A pregnant patient with intractable nausea and pain from cannabinoid hyperemesis syndrome improved significantly after topical capsaicin cream when other treatments failed.
OB-GYNs, emergency physicians, and clinicians managing nausea in pregnant patients with cannabis use history.
Topical capsaicin resolved CHS symptoms in a pregnant patient when multiple anti-emetics failed
What the researchers found
A 34-year-old woman at 11 weeks gestation with intractable abdominal pain and nausea unresponsive to extensive gastrointestinal workup and multimodal antiemetic treatment was ultimately diagnosed with CHS. Topical capsaicin cream provided significant symptom improvement when oral pain management options were limited by pregnancy.
Why it matters
CHS diagnosis is particularly challenging in pregnancy because nausea is expected, and treatment options are limited by fetal safety concerns. Topical capsaicin avoids systemic drug exposure, making it an attractive option.
The numbers in context
Patient was 34 years old at 11 weeks gestation. Symptoms were refractory to multimodal antiemetic treatment before capsaicin was trialed.
How the study worked
Single case report from a clinical setting.
What this study cannot tell us
Single case report provides the lowest level of clinical evidence. Cannot rule out spontaneous improvement or placebo effect. No long-term follow-up on pregnancy outcomes reported.
How to read the evidence
Single case report with no controls. Provides a clinical observation worth further study but cannot establish efficacy.
When this study was published
2025 publication.
The bigger picture
CHS is likely underdiagnosed in pregnant patients because symptoms overlap with hyperemesis gravidarum. As cannabis use during pregnancy remains common despite medical advice against it, clinicians need to consider CHS in the differential.
Questions still open
- How often is CHS misdiagnosed as hyperemesis gravidarum?
- Is topical capsaicin safe throughout pregnancy for CHS management?
Read the original research
Topical Capsaicin for Symptomatic Treatment of Cannabinoid Hyperemesis Syndrome in a Pregnant Patient: A Case Report.
Pain medicine case reports, 9(6), 311-313
Citation
Huang, Jenny; Rayasam, Swathi; Graham, Caleb; Jones, Stephanie. (2025). Topical Capsaicin for Symptomatic Treatment of Cannabinoid Hyperemesis Syndrome in a Pregnant Patient: A Case Report.. Pain medicine case reports, 9(6), 311-313.
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