How is HG different from CHS?

Hyperemesis Gravidarum (HG)-min (1)

Hyperemesis Gravidarum (HG)

  • Presents in pregnancy, before 16 weeks gestation
  • Severe vomiting episodes with persistent symptoms in between
  • Some patients are resistant to typical antiemetic treatments
  • Abdominal pain can be present with secondary cause: reflux, gallstones, constipation, muscle strain
  • Often avoids showering/bathing because worsens symptoms
  • May use cannabis to relieve symptoms, or no cannabis use
  • May have had symptoms in a prior pregnancy
  • May have significant weight loss
  • No effect with cessation of cannabis, or symptoms worsen

Cannibinoid Hyperemesis Syndrome (CHS)

  • Regular symptoms for 3 months with initial onset >6 months (Rome IV criteria)
  • Return to baseline in between episodes
  • Resistance to antiemetics common
  • Abdominal pain common and severe, resistant to opioids
  • Relief of symptoms with hot shower/bath
  • Long history of cannabis use (typically years) or heavy use (4+ g/day), positive tox screen
  • Likely had symptoms prior to pregnancy
  • Little to no weight loss
  • Symptoms improve with cessation of cannabis use