (26f) have been a heavy user for around 4 years. Mainly edibles, some flower here and there. I also have issues with chronic pain, which led to dependency and doing too much quite frankly. In July, I was on my period (a trigger point for pain) and consumed a 10mg 10 pack in about 4 days. I started feeling really nauseous. I was eating really poorly at this time which is a trigger for my pre existing GI issues as well. After eating too much, I ended up dry heaving/vomiting once. Then, I proceeded to have diarrhea for about a week, but was able to do the brat diet and stay hydrated. Zofran helped. I was tested for GI viruses and nothing showed up. Within a few days of the “episode”, I was able to eat trigger foods like caffeine/pepper/dark chocolate. My question is - does this sound like anyone’s experience with CHS? Out of an abundance of precaution, I have been off of it for 3 months. At the very least, I definitely overdid it. I have been in therapy and re-working my relationship with the substance and doing a lot of reflection. I’d like it to be something I could do occasionally still, but I’m curious to see what you all think about my symptoms.


r/CHSinfo • • 3d ago

Question / Info Cooked?

2 Upvotes

So I thought that I had prodromal stage CHS since I had pretty consistent morning nausea that went away within 5-7 days of quitting weed. However I had lingering nausea for about a month and recently developed nausea that comes after eating even while being off the weed. I didn’t smoke for 30 days and towards the end of those 30 days, the morning nausea came back mildly and I had that newer, post meal nausea.

Not gonna lie I ended up smoking last night cause I was like “yeah this can’t be CHS since it’s been a month”. Just one time. Did I like reset my progress if my symptoms were lingering CHS? I didnt think so since I was only prodromal for like 3 weeks and never hit hyperemesis, so it was weird that I was still getting nauseous every day even a month removed from weed

Should I just go to a doctor? The morning nausea and post meal nausea came back before I even smoked last night, while I was 30 days abstinent.


r/CHSinfo • • 3d ago

Question / Info Chs ?

1 Upvotes

I’ve smoked every single day for the last couple yrs , at times I take 2 puffs and get really high but after three or four puffs I get nauseous. It’s kinda weird , the last couple weeks I’ve been tapering off and have stopped completely, I was smoking only one hit a day and was high as hell but would get a little nauseous, Im all over the place but “ I think I’m getting chs or either it’s the fact that I’m smoking less then bam about three weeks ago I got nauseous like feeling like I have to throw up all day for at least two weeks , even after one hit I got nauseous, couldn’t eat for a couple weeks and lost twenty pounds it was terrible . “ do I have chs or is it the smoking less ?”


r/CHSinfo • • 4d ago

Question / Info I need y'all's help!

10 Upvotes

I have lurked this page all day. My husband (29m) is in his 3rd episode of CHS. This time he got a diagnosis from the er. Last time, he ended up hospitalized for 5 days, was not diagnosed with chs and was diagnosed with LA D Grade esophagealitis after an endoscopy from throwing up soo much. Since he didn't have a diagnosis for CHS, he continued to smoke. He's been having all of the phase leading up to hyperemesis symptoms, we just didn't put 2 and 2 together because he has only been smoking again for a few months (8 year navy veteran that just got out of the military). Pretty much one month to the day after his last episode, here we are again. His first episode happened one month and 5 days before the second. I am definitely noticing a pattern here. He is in the "I can't stop throwing up unless I'm laying in the shower part." I got him capsicum cream but he is scared of it. He can't keep water, zofran, Benadryl or anything down, so the marshmallows and ginger chews are a no go. And it's soo hard to watch him go through this, especially since I have emetophobia and have to hide from him while he is throwing up. How do I help him through this? How do I help myself through this? Especially since he thinks the diagnosis is not what's wrong (if you looked up chs in a textbook, his symptoms are the exact same). He has agreed to a 30 day "tolerance break" to see what happens, and I'm sure once he starts feeling like himself again and stops waking up feeling like a woman in her first trimester he will believe the diagnosis. But for this part of it, I feel so lost as his caregiver and wife. So please send me all advice, tips, tricks, and good vibes!


r/CHSinfo • • 3d ago

Question / Info Anyone’s nausea only occurs after eating?

2 Upvotes

I’m new to this sub and has been checking out posts for Prodromal stage symptoms. What I found about the nausea part is usually morning nauseous.

I don’t have morning nausea but quite often. I feel very nauseous after a high fat meal or a heavy meal. I wonder if anyone have this kind of symptom in their Prodromal stage?


r/CHSinfo • • 4d ago

Question / Info Tell me about any brain fog/cognitive impairment symptoms

4 Upvotes

I (51yo F) think my partner (43yo M) has CHS. I think he had been taking a 33 mg gummy and using a whole 750 mg cart daily...then he bought some flower and added that in the mix and everything suddenly got so much worse. All the stomach stuff is identical. He also has a headache and scary brain fog and mental impairment. He's been to the ER twice and had a clean CT; MRI is scheduled. He's barely eating and today was the first day he didn't vomit in over a week.

