A CHS Patient Ran for 15 Straight Hours to Relieve Symptoms and Developed Rhabdomyolysis | Research

The takeaway

A 24-year-old with cannabinoid hyperemesis syndrome discovered that jogging relieved his symptoms, then ran continuously for 15 hours, resulting in rhabdomyolysis (muscle breakdown) requiring hospitalization.

Readers with CHS seeking to understand why hot showers help and what alternatives exist.

15 hours of continuous running relieved CHS symptoms but caused rhabdomyolysis

What the researchers found

A 24-year-old daily marijuana user with a history of CHS discovered that running, like hot bathing, alleviated his nausea and vomiting symptoms. During an episode, he jogged continuously for 15 hours, which led to rhabdomyolysis, a dangerous condition where muscle tissue breaks down and releases proteins into the blood that can damage the kidneys.

This is the first reported case of exercise-alleviated CHS symptoms. The authors propose that exercise, like hot water bathing, works by redistributing blood flow away from the gut (the enteric circulation). This blood flow redistribution hypothesis could explain why both heat (which causes cutaneous vasodilation) and exercise (which redirects blood to muscles) provide symptomatic relief in CHS.

Why it matters

This case provides a novel data point for understanding CHS pathophysiology. The finding that exercise mimics hot water in relieving symptoms supports the theory that CHS is related to abnormal enteric blood flow regulation. It also highlights the desperation of CHS patients, who may engage in extreme behaviors to find relief from an illness that standard antiemetics cannot treat.

The numbers in context

Patient age: 24. Duration of continuous running: 15 hours. Result: rhabdomyolysis. First reported case of exercise-relieved CHS.

How the study worked

Single case report with clinical description and mechanistic hypothesis.

What this study cannot tell us

Single case report. The blood flow redistribution hypothesis has not been directly tested. Rhabdomyolysis from 15 hours of running could occur independent of CHS. The case does not prove that exercise is a generally effective CHS treatment.

How to read the evidence

Preliminary evidence from a single case report.

When this study was published

Published in 2017. First case linking exercise to CHS symptom relief.

The bigger picture

CHS patients are known for their compulsive hot bathing, sometimes showering for hours on end. This case extends the pattern to exercise, suggesting that any activity that redistributes blood flow away from the gastrointestinal tract may provide relief. Understanding this mechanism could lead to more targeted treatments.

Questions still open

Could moderate exercise be recommended as a safer alternative to hours-long hot bathing? Does blood flow monitoring during CHS episodes support the redistribution hypothesis? Are CHS patients at higher risk for complications from their compulsive symptom-relief behaviors?

Common questions

Can exercise help with CHS symptoms?

This case report documented one patient who found jogging relieved his CHS symptoms, similar to hot bathing. However, his 15-hour run caused a dangerous muscle breakdown condition. Moderate exercise has not been studied as a CHS treatment and should not replace medical care.

Why would running help CHS like hot showers do?

The proposed explanation is that both exercise and hot water redirect blood flow away from the intestinal circulation. If CHS involves abnormal gut blood flow regulation, anything that shifts blood elsewhere (to skin during hot baths, to muscles during exercise) might temporarily relieve symptoms.

Read the original research

Running Out of Options: Rhabdomyolysis Associated with Cannabis Hyperemesis Syndrome.

Journal of general internal medicine, 32(12), 1407-1409

View on PubMed ↗Publisher’s paper ↗

Citation

Trappey, Bernard E; Olson, Andrew P J. (2017). Running Out of Options: Rhabdomyolysis Associated with Cannabis Hyperemesis Syndrome.. Journal of general internal medicine, 32(12), 1407-1409. https://doi.org/10.1007/s11606-017-4111-1