81% of Adults with Cyclic Vomiting Syndrome Reported Marijuana Use | Research

The takeaway

In a survey of 514 adults with cyclic vomiting syndrome, 81% reported marijuana use, with most saying it improved nausea, appetite, and stress, while 67% used hot showers for symptom relief.

Read this if you have cyclic vomiting and want to understand the relationship with marijuana use.

81% of CVS patients used marijuana; 67% used hot showers for relief

What the researchers found

Of 437 CVS patients who completed questions about marijuana use, 81% reported use and only 19% had never used. 54% used marijuana for health reasons and 43% for recreational purposes. Users reported improvements in nausea, appetite, general well-being, stress levels, and vomiting.

Marijuana users were more likely to be male and have an associated anxiety disorder. Hot shower/bath use for symptom relief was reported by 67% of all patients, and this was significantly associated with marijuana use (OR 2.54, 95% CI: 1.50-4.31, p=0.0006).

Importantly, hot showers were not exclusive to marijuana users (they were also used by non-users), challenging the assumption that compulsive bathing is pathognomonic (uniquely diagnostic) of cannabinoid hyperemesis syndrome.

Why it matters

The overlap between cyclic vomiting syndrome and cannabinoid hyperemesis syndrome is a significant diagnostic challenge. This study shows that marijuana use is extremely common in CVS patients and that hot showers are used by both marijuana users and non-users, complicating the clinical distinction between these two conditions.

The numbers in context

514 respondents, 437 completed marijuana questions. 81% used marijuana. 54% for health. 43% recreational. 67% used hot showers. Hot shower-marijuana association: OR 2.54 (p=0.0006).

How the study worked

An anonymous internet-based survey was completed by 514 adults (18+) diagnosed with CVS by a healthcare provider. The survey assessed marijuana use patterns, motivations, perceived effects, and hot shower use. Mean age was 34 years, 63% female, 92% Caucasian, 82% from the USA.

What this study cannot tell us

Internet-based surveys are subject to self-selection bias. Patients may not have received accurate diagnoses. The survey could not distinguish between CVS patients who use marijuana for symptom relief and CHS patients who have been misdiagnosed with CVS. The predominantly Caucasian, female, U.S. sample may not be representative.

How to read the evidence

This is an internet-based survey subject to self-selection bias and diagnostic uncertainty between CVS and CHS.

When this study was published

Published in 2014. Understanding of both CVS and CHS has evolved since.

The bigger picture

The relationship between CVS and CHS is complex and controversial. Some patients diagnosed with CVS may actually have CHS, while others with CVS may use marijuana for legitimate symptom relief. This study highlights the need for better diagnostic criteria and careful clinical evaluation.

Questions still open

How many patients diagnosed with CVS actually have CHS? Does marijuana help or worsen CVS symptoms in the long run? Can clinical features reliably distinguish CVS from CHS?

Common questions

What is the difference between CVS and CHS?

Cyclic vomiting syndrome (CVS) involves recurrent episodes of severe vomiting with symptom-free intervals. Cannabinoid hyperemesis syndrome (CHS) has similar symptoms but is caused by chronic cannabis use and resolves with cessation. Distinguishing them in cannabis users is challenging.

Why do hot showers help?

The mechanism is not fully understood. Hot water may activate TRPV1 receptors or redirect blood flow. The finding that non-marijuana users also use hot showers suggests this behavior is not unique to CHS and may be a general response to severe nausea.

Read the original research

An Internet survey of marijuana and hot shower use in adults with cyclic vomiting syndrome (CVS).

Experimental brain research, 232(8), 2563-70

View on PubMed ↗Publisher’s paper ↗

Citation

Venkatesan, Thangam; Sengupta, Jyotirmoy; Lodhi, Atena; Schroeder, Abigail; Adams, Kathleen; Hogan, Walter J; Wang, Yanzhi; Andrews, Christopher; Storr, Martin. (2014). An Internet survey of marijuana and hot shower use in adults with cyclic vomiting syndrome (CVS).. Experimental brain research, 232(8), 2563-70. https://doi.org/10.1007/s00221-014-3967-0