Case study and review consolidates clinical features and treatment approaches for cannabinoid hyperemesis syndrome | Research

The takeaway

Cannabinoid hyperemesis syndrome, first described in 2004, is becoming more prevalent in emergency departments as cannabis legalization expands, but early recognition and standardized treatment remain challenging.

Emergency clinicians, chronic cannabis users experiencing unexplained vomiting

CHS, first described in 2004, is increasingly seen in EDs as cannabis legalization expands

What the researchers found

CHS symptoms include cyclical nausea, vomiting, and abdominal pain in chronic cannabis users, often relieved by compulsive hot bathing. The condition is becoming more prevalent but frequently goes unrecognized. The pathophysiology remains largely unknown, and symptoms can be complicated by comorbidities.

Why it matters

CHS is likely underdiagnosed, leading to unnecessary and costly workups. Better recognition by emergency clinicians could improve patient outcomes and reduce healthcare costs.

The numbers in context

CHS first described in literature in 2004. Review covers 10 years of published literature.

How the study worked

Case study with patient interview and chart review, combined with a 10-year literature review to consolidate findings on clinical characteristics, pathogenesis, diagnostics, and treatment approaches.

What this study cannot tell us

Single case study supplemented with narrative review; CHS pathophysiology remains poorly understood; no standardized diagnostic criteria or treatment protocols exist.

How to read the evidence

Single case report with narrative literature review; no systematic methodology.

When this study was published

Published in 2020.

The bigger picture

As cannabis use becomes more widespread and products become more potent, CHS is expected to become an increasingly common emergency department presentation that all acute care clinicians should recognize.

Questions still open

What mechanism causes chronic cannabis use to trigger CHS in some users but not others? Why does hot bathing provide temporary relief?

Common questions

What is cannabinoid hyperemesis syndrome?

CHS is a condition affecting some chronic cannabis users characterized by cyclical episodes of severe nausea, vomiting, and abdominal pain. A distinctive feature is that symptoms are often temporarily relieved by hot bathing. Cessation of cannabis use typically resolves the condition.

How common is CHS?

The exact prevalence is unknown because CHS is frequently misdiagnosed. It is becoming more commonly recognized in emergency departments as cannabis use increases, but many cases likely go undiagnosed or are attributed to other causes of cyclical vomiting.

Read the original research

Cannabinoid hyperemesis syndrome: A case study and discussion.

Journal of the American Association of Nurse Practitioners, 32(3), 269-276

View on PubMed ↗Publisher’s paper ↗

Citation

Creedon, Eliza S; Maloy, Melony K; DelloStritto, Rita A. (2020). Cannabinoid hyperemesis syndrome: A case study and discussion.. Journal of the American Association of Nurse Practitioners, 32(3), 269-276. https://doi.org/10.1097/JXX.0000000000000215