How is HG different from CHS?
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
