A Young Woman With Diabetes Was Misdiagnosed With Gastroparesis for Two Years Before Cannabis Was Identified as the Cause
A 23-year-old woman with type 1 diabetes had monthly ER visits for two years for intractable vomiting attributed to diabetic gastroparesis, until cannabinoid hyperemesis syndrome was identified and symptoms resolved completely after stopping cannabis.
Quick Facts
What This Study Found
The patient presented monthly to the ER for two years with intractable nausea and vomiting, managed as diabetic gastroparesis despite a normal gastric emptying study. She reported consistent cannabis use for several years and symptom relief with hot baths. After counseling, she stopped cannabis for two months and was completely symptom-free.
Key Numbers
Monthly ER visits for 2 years. Normal gastric emptying study 6 months prior. Multiple unremarkable abdominal CT scans. Complete symptom resolution after 2 months cannabis cessation.
How They Did This
Single case report of a 23-year-old woman with uncontrolled type 1 diabetes presenting with cannabinoid hyperemesis syndrome misdiagnosed as diabetic gastroparesis.
Why This Research Matters
Cannabinoid hyperemesis syndrome (CHS) can mimic conditions common in diabetes like gastroparesis, leading to years of misdiagnosis. This case underscores the importance of asking about cannabis use in patients with cyclic vomiting, especially when standard treatments fail and gastric emptying is normal.
The Bigger Picture
As cannabis use becomes more common, CHS diagnoses are increasing. But in patients with pre-existing conditions that cause similar symptoms, like diabetes, cannabis as a cause may be overlooked for years. The hot bath relief pattern is a clinical clue that should prompt cannabis use inquiry.
What This Study Doesn't Tell Us
Single case report cannot establish generalizable patterns. The patient had uncontrolled diabetes, which could contribute to GI symptoms independently. No objective measurement of cannabis use or cessation.
Questions This Raises
- ?How many patients with diabetes and cyclic vomiting have unrecognized CHS?
- ?Should screening for cannabis use be standard in diabetes patients presenting with unexplained GI symptoms?
Trust & Context
- Key Stat:
- 2 years of misdiagnosis resolved by identifying cannabis as the cause
- Evidence Grade:
- Single case report providing a clinical teaching point but no statistical evidence.
- Study Age:
- Published 2023.
- Original Title:
- Cannabinoid Hyperemesis Syndrome in a 23-Year-Old Woman with Uncontrolled Type 1 Diabetes Mellitus.
- Published In:
- The American journal of case reports, 24, e938418 (2023)
- Database ID:
- RTHC-04807
Evidence Hierarchy
Describes what happened to one person or a small group.
What do these levels mean? →Frequently Asked Questions
Can cannabis cause vomiting even though it is used for nausea?
Yes. Cannabinoid hyperemesis syndrome causes cyclic vomiting in chronic cannabis users, paradoxically opposite to the anti-nausea effects cannabis is known for.
How was CHS identified in this patient?
After two years of treatment for presumed diabetic gastroparesis, detailed drug history revealed chronic cannabis use and symptom relief with hot baths, classic signs of CHS. Symptoms resolved after stopping cannabis.
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Cite This Study
https://rethinkthc.com/research/RTHC-04807APA
Nana Sede Mbakop, Raissa; Kesiena, Onoriode; Greene, Tayla E; Amakye, Dominic. (2023). Cannabinoid Hyperemesis Syndrome in a 23-Year-Old Woman with Uncontrolled Type 1 Diabetes Mellitus.. The American journal of case reports, 24, e938418. https://doi.org/10.12659/AJCR.938418
MLA
Nana Sede Mbakop, Raissa, et al. "Cannabinoid Hyperemesis Syndrome in a 23-Year-Old Woman with Uncontrolled Type 1 Diabetes Mellitus.." The American journal of case reports, 2023. https://doi.org/10.12659/AJCR.938418
RethinkTHC
RethinkTHC Research Database. "Cannabinoid Hyperemesis Syndrome in a 23-Year-Old Woman with..." RTHC-04807. Retrieved from https://rethinkthc.com/research/nana-2023-cannabinoid-hyperemesis-syndrome-in
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.