Cannabinoid hyperemesis syndrome diagnosis requires knowing that cannabis cessation must last at least 3 months | Research

The takeaway

A 22-year-old with 2 years of recurrent nausea and vomiting was diagnosed with CHS after extensive inconclusive testing; symptoms improved with cessation but returned on relapse.

Emergency physicians, gastroenterologists, family doctors

2 years of unnecessary investigations before CHS was diagnosed

What the researchers found

CHS diagnosed using Rome IV criteria after 2 years of unnecessary investigations; minimum 3 months cannabis cessation required for diagnosis confirmation; symptoms recurred with relapse.

Why it matters

CHS remains underdiagnosed because many clinicians do not ask about cannabis use or know the diagnostic criteria, leading to prolonged suffering.

The numbers in context

22-year-old; daily cannabis user; 2 years of symptoms before diagnosis; minimum 3 months cessation required.

How the study worked

Case report of a 22-year-old female daily cannabis user with 2 years of cyclic nausea, vomiting, and abdominal pain; diagnosed after applying Rome IV criteria.

What this study cannot tell us

Single case report; cannot generalize; 3-month cessation timeframe from expert consensus rather than rigorous trials.

How to read the evidence

Single case report provides clinical illustration but cannot establish prevalence or treatment efficacy.

When this study was published

Published 2025

The bigger picture

As cannabis use increases post-legalization, CHS prevalence is rising, making clinical awareness increasingly important.

Questions still open

How many emergency visits for cyclic vomiting are undiagnosed CHS? Would systematic cannabis screening reduce diagnostic delay? Is 3 months sufficient for all patients?

Common questions

What is cannabinoid hyperemesis syndrome?

A condition in chronic cannabis users causing cyclic severe nausea, vomiting, and abdominal pain, often temporarily relieved by hot showers. It requires complete cannabis cessation for at least 3 months to resolve.

Why is CHS hard to diagnose?

Many clinicians do not ask about cannabis use, and symptoms mimic other GI conditions. Patients may undergo years of testing before the connection to cannabis is made.

Read the original research

Proper counseling for diagnosis and management of cannabinoid hyperemesis syndrome: a case report.

Family practice, 42(2)

View on PubMed ↗Publisher’s paper ↗

Citation

Cholette-Tétrault, Samuel; Grad, Roland. (2025). Proper counseling for diagnosis and management of cannabinoid hyperemesis syndrome: a case report.. Family practice, 42(2). https://doi.org/10.1093/fampra/cmae067