Two pediatric patients with chronic marijuana use developed severe nausea and vomiting that resolved only when they stopped using cannabis, marking the first reported cases of cannabinoid hyperemesis in adolescents.
Read this if you want to know about severe vomiting episodes linked to cannabis use in young people.
First pediatric cases of cannabinoid hyperemesis syndrome reported
What the researchers found
Two adolescent patients presented with severe nausea and uncontrollable vomiting (hyperemesis) in the setting of chronic marijuana use. Both underwent extensive gastrointestinal workups that failed to identify any other cause.
In both cases, symptoms resolved when the patients stopped using marijuana. Both patients also displayed compulsive bathing behavior, a hallmark feature of cannabinoid hyperemesis syndrome (CHS) that had been consistently reported in adult cases.
These represented the first documented cases of CHS in pediatric patients, as the syndrome had previously been described only in adults.
Why it matters
This report expanded recognition of cannabinoid hyperemesis syndrome to include adolescent patients, suggesting clinicians should consider CHS in younger patients with unexplained cyclic vomiting and marijuana use history.
The numbers in context
2 pediatric patients. Both had extensive GI workups with no identified cause. Both exhibited compulsive bathing. Both improved with cannabis cessation.
How the study worked
Case report of two pediatric patients presenting to the emergency department with severe cyclic vomiting and chronic marijuana use histories. Both received extensive gastrointestinal evaluations. Symptom resolution was documented after cannabis cessation.
What this study cannot tell us
Case reports cannot establish causation and represent only two patients. The mechanism of CHS remained poorly understood at the time.
How to read the evidence
Case report of two patients. Useful for identifying new clinical presentations but cannot establish prevalence or causation.
When this study was published
Published in 2010. CHS has since been widely recognized in both adult and pediatric populations.
The bigger picture
As cannabis use among adolescents increased, recognizing CHS in this age group became important for avoiding unnecessary testing and delayed diagnosis.
Questions still open
- How common is CHS among adolescent cannabis users? Are there risk factors that make some young users more susceptible than others?
Common questions
What is cannabinoid hyperemesis syndrome?
Why did these patients take compulsive baths?
Read the original research
Pediatric cannabinoid hyperemesis: two cases.
Pediatric emergency care, 26(12), 919-20
Citation
Miller, Joseph B; Walsh, Mark; Patel, Pankaj A; Rogan, Michael; Arnold, Cliff; Maloney, Megan; Donnino, Michael. (2010). Pediatric cannabinoid hyperemesis: two cases.. Pediatric emergency care, 26(12), 919-20. https://doi.org/10.1097/PEC.0b013e3181fe9189
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