The 98-Patient Case Series That Shaped Cannabinoid Hyperemesis

Retrospective case series from a single academic center. Electronic medical records from January 1, 2005 to June 15, 2010 were screened. Inclusion required recurrent vomiting without another identified cause and cannabis use preceding symptom onset. Of 1,571 records initially identified, 98 patients met inclusion criteria. Symptom features, cannabis exposure history, and bathing behavior were abstracted when documented. Follow-up information was available for only 10 patients. No control group and no standardized toxicology confirmation were reported in the abstract.

By 2012, clinicians were seeing patients with cyclic vomiting, abdominal pain, and a peculiar report that hot showers gave relief. Individual case reports were accumulating, but a larger, structured series had been missing. This study gathered nearly 100 such patients into one dataset, described the shared features, and outlined criteria that many clinicians began using to recognize cannabinoid hyperemesis in practice.

Cannabinoid hyperemesis has been easy to miss because its core symptoms overlap with other conditions like cyclic vomiting syndrome and gastroparesis. This series helped codify a recognizable profile: younger age, frequent long-term cannabis exposure, recurrent vomiting with abdominal pain, and relief with hot bathing. The resolution reported by most of the few who stopped using cannabis suggests a potential exposure-outcome link, but the limited and selective follow-up means that conclusion cannot be generalized from this dataset alone. The proposed diagnostic criteria from this paper influenced how CH is discussed and documented, even as unanswered questions remain about mechanisms, risk factors, and prevalence.

Single-center retrospective design with no control group. Case identification relied on chart documentation and clinician judgment, which introduces selection and misclassification risk. Key exposure variables were missing for many patients, including exact duration, dose, product type, and potency. Hot bathing behavior was only documented for a subset. Only 10 percent had follow-up data, and cessation was self-reported without objective verification. The series included only patients under 50, limiting generalizability to older adults.