Cannabinoid hyperemesis syndrome: Clinical diagnosis of an underrecognised manifestation of chronic cannabis abuse

Abstract

Cannabis is a common drug of abuse that is associated with various long-term and short-term adverse effects. The nature of its association with vomiting after chronic abuse is obscure and is underrecognised by clinicians. In some patients this vomiting can take on a pattern similar to cyclic vomiting syndrome with a peculiar compulsive hot bathing pattern, which relieves intense feelings of nausea and accompanying symptoms. In this case report, we describe a twentytwo year-old-male with a history of chronic cannabis abuse presenting with recurrent vomiting, intense nausea and abdominal pain. In addition, the patient reported that the hot baths improved his symptoms during these episodes. Abstinence from cannabis led to resolution of the vomiting symptoms and abdominal pain. We conclude that in the setting of chronic cannabis abuse, patients presenting with chronic severe nausea and vomiting that can sometimes be accompanied by abdominal pain and compulsive hot bathing behaviour, in the absence of other obvious causes, a diagnosis of cannabinoid hyperemesis syndrome should be considered.

Cannabinoid Hyperemesis Syndrome

“…With more recent research, these symptoms of recurrent nausea, vomiting, and abdominal pain have been identified as a medical condition named cannabinoid hyperemesis syndrome (CHS). The triad of symptoms of CHS is identified in recent studies as nausea, vomiting, and abdominal pain, relieved by taking hot baths or showers (Simonetto, Oxentenko, Herman, & Szostek, 2012;Sontineni, Chaudhary, Sontineni, & Lanspa, 2009;Soriano-Co, Batke, & Cappell, 2010;Sun & Zimmerman, 2013). These studies supported the findings of Allen et al's (2004) study.…”

Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment—a Systematic Review

“…Seven unique diagnostic frameworks were identified [6,9,30,51,[119][120][121]. There was a significant overlap among major diagnostic characteristics between the authors.…”

Cannabinoid Hyperemesis: A Case Series of 98 Patients

“…Since 2004, 13 case reports and 3 small case series, the largest of which consisted of 9 patients, have been published in further support of CH. [4][5][6][7][8][9][10] In 2009, Sontineni et al 7 described important clinical features of CH, which included long-term cannabis use, cyclic vomiting, colicky abdominal pain, compulsive use of hot showers, and improvement of symptoms with cannabis cessation.…”