Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Mar 14, 2009; 15(10): 1264-1266
Published online Mar 14, 2009. doi: 10.3748/wjg.15.1264
Cannabinoid hyperemesis syndrome: Clinical diagnosis of an underrecognised manifestation of chronic cannabis abuse
Siva P Sontineni, Sanjay Chaudhary, Vijaya Sontineni, Stephen J Lanspa
Siva P Sontineni, Sanjay Chaudhary, Vijaya Sontineni, Stephen J Lanspa, Department of Medicine, Creighton University, Suite 5850, 601 N 30th Street, Omaha, NE 68131, United States
Author contributions: Sontineni SP provided the patient’s data, organized, conceptualized and contributed to the manuscript writing and final approval; Chaudhary S collected the patient data, reviewed the literature and contributed to the manuscript writing; Sontineni V reviewed the literature and compiled the references; Lanspa SJ supervised, provided critical review and obtained financial support from the division; All authors approved the final manuscript.
Correspondence to: Siva P Sontineni, MD, Department of Internal Medicine, 601 N 30th St Suite 5850, Creighton University Medical Centre, Omaha, NE 68131, United States. ssontineni@gmail.com
Telephone: +1-402-4158319
Fax: +1-402-2804220
Received: October 25, 2008
Revised: February 8, 2009
Accepted: February 15, 2009
Published online: March 14, 2009
Abstract

Cannabis is a common drug of abuse that is associated with various long-term and short-term adverse effects. The nature of its association with vomiting after chronic abuse is obscure and is underrecognised by clinicians. In some patients this vomiting can take on a pattern similar to cyclic vomiting syndrome with a peculiar compulsive hot bathing pattern, which relieves intense feelings of nausea and accompanying symptoms. In this case report, we describe a twenty-two year-old-male with a history of chronic cannabis abuse presenting with recurrent vomiting, intense nausea and abdominal pain. In addition, the patient reported that the hot baths improved his symptoms during these episodes. Abstinence from cannabis led to resolution of the vomiting symptoms and abdominal pain. We conclude that in the setting of chronic cannabis abuse, patients presenting with chronic severe nausea and vomiting that can sometimes be accompanied by abdominal pain and compulsive hot bathing behaviour, in the absence of other obvious causes, a diagnosis of cannabinoid hyperemesis syndrome should be considered.

Keywords: Cannabinoid; Cannabis; Cyclic vomiting; Hyperemesis; Marijuana; Vomiting