Cannabis Hyperemesis Syndrome: A Still Under-Recognized Syndrome

Authors

• Attout Hassene Internal Medicine Unit, General Hospital, Ales, France
• Amichi Sofia Internal Medicine Unit, General Hospital, Ales, France
• Josse Françoise Internal Medicine Unit, GHER, Saint-Benoît, Reunion
• Appavoupoule Vincent Internal Medicine Unit, GHER, Saint-Benoît, Reunion
• Randriajohany Andrey Internal Medicine Unit, GHER, Saint-Benoît, Reunion
• Thirapathi Yogananda Internal Medicine Unit, GHER, Saint-Benoît, Reunion

dr.attout@ch-ales.fr

Keywords

Abstract

Cannabis is one of the most widely used illicit drugs in the world. Its use is associated with several short- and long-term side-effects such as changes in mood, impaired memory, impaired attention, depression and anxiety, and it is correlated with schizophrenia. Cannabinoid hyperemesis syndrome (CHS) is characterized by chronic cannabis use, cyclic intractable nausea and vomiting, and compulsive hot bathing. Patients are typically diagnosed with CHS only after multiple medical evaluations. Recent research has identified type 1 cannabinoid receptors in the intestinal nerve plexus that have an inhibitory effect on gastrointestinal motility. This effect may explain hyperemesis in cannabis users. The thermoregulatory role of endocannabinoids may be responsible for compulsive hot bathing. We describe the cases of two young men seeking repeated emergency room care with recurrent nausea and vomiting. Abstinence from cannabis led to resolution of vomiting symptoms and abdominal pain.