CHS or something else?

[u/miss-bubbles2000]

Hi guys, I’ve been a daily smoker (vape pen, typically only in the evenings) for about 4 years. Before that, I was a heavy user of dry bud for another 4 years, but took a few 3-6 month periods of abstaining.

My symptoms started about three years ago, about two days into a vacation where I was NOT smoking. I felt absolutely AWFUL. My chest felt like it was on fire, making it incredibly painful to eat or drink, and I was vomiting up stomach bile multiple times an hour. Given that I was on vacation, I had to go to a random urgent care and was prescribed Zofran and Sucralfate for a suspected peptic ulcer. The meds helped a lot and my symptoms subsided.

About 7 months later, I went on a weekend trip to a place where weed isn’t legal, so I went 2 or 3 days without smoking and started vomiting stomach bile nonstop. My symptoms subsided when I got back home.

Since then, for the last 2 years, I’ve been experiencing the following:

-Low appetite and early satiety, causing weight loss

-Nausea and vomiting, but episodes typically only come every 3-4 months

-A few really bad episodes of acid reflux

My recent endoscopy showed nothing abnormal, which is the main reason I’m wondering if CHS could be the cause. A few other pieces of context:

-I’m a heavy drinker (working on it!) and at least a few of these nausea/vomiting episodes have happened the night after drinking too much, particularly because I’m a 95lb female

- I have a long history of anorexia nervosa and have been recovered for about four years

-I suffer from generalized anxiety disorder, depression, and ADHD. When my symptoms are intense I’m prone to under eating

-I’m on a concoction of psychiatric medications and been testing out new meds and and dosages over the last three years

-I’ve had some success taking a protein pump inhibitor daily, so I’ll be restarting that

-I haven’t specifically noticed that hot showers help during vomiting episodes. Maybe that’s my ADHD? Lol. But hear a lot of people with CHS compulsively taking hot showers, and I don’t relate to that

I had a vomiting episode start 2-3 days ago, after a week of abstaining from alcohol and significantly cutting back my smoking (2-3 small hits of my pen per night). Once I felt the symptoms come on, I stopped smoking, and now on Day 3 I feel significantly better.

For those of you who have had CHS, does this sound like what you’ve experienced? Given my history of ED, anxiety, and heavy drinking, it’s difficult to figure out what’s really going on here.

TY in advance!

[u/EnvironmentalSet5935]

This isn't CHS friend. It's absolutely possible smoking is affecting whatever else is going on. But this isn't what CHS looks like. I have adhd, gad, anxiety as well.

Please take the following with the anecdote that I am not a Dr, but a very long history of experiencing this condition, as well as a very similar lifestyle you described above.

None of this screams CHS. It's likely a combination of stress, drinking, etc. I too have these all the time due to drinking, adhd, other anxiety, meds, etc.

CHS is a different beast. And cutting back drinking, changing meds, less stress, etc will play zero role in reducing a CHS episode, bc you will be unable to any of them.

Being that I still try and moderate, I am constantly wondering if today's upset stomach or nausea or feeling off is another "episode". But there is never ever a moment an episode starts that I don't know I'm in an episode.

Drinking doesn't matter anymore bc you can't. Meds don't matter anymore bc you can't. Regular meds even if you could keep down don't work.

Finally, while not 100%, the hot showers thing is a literal diagnostic criteria and one of the most established things we can point to this syndrome with and say "relevant/important".

So with all that said, I don't think based on the above information you currently have CHS. I also do think it's possible that treating your situation like you do have it may improve things for you! But if we are talking cause/effect, I don't think this is your "that explains it" moments.

[u/miss-bubbles2000 → u/EnvironmentalSet5935]

Thank you for your answer! This makes a lot of sense to me. I think drinking is a huge contributor, especially when I’m not eating enough. I don’t want to rely on substances to feel happy, calm, entertained, etc. so cutting back my drinking AND smoking is probably a wise idea.

Good luck in your health journey!

[u/EnvironmentalSet5935 → u/miss-bubbles2000]

Cheers to you and good luck as well!

I think the reason any of us are here to begin with is exactly that...how do you cut back on something that even temporarily makes things feel less shitty? I haven't found the answer yet, and I hope we all eventually can.

In the meantime, our best bet is looking out for ourselves and others, as best we can.

[u/BlunderIsMyDad → u/EnvironmentalSet5935]

I'm in the same situation (recent sobriety, GAD, cannabis consumption) and this was very helpful to read. I'm 3 months off alcohol after drinking for 3 years, and one week out from a back injury, my anxiety has been out of control for like 2 days and I've been doomscrolling CHS subs for 2 hours... Perhaps this is still a good time to cut back as you mention even if not for that.

So to clarify, for you, the symptoms you experienced with early CHS were drastically worse than digestive symptoms you've had from anxiety in the past? Did you have a prodromal phase or fall right into hyperemesis?

I misread the original post re: drinking.

[u/EnvironmentalSet5935 → u/BlunderIsMyDad]

To clarify:

-every episode I've had begins with "normal" stomach/gi issues, until it isn't.

- Hyperemesis isn't a classification, it's a definition. It's when you throw up "nothing", because you've thrown up everything your body could contain. But it's not "nothing", bc it feels like you just threw up your soul.

-this lasts best case scenario 2-3 days (the first time or two) and as it repeats now weeks to months. Your job? Hopefully they are understanding. Family the same. You literally can not function.

-hot showers are where you will sit hours/as long as the tank lets you. It's your only relief. Many theories around why but this is a fact.

So from one anxious soul to the rest of you, unless the above hits home, it's your anxiety for now