A 29-year-old with the classic triad of cyclic vomiting, chronic marijuana use, and compulsive bathing was diagnosed with CHS after extensive workup as a diagnosis of exclusion.
Read this if you use cannabis regularly and have experienced unexplained bouts of vomiting.
Classic triad: cyclic vomiting + chronic cannabis + compulsive bathing
What the researchers found
A 29-year-old man presented with recurrent episodes of intractable vomiting that followed the classical triad of cannabinoid hyperemesis syndrome: cyclic vomiting, chronic marijuana use, and compulsive hot bathing. The diagnosis was made after other causes were excluded.
The authors emphasized that despite marijuana's well-established antiemetic properties, a paradoxical hyperemetic effect occurs in some chronic users. CHS remained underrecognized at the time of publication, leading to delayed diagnosis and unnecessary medical investigations.
The case reinforced that CHS should be considered plausible in any patient presenting with recurrent intractable vomiting and a strong history of cannabis use, even though it remains a diagnosis of exclusion.
Why it matters
Each CHS case report adds to the medical literature, helping establish diagnostic patterns and raising awareness among clinicians who may not yet be familiar with the condition.
The numbers in context
One patient, age 29. Classical triad present: cyclic vomiting, chronic marijuana use, compulsive bathing. Diagnosis of exclusion.
How the study worked
Single case report of a 29-year-old male with cannabinoid hyperemesis syndrome, with review of the paradoxical relationship between cannabis's antiemetic and hyperemetic effects.
What this study cannot tell us
Single case report. Diagnosis of exclusion means other conditions must be ruled out first. No information on the specific quantity or duration of cannabis use that preceded the syndrome.
How to read the evidence
Single case report adding to the growing CHS literature.
When this study was published
Published in 2015. CHS diagnostic awareness has improved significantly since.
The bigger picture
The growing number of CHS case reports has gradually shifted it from a medical curiosity to a recognized clinical entity. Each report helps solidify the diagnostic criteria and raises awareness among emergency and primary care physicians.
Questions still open
- What distinguishes cannabis users who develop CHS from those who do not? Could a positive diagnostic test be developed to replace the current exclusion-based approach? Is there a genetic predisposition?
Common questions
What are the signs of CHS?
Why would cannabis cause vomiting if it's an antiemetic?
Read the original research
Cannabinoid Hyperemesis Syndrome: A Paradoxical Cannabis Effect.
Case reports in gastrointestinal medicine, 2015, 405238
Citation
Figueroa-Rivera, Ivonne Marie; Estremera-Marcial, Rodolfo; Sierra-Mercado, Marielly; Gutiérrez-Núñez, José; Toro, Doris H. (2015). Cannabinoid Hyperemesis Syndrome: A Paradoxical Cannabis Effect.. Case reports in gastrointestinal medicine, 2015, 405238. https://doi.org/10.1155/2015/405238
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