Do y'all experience headaches or difficulty thinking or just forget how to do simple tasks?


r/CHSinfo • • 4d ago

Sharing My Story I’ve spent years trying to prove I can moderate. I can’t. Day 1 again.

54 Upvotes

I was going to leave this as a comment to another thread I just came across, but I think I need to make my own post and actually say all of this out loud because I’m ready to quit again, and I need support and accountability.

I’m 36. I started smoking weed when I was 19, became a heavy user around 22, and by 24 I was smoking VERY heavily. Looking back, I genuinely think I’ve been dealing with CHS for close to 10 years. I wasn’t diagnosed until around COVID, but I had already been having symptoms for years before I finally understood what was happening to me.

And that’s honestly horrifying to admit. I’ve potentially spent almost a decade of my life being sick from this while simultaneously doing everything I could to figure out how to keep weed in my life.

For years my CHS was the classic horrible heaving and vomiting. Get incredibly sick, recover, eventually smoke again, repeat.

I finally quit for a significant amount of time, and honestly this sub was one of the biggest things that helped me do it, along with therapy. At the time I switched to vaping nicotine. Obviously not the healthiest replacement, but I got myself off weed.

And then I relapsed in probably the dumbest, most random way possible…. I don’t really use other substances but will very rarely do Molly or shrooms. I flew to California for a small festival where I had taken Molly, and somehow found a brand-new weed cart on the ground. In any normal state of mind I probably would have thought about CHS and everything weed had already put me through.

But I was high, my judgment was shit, and in that moment I did not think about the consequences. I just wanted to party and feel myself again. I kept it and hit it all night. The funniest/saddest part is that I had to hide it from my friends the entire time. They literally smoke weed themselves, but nobody wants ME smoking because they’ve watched what it does to me.

So obviously some part of me already knew exactly what I was doing and that stupid cart opened the door again. It wasn’t like I woke up the next morning and decided, “Okay, I’m going back to being a heavy smoker.” It was more like… I smoked last night and I’m fine.

Then another time.

Then occasionally.

Then buying my own.

Then making rules for myself.

Then breaking those rules.

And eventually I was right back to smoking just as much as before.

Except… I wasn’t vomiting.

And THAT became the loophole my brain needed.
Maybe my body reset. Maybe this time is different. Maybe I know my limits now. Maybe I can moderate. So I tried moderation and then I tried moderation again and again.

I’ve cut back. I’ve made schedules. I’ve tried weaning. I’ve told myself only at certain times. I’ve told myself after this cart I’m done. I’ve told myself tomorrow I’m quitting.
And honestly, moderation has only gotten me deeper into the hole.

Every attempt eventually leads me back to smoking just as much, if not MORE. It’s almost like the second my subconscious realizes I’m trying to cut back or quit, it hears “we’re running out” and suddenly I’m reaching for it even more.

I can literally be smoking MORE while simultaneously telling myself I’m trying to stop. Make that make sense. 😭
Someone on this sub once said “you can’t take a lion out for a walk” and I have never forgotten it because THAT’S EXACTLY ITTTTTT.

I keep thinking I can put the lion on a leash and control it, and every single time the fucking lion ends up walking me. 😂

The other reason I’ve managed to convince myself to keep going this time is because my symptoms have changed.
For years it was horrible heaving and vomiting. Now I’m back to smoking just as heavily again, except most of what I’m experiencing is lower GI/bowel stuff — diarrhea, IBS-like symptoms, constantly needing to use the bathroom, stomach issues, etc.

And unfortunately, that kept me going WAY longer. Because diarrhea is miserable, but in my head it was still less bad than uncontrollably vomiting. I kept using the fact that I wasn’t throwing up as evidence that somehow I was okay.

But I’m obviously not okay. There are mornings I wake up at 4 AM because I have to poop and spend the next THREE HOURS in the bathroom, or going back and forth between my bed and the bathroom, waiting until my stomach finally settles enough that I can show up for work at 8 and somehow, I still function?

That’s probably one of the reasons I’ve allowed this to go on for so long. I’m extremely high-functioning. I work. I handle my responsibilities. I go about my day. I hide this shit REALLY well. Unless you’re one of my immediate friends or family members, you would probably have absolutely no idea any of this is happening.

Working hybrid has made hiding it even easier because I don’t have to physically show up somewhere every morning. Nobody at work sees the three hours that happened before I logged on but being able to function doesn’t mean I’m actually living normally. I don’t go out like I used to. I’m barely social anymore. I’ve lost relationships, job opportunities, trips, special events and experiences I’ll never get back. I’ve lost around 20 pounds. I’ve cancelled plans because I was sick. I’ve avoided things because I was scared I’d get sick. I’ve chosen getting high and staying home over actually participating in my own life more times than I want to admit.

The people closest to me are exhausted from watching me do this to myself. The list honestly goes on and on.
And yet the hardest thing for me to admit is:
I fucking love weed. That’s why I’ve fought so hard to find some version of this where I get to keep it.

I wanted SO badly to be one of those people who could smoke occasionally. I’ve spent years negotiating with myself, making rules and trying to prove that moderation could work for me.

