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Study breakdown

Ten-year pediatric case series described cannabinoid hyperemesis features in 34 adolescents

Case ReportPreliminary evidence
The takeaway

A 10-year case series of 34 adolescents with cannabis hyperemesis found clinical features similar to adults, including cyclic vomiting, abdominal pain, and relief from hot showers.

Pediatricians, emergency medicine providers, parents, and anyone interested in cannabis-related health effects in adolescents.

34 adolescent cases over 10 years at a single institution

What the researchers found

Thirty-four patients aged 13-20 (median 17) presented with cyclic nausea and vomiting after at least 3 months of regular cannabis use. Clinical features mirrored adult cannabis hyperemesis, including abdominal pain, bowel changes, and hot shower relief. No specific antiemetic showed particular benefit.

Why it matters

Cannabis hyperemesis is increasingly recognized in adults but remains under-diagnosed in adolescents. This case series provides evidence that the condition presents similarly in younger patients and offers pragmatic diagnostic criteria for pediatric cases.

The numbers in context

34 patients aged 13-20; median age 17 years; 10-year period at one institution; symptoms after at least 3 months of regular use

How the study worked

Researchers reviewed records at a single institution over 10 years, including patients with cannabis-related or cyclic vomiting diagnosis codes who developed regular vomiting after starting regular cannabis use and had no better explanatory diagnosis.

What this study cannot tell us

Single institution, retrospective case review. Follow-up recorded in fewer than half of patients. Drug history documentation frequently incomplete. No control group.

How to read the evidence

Retrospective case series with limited follow-up, though the 10-year span and focus on an underrecognized pediatric condition add clinical value.

When this study was published

Published in 2021.

The bigger picture

As cannabis use among adolescents continues, clinicians seeing young patients with unexplained cyclic vomiting need to consider cannabis hyperemesis. This series suggests the condition is not rare in pediatric settings but is likely underdiagnosed.

Questions still open

  • How many adolescents with cyclic vomiting are being missed because drug histories are incomplete? What is the true incidence of pediatric cannabis hyperemesis? Does adolescent-onset CHS differ in long-term outcomes from adult-onset?

Common questions

How did adolescent cannabis hyperemesis compare to adult cases?
The presenting features were broadly similar: cyclic nausea and vomiting after regular cannabis use, abdominal pain, bowel changes, and relief from hot showers or baths.
Did any anti-nausea medication work?
No specific antiemetic was found to be particularly beneficial in this adolescent case series.

Read the original research

Pediatric Cannabinoid Hyperemesis: A Single Institution 10-Year Case Series.

The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 68(2), 255-261

Citation

Lonsdale, Hannah; Kimsey, Kathryn M; Brown, Jerry M; Dey, Aditi; Peck, Jacquelin; Son, Sorany; Wilsey, Michael. (2021). Pediatric Cannabinoid Hyperemesis: A Single Institution 10-Year Case Series.. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 68(2), 255-261. https://doi.org/10.1016/j.jadohealth.2020.09.024

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