Cannabinoids Hyperemesis Syndrome

Cannabinoid hyperemesis syndrome (CHS) is characterized by chronic marijuana use, cyclic vomiting, abdominal pain, and compulsive need to take hot showers. This syndrome is an episodic, recurrent disorder in which three phases have been described: a prodromal, hyper-emetic, and a recovery phase with resolution of symptoms upon cessation of marijuana use.
We report a case of a 33-year- old female with long history of cannabinoid use who presented to emergency department complaining of abdominal pain, nausea and vomiting for 3 days. She reported having recurrent similar episodes for the last 4 years, usually every 3 - 4 months. An extensive gastrointestinal evaluation was done before, but failed to identify a clear cause for her symptoms. Based on the diagnostic criteria for CHS, the diagnosis of CHS was made. After discharge the patient had a symptom-free period with the cessation of marijuana use. However, she relapsed later and her symptoms returned.
This case illustrates the importance of having a high index of suspicion for CHS in patients with history of cannabis use, since earlier recognition of can help reduce unnecessary workups, doctor visits, and hospital admissions.