Archive for category: Cannabinoid Hyperemesis Syndrome

Cannabis use is becoming more common globally, making it important for physicians to be aware of cannabinoid hyperemesis syndrome (CHS). CHS presents in chronic cannabis users, typically under the age of 50, and entails a severe cyclic nausea and vomiting pattern with abdominal pain but normal bowel habits. Symptoms typically predominate in the morning, are relieved by hot baths or showers, and resolve with discontinuation of cannabis use. This report details a case of a 32-year-old woman who presented to the emergency department at a large Canadian hospital with severe nausea, vomiting and a history of regular use of marijuana cigarettes. In an attempt to alleviate her symptoms she reported taking frequent hot baths and using as many as five marijuana cigarettes per day. The patient’s clinical presentation, chronic daily use of marijuana and relief of symptoms with hot baths led to the diagnosis of CHS. The antiemetic properties of cannabis are widely known in the community, meaning patients may not associate marijuana use with their symptoms. Additionally, cyclic vomiting syndrome is present in many different conditions, making physician awareness of this syndrome crucial. Recognition and diagnosis of this condition can prevent unnecessary, costly diagnostic tests, and provide an opportunity to initiate counselling on cessation.