Cannabinoid hyperemesis syndrome affected 1.6% of patients with unexplained abdominal pain in French ERs | Research

The takeaway

Among nearly 2,850 patients presenting to two French emergency departments with unexplained abdominal pain, 48 (1.6%) met criteria for cannabinoid hyperemesis syndrome, with hot showers being the most effective treatment.

Emergency physicians, gastroenterologists, and healthcare administrators.

1.6% of unexplained abdominal pain cases were cannabinoid hyperemesis syndrome

What the researchers found

CHS patients used cannabis daily and spent significantly more hours in emergency departments (11 vs. 6.5 hours) with more frequent visits (4.9 vs. 3). Hot showers were the most effective symptom relief in 54.2% of cases. Follow-up was limited, and cannabis cessation was difficult to implement.

Why it matters

This is one of few prospective studies quantifying CHS prevalence in emergency settings, showing it is both underrecognized and resource-intensive in terms of ED utilization.

The numbers in context

Target population: 2,848 patients. CHS cases: 48 (1.6%). All 48 used cannabis daily. Hot shower effective: 54.2%. Mean ED hours with CHS: 11 vs. 6.5. Mean ED visits: 4.9 vs. 3. Hospitalized: 20.3%.

How the study worked

Prospective cohort study recruiting patients with unexplained abdominal pain syndrome from two Marseille hospital emergency departments (October 2017 to July 2018). CHS was defined as chronic cannabis use with nausea and vomiting per Simonetto criteria.

What this study cannot tell us

Relatively small CHS cohort (48 patients). Limited to two hospitals in one French city. Follow-up was limited, preventing assessment of long-term outcomes. Prospective identification depended on clinical suspicion.

How to read the evidence

Prospective design with standardized diagnostic criteria strengthens findings, though limited sample size.

When this study was published

Published in 2021 with data from 2017-2018.

The bigger picture

CHS places a disproportionate burden on emergency departments through longer visits and repeat presentations, highlighting the need for better outpatient management strategies.

Questions still open

Why is cannabis cessation so difficult for CHS patients despite severe symptoms? Could capsaicin cream replace hot showers as a more practical treatment?

Common questions

How common is CHS in emergency departments?

In this study, 1.6% of patients presenting with unexplained abdominal pain met criteria for CHS. All were daily cannabis users.

What treatment works best for CHS?

Hot showers were the most effective symptom relief in 54.2% of cases, but the only true treatment is stopping cannabis use, which proved difficult to implement.

Read the original research

Cannabinoid hyperemesis syndrome in two French emergency departments: a prospective cohort.

Fundamental & clinical pharmacology, 35(1), 186-191

View on PubMed ↗Publisher’s paper ↗

Citation

Weiss, Julie; Torrents, Romain; Verhamme, Baptiste; Roch, Antoine; Lazerges, Pierre; Jego, Maeva; Michelet, Pierre; Simon, Nicolas. (2021). Cannabinoid hyperemesis syndrome in two French emergency departments: a prospective cohort.. Fundamental & clinical pharmacology, 35(1), 186-191. https://doi.org/10.1111/fcp.12580