Topical Capsaicin for Treating Cannabinoid Hyperemesis Syndrome

Area of Science:

• Gastroenterology
• Toxicology

Background:

• Cannabinoid hyperemesis syndrome (CHS) is increasingly prevalent due to rising marijuana use.
• CHS patients often present with severe, cyclical nausea and vomiting, refractory to standard treatments.
• This condition necessitates novel therapeutic strategies beyond typical antiemetics and analgesics.

Observation:

• A case study involving a 41-year-old female with a history of excessive cannabis consumption presented with severe epigastric pain, nausea, and vomiting.
• Despite standard emergency department interventions including IV fluids, antiemetics, and morphine, the patient experienced no symptomatic relief.
• Diagnostic workup, including laboratory tests, EKG, and CT scans, yielded unremarkable results, pointing towards CHS.

Findings:

• Topical capsaicin applied to the epigastric region provided rapid and dramatic symptom relief within 24 hours.
• Endoscopic re-evaluation confirmed no underlying gastrointestinal pathology such as ulcers, celiac disease, or esophagitis.
• The patient was discharged on topical capsaicin and advised on marijuana abstinence, remaining symptom-free post-discharge.

Implications:

• Topical capsaicin represents a viable and effective alternative treatment for cannabinoid hyperemesis syndrome.
• This intervention may reduce reliance on opioids and other antiemetics for CHS management.
• Further research into capsaicin's efficacy in CHS is warranted to establish it as a standard treatment option.