A 17-year-old visited the ER five times before cannabinoid hyperemesis syndrome was diagnosed

What the researchers found

A 17-year-old visited the emergency department five times over one year with uncontrolled nausea, profuse vomiting, and weight loss. The diagnosis of cannabinoid hyperemesis syndrome (CHS) was not considered until after extensive and unnecessary medical workups.

The patient's symptoms improved with repetitive hot showering and resolved when cannabis use was stopped, both hallmark features of CHS. The authors noted that while cannabis use among Canadian youth was declining, it remained twice as prevalent as among adults, making adolescent CHS an underrecognized concern.

The case report emphasized that CHS should be included in the differential diagnosis for any case of cyclic vomiting, regardless of the patient's age. The condition is underdiagnosed in adults and even more so in adolescents, where clinicians may be less likely to inquire about substance use.

Why it matters

Five emergency visits before diagnosis means significant suffering, unnecessary testing, and healthcare costs. Increased awareness of CHS in adolescent patients could dramatically reduce time to diagnosis and improve care.

The numbers in context

One patient, age 17. Five emergency department visits over one year. Canadian youth cannabis use was declining since 2008 but remained twice the adult rate.

How the study worked

Single case report of a 17-year-old with cannabinoid hyperemesis syndrome, including review of clinical presentation, diagnostic considerations, and treatment approaches for CHS in the adolescent population.

What this study cannot tell us

Single case report cannot establish prevalence or risk factors. Canadian healthcare context may differ from other systems. The case does not provide information about what level of use triggers CHS in adolescents.

How to read the evidence

Single case report. Illustrative of diagnostic delays but cannot establish broader patterns.

When this study was published

Published in 2015. Adolescent CHS awareness has improved since.

The bigger picture

CHS was first described in adults, and awareness in adolescent medicine has lagged behind. As cannabis remains widely used by teenagers, clinicians who treat young people need to add CHS to their diagnostic considerations for unexplained cyclic vomiting.

Questions still open

• How common is CHS in adolescents compared to adults? Are teenagers more or less susceptible to CHS than adult chronic users? What is the minimum frequency and duration of cannabis use that puts adolescents at risk?

Common questions

Read the original research

Cannabinoid Hyperemesis Syndrome in a 17-Year-Old Adolescent.

The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 57(5), 565-7

Citation

Desjardins, Noémie; Jamoulle, Olivier; Taddeo, Danielle; Stheneur, Chantal. (2015). Cannabinoid Hyperemesis Syndrome in a 17-Year-Old Adolescent.. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 57(5), 565-7. https://doi.org/10.1016/j.jadohealth.2015.07.019

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