Cannabinoid hyperemesis and compulsive bathing: a case series and paradoxical pathophysiological explanation

Area of Science:

• Gastroenterology
• Toxicology
• Psychiatry

Background:

• Cannabinoid hyperemesis syndrome (CHS) is a poorly understood condition.
• It is associated with chronic, heavy cannabis use.
• Patients often exhibit compulsive bathing behaviors that provide temporary relief.

Observation:

• Four adult patients presented with severe cyclical vomiting.
• Extensive gastrointestinal workups did not reveal an alternative diagnosis.
• All patients reported chronic marijuana abuse.

Findings:

• Discontinuation of marijuana use led to complete symptom resolution in all patients.
• The characteristic compulsive bathing was also alleviated upon cessation.
• CHS should be considered in patients with unexplained cyclical vomiting.

Implications:

• Increasing marijuana use necessitates greater awareness of CHS among clinicians.
• This syndrome poses a diagnostic challenge due to its cyclical nature and association with substance abuse.
• Prompt identification and intervention (cessation of marijuana) are key to managing CHS.