A population survey of nearly 6,000 adults found 2.2% met criteria for functional nausea/vomiting disorders, with all seven cases of cannabinoid hyperemesis syndrome located in the US and hot water bathing behavior augmented by cannabis use across all vomiting disorders.
Gastroenterologists, emergency physicians, and researchers studying cannabinoid hyperemesis syndrome.
2.2% population prevalence
What the researchers found
FNVDs affected 2.2% of the population. CVS prevalence was higher in the US (2%) than Canada (0.7%) or UK (1%). All 7 cases meeting cannabinoid hyperemesis criteria were in the US. Hot water bathing to relieve vomiting was significantly more common in CVS (44%) than CNVS (19%) and was independent of cannabis use but augmented by it.
Why it matters
This is one of the first population-level estimates of cannabinoid hyperemesis syndrome prevalence using standardized diagnostic criteria. The finding that hot bathing behavior occurs in all functional vomiting disorders, not just cannabinoid hyperemesis, challenges assumptions about diagnosis.
The numbers in context
5,931 adults surveyed. 2.2% (n=131) met FNVD criteria. US prevalence: 3%. CVS: US 2%, Canada 0.7%, UK 1%. 7 cannabinoid hyperemesis cases, all in US. Hot bathing: CVS 44% vs CNVS 19% (p=.03). Cannabis augmented hot bathing behavior.
How the study worked
Internet cross-sectional health survey of 5,931 adults across the US, Canada, and UK in 2015. Quota-based sampling for demographic balance. Rome IV diagnostic criteria for functional nausea and vomiting disorders.
What this study cannot tell us
Internet survey with self-reported symptoms. Cannabis use patterns were not detailed. The 7 cannabinoid hyperemesis cases are too few for meaningful subgroup analysis. Cultural differences in cannabis access may explain geographic variation.
How to read the evidence
Rated moderate because this is a large population-representative survey using standardized Rome IV criteria, though self-report and small subgroup sizes limit some findings.
When this study was published
Published in 2019 based on 2015 data, before recreational cannabis legalization in Canada (2018).
The bigger picture
The finding that hot water bathing is not unique to cannabinoid hyperemesis, but is amplified by cannabis, suggests a more nuanced relationship between cannabis and vomiting disorders than previously appreciated. It also raises questions about diagnostic specificity.
Questions still open
- Why is cannabinoid hyperemesis apparently more prevalent in the US? Does cannabis cause the vomiting or exacerbate a pre-existing tendency? Could some cyclic vomiting syndrome cases be undiagnosed cannabinoid hyperemesis?
Common questions
How common is cannabinoid hyperemesis syndrome?
Why do people with vomiting disorders take hot baths?
Read the original research
Epidemiology, Clinical Characteristics, and Associations for Rome IV Functional Nausea and Vomiting Disorders in Adults.
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 17(5), 878-886
Citation
Aziz, Imran; Palsson, Olafur S; Whitehead, William E; Sperber, Ami D; Simrén, Magnus; Törnblom, Hans. (2019). Epidemiology, Clinical Characteristics, and Associations for Rome IV Functional Nausea and Vomiting Disorders in Adults.. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 17(5), 878-886. https://doi.org/10.1016/j.cgh.2018.05.020
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