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Study breakdown

A Clinician's Guide to Diagnosing and Treating Cannabinoid Hyperemesis Syndrome

ReviewModerate evidence
The takeaway

CHS is under-diagnosed, presents with cyclic vomiting and compulsive hot shower use, and often fails to respond to standard anti-nausea medications.

Emergency physicians, primary care clinicians, and gastroenterologists.

Standard antiemetics often fail for CHS; abstinence is the only effective long-term approach

What the researchers found

CHS is characterized by cyclic, severe vomiting, compulsive hot showering, and chronic cannabis use history. Standard antiemetics may not fully work. Abstinence remains the most effective long-term approach.

Why it matters

CHS is under-recognized, leading to repeated unnecessary ER visits and testing. Better recognition could reduce costs and patient suffering.

The numbers in context

Ondansetron may not fully attenuate symptoms. Abstinence is most effective prevention.

How the study worked

Clinical review article aimed at helping clinicians identify and treat CHS.

What this study cannot tell us

Narrative review. CHS pathophysiology incompletely understood. Treatment evidence from case reports mostly.

How to read the evidence

Clinical review drawing on limited but growing CHS literature.

When this study was published

Published in 2024.

The bigger picture

As cannabis use shifts toward higher potency and frequency, CHS will likely become increasingly common.

Questions still open

  • What minimum cannabis exposure triggers CHS?
  • Are some individuals genetically predisposed?

Common questions

What is cannabinoid hyperemesis syndrome?
CHS causes severe cyclic vomiting in chronic cannabis users, often with compulsive hot showering. Standard anti-nausea drugs frequently fail.
How is CHS treated?
Various interventions help acutely, but complete cannabis abstinence is the only proven long-term prevention.

Read the original research

Cannabinoid Hyperemesis Syndrome (CHS) - An emerging gastrointestinal disorder and clinical challenge.

Disease-a-month : DM, 70(12), 101832

Citation

McFee, R B. (2024). Cannabinoid Hyperemesis Syndrome (CHS) - An emerging gastrointestinal disorder and clinical challenge.. Disease-a-month : DM, 70(12), 101832. https://doi.org/10.1016/j.disamonth.2024.101832

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