Cannabinoid Hyperemesis Syndrome: Literature Review

CHS is characterized by cyclic episodes of severe nausea, vomiting, and abdominal pain in individuals with a history of chronic cannabis use. Despite being paradoxical to the widely known antiemetic properties of cannabis, CHS continues to challenge healthcare professionals due to its often elusive diagnosis and mismanagement. The pathophysiology of CHS remains incompletely understood, but current research suggests that prolonged exposure to cannabinoids may disrupt the endocannabinoid system, resulting in dysregulated thermoregulation, gastrointestinal motility, and emesis. Additionally, genetic factors and individual variations in cannabis use patterns may contribute to the development of CHS. Diagnosis of CHS remains challenging, primarily based on clinical criteria, including a history of regular cannabis use, characteristic cyclic vomiting episodes, and symptom relief with hot showers or baths. Differential diagnosis must exclude other causes of cyclic vomiting, making CHS a diagnosis of exclusion. Management of CHS centers around discontinuing cannabis use, which typically leads to symptom resolution over time. Supportive care, including hydration and antiemetic medications, may be necessary during acute episodes. Capsaicin cream, a topical analgesic, has shown promise in alleviating symptoms in some cases. Behavioral therapy and substance abuse counseling may be essential to prevent relapse.