Cannabinoid Hyperemesis Syndrome

The differential diagnosis of abdominal cramping accompanied by nausea and vomiting, is overwhelmingly broad. It demands a finely detailed history to further tease out an etiology as well as directed treatments. In addition to infectious and neurologic causes of said symptoms, it is important to remember potential chemical causes responsible for clinical pictures featuring abdominal cramping, nausea, and vomiting. In 2004, a peculiar syndrome of vomiting associated with chronic cannabis use appeared in the literature with the curious historical qualifier that symptoms seemed to be relieved with hot showering or bathing.[1][2] This syndrome came to be known as cannabinoid hyperemesis syndrome (CHS). With the increasing use of cannabis among all manner of age groups, especially recreationally among adolescents as well as medically for use as an antiemetic in chemotherapy-induced vomiting, appetite stimulant in those with cachexia, and analgesic (e.g., for peripheral neuropathies) and as an antispasmodic in multiple sclerosis, it is important to recognize this phenomenon’s risk factors and presentation in both emergency and primary care.[1][3][4]