Cannabinoid hyperemesis: what is it and what are its symptoms?

There are many disorders caused by chronic cannabis use. Unfortunately, cannabinoid hyperemesis is new to medical knowledge and tends to be underdiagnosed.

Last update: November 29, 2021

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

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

Phases of cannabinoid hyperemesis

Experts affirm that the syndrome in question is divided into 3 major phases, which present very marked differences between them. They are the prodromal, hyperemesis and recovery phases.

1. Prodromal phase

This is the initial stage of the condition, so clinical manifestations are mild and do not limit daily activities. The prodromal phase is characterized by the presence of morning sickness and abdominal pain.

The patient can persist in this stage for many months or years without receiving an accurate diagnosis. The delay is due to the fact that people do not admit that they use marijuana and the symptoms are associated with other pathologies.

Secondly, one of the best known medical applications of marijuana is the reduction of nausea and vomitingas well as chronic pain relief. This fact causes people to increase their use of cannabis to improve symptoms, which accelerates the progress of the disorder.

2. Hyperemesis phase

This phase is characterized by the presence of obvious clinical symptoms. Vomiting and abdominal pain suddenly get worse, and can even incapacitate people. Symptoms are cyclical, lasting between 24 and 48 hours.

The syndrome improves after taking baths with hot water. In this sense, people feel a strong urge to take constant showers.

Hot showers improve symptoms, so patients use them frequently.

3. Recovery phase

The main characteristic of this phase is the disappearance of symptoms. Those affected decrease the frequency of daily baths considerably, returning to the usual showers. What’s more, vomiting and abdominal discomfort disappear completely.

The duration of this phase is highly variable, and can range from months to years. However, it should be noted that people can relapse if they use cannabis again.

Symptoms of cannabinoid hyperemesis

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

On the other hand, people can also present the following:

  • Constant and intense nausea.
  • Loss of appetite
  • Involuntary weight loss
  • incrise of cardiac frecuency.

Most of these symptoms last the same time as the hyperemesis phase, that is, between 1 and 2 days. However, the duration may be longer if constant marijuana use continues.

Possible complications

The main complication of cannabinoid hyperemesis syndrome is dehydration. Constant vomiting results in a considerable loss of fluids and electrolytes, which causes various systemic manifestations.

The loss of water and electrolytes causes the body to not have a natural balance. In this way, the following complications are possible:

  • Involuntary muscle contractions
  • Seizures
  • General weakness
  • Shock.
  • Severe arrhythmias
  • Renal insufficiency.

Causes of cannabinoid hyperemesis

Unfortunately, the precise cause of cannabinoid hyperemesis has yet to be established. It is important to note that it is a syndrome discovered in 2004, so more research is needed.

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

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


The diagnosis of cannabinoid hyperemesis is a real challenge for specialists. People often hide that they use marijuana on a recurring basis, which makes an accurate and timely approach impossible.

Laboratory tests are not helpful in identifying the condition, so doctors often rely on the clinic and drug history. Nowadays, criteria have been established that facilitate the detection of the alteration, among which the following stand out:

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

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

Cannabis use is the indicative data that can guide the diagnosis when in doubt.

Treatment and prevention of cannabinoid hyperemesis

Treatment of cannabinoid hyperemesis during the vomiting phase consists of relieve symptoms and avoid dehydration. People should drink plenty of fluids to avoid complications. In addition, the use of antiemetics can decrease the intensity.

Hospitalization will be necessary in the most severe cases or when there are multiple complications. Nevertheless, the definitive treatment is to stop using marijuana. Symptoms go away within 1 or 2 days after stopping use.

The real problem is that marijuana creates dependence, so it can be very difficult to give up the substance. In this way, people tend to consume again, so the symptoms reappear immediately.

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

A recent and underdiagnosed illness

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

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

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