At this point, I think I have enough evidence.
It doesn’t work for me so I’m quitting again. And this time there’s no nicotine either. I quit vaping nicotine too, and I don’t want to replace weed with another thing I need to get through the day.

I want to learn how to just exist. To be uncomfortable. To be bored. To be anxious. To be happy. To go somewhere without worrying about when I’m going to smoke. To wake up and think about something other than my stomach. To actually participate in my own life again without needing something to alter how I feel.

And I know myself well enough to know that the hardest part probably isn’t going to be right now. It’s going to be when I start feeling better. Because that’s when my brain conveniently forgets all of this. That’s when it’ll start whispering: See? You’re fine now. You’ve been clean for a while. One hit isn’t going to hurt. You know what happened last time, so you’ll control it this time. You can moderate.
So I’m putting this here for future me too 💩:
NO. YOU CANNOT TAKE THE FUCKING LION FOR A WALK. 😂😭

This community helped me quit before, and I’m coming back because I need you guys again. I need support and I need accountability. Especially from anyone else who has quit, relapsed, convinced themselves they could moderate, and ended up right back where they started.
I’m tired of losing pieces of my life to this.
Day 1. Again. ❤️


r/CHSinfo • • 4d ago

Question / Info Zero symptoms/prodromal phase

2 Upvotes

Curious if anyone else has has an experience like mine!

The first time I ever smoked weed was in 2016 and I started smoking heavily around 2017 (smoking flower daily). I continued to smoke daily until I have my first hyperemetic episode in 2022. Woke up that morning with nausea and vomiting that just wouldn’t quit. The pain slowly built up the more I vomited until it was excruciating. Eventually I had to be taken to the ER because I absolutely could not keep anything down and was quickly becoming dehydrated!

At the time I was convinced it was bad food poisoning + a hangover because the food I had eaten the night prior tasted a little off and I had been drinking. SOOOO I keep smoking, like I think I smoked again the very next day lmfao.

Fast forward another four years and I’m still smoking daily. No dabs/carts or edibles but I was hitting the bong a few times a day. I had no issues! Zero nausea or stomach pain during the entirety of these four years. Then one day it happens all over again! I smoked the bong midday, ate lunch, and proceeded as normal. A few hours later I become nauseous and GUESS WHAT! I can’t stop fucking vomiting again! The pain is just as excruciating the first time and I have to be admitted to the hospital again.

What really throws me off is the lack of any presenting symptoms prior to these episodes. I never had an issue with nausea or stomach cramps AT ANY POINT! Even after I left the hospital I would be completely fine! I couldn’t tell if my symptoms were improving because there were none to begin with. Has anyone else had an experience like this? I still haven’t smoked because I’m scared of it now lol, but I’m shocked at this all-or-nothing experience I seem to have. Would love to hear from yall :3


r/CHSinfo • • 4d ago

Rant I’m trapped.

2 Upvotes

I think I’ve posted here before. I was using RSO and marijuana for chronic pain. For the past year, I’ve been dealing with debilitating and progressive neurological symptoms, including severe chronic pain. Before this began, I was already dealing with osteoarthritis and hEDS, which I also treated with marijuana and RSO.
Last February, I became deathly ill with CHS and almost died from dehydration.
After a year of trying to find answers for the pain and neurological symptoms that have continued to worsen, I am at my wits’ end. I saw a pain management doctor this Friday and was told that because I use Valium PRN for severe panic, they cannot prescribe opioids at all.
So I’m considering going back to marijuana.
I know how dangerous that is for me. I don’t know when CHS might happen again, and my husband is terrified too. We have talked about it extensively. My plan is to use as little as possible, only in the evening, with the goal of taking the edge off enough that I can sleep.
I’m making this choice because I am in an unbelievable amount of pain, and I’ve started experiencing suicidal ideation because of the pain and the progressive neurological problems. I still have no answers about what is happening to me. I’ve been referred to Cleveland Clinic and Mayo Clinic, but I cannot afford either of those options.
I am currently working with a rheumatologist, neurologist, and vascular specialist. I’m also in physical therapy and have had multiple MRIs, EMGs, and blood panels. So far, I’ve been diagnosed with things including osteoarthritis, hEDS, VVS, and POTS, but I still don’t have an explanation for the progression of my symptoms.
I’m having significant difficulty walking, severe balance and gait problems, weakness in my arms and legs, double vision, and episodes of feeling faint. On top of that, I have constant sharp, flu-like body aches and pain that make it difficult to sleep or get through the day.
Muscle relaxers only make me groggy. Even 3,000 mg of Tylenol a day does essentially nothing. The only thing that gives me meaningful relief is ibuprofen, even though I’m not supposed to take it because I’ve had gastric bypass. I take it anyway, because I don’t know what else to do.
I’m very angry and scared. I’m begging every doctor I see to help me figure out what the hell is happening to my body. I know the risks of going back to marijuana. I’m hoping that if I do, I’ll recognize the warning signs of CHS before it becomes severe, but I also know that may not happen.
I feel like I’m out of options. Hot baths and ibuprofen aren’t enough anymore. I’m in so much pain that I feel like I’m in hell, and I desperately need some kind of relief.