[Cannabinoid hyperemesis syndrome: A review of the literature]

Cannabis is the most widely used illicit drug in the world. In France, cannabis use has been increasing among youth since 2011, in both experimental use and regular consumption. A distinct syndrome, characterized by recurrent vomiting associated with abdominal pain and compulsive bathing, has been increasingly recognized in adult chronic users. Cannabinoid hyperemesis syndrome (CHS) is still underdiagnosed in adults and even more so among adolescents. Classically, CHS progresses into three distinct phases: prodromal, hyperemetic, and recovery. During the prodromal phase, the patient develops early morning nausea, a fear of vomiting, and abdominal discomfort. Afterward, the hyperemetic phase consists of incapacitating nausea and profuse vomiting. Most patients complain of mild abdominal pain and weight loss. Patients are relieved by taking hot showers. The recovery stage begins with cessation of cannabis use. The majority of patients will develop this symptom within 1-5years after the beginning of consumption. CHS is a clinical diagnosis and should be considered in every case of cyclical vomiting. To date, the specific etiology of CHS is unknown as is the pathophysiology of improvement with hot baths. All youth presenting with cyclic vomiting should be questioned about cannabis use and compulsive hot bathing. The early recognition of this syndrome will save unnecessary and invasive investigations.