The 23-year-old woman arrived at the hospital and could not stop vomiting – again.
For almost two years, the young woman had visited the emergency department nearly every month with the same symptoms: nausea, abdominal pain, and throwing up uncontrollably.
Doctors initially thought the patient's woes were caused by gastroparesis, a condition where the stomach doesn't empty properly. The digestive disorder commonly affects people with diabetes, which this patient had.
However, previous studies and scans of her digestive system had come back normal, and the medication prescribed to treat gastroparesis wasn't helping.
It was only when the woman mentioned she was a frequent cannabis user that her doctors began to consider a new diagnosis, according to a recently released report in the American Journal of Case Reports.
A key clue was hot baths that relieved her symptoms
On one of her ER trips, the patient's urine tested positive for cannabis, and she told doctors that she smoked cannabis at least five times a week.
She said she had smoked two days before her most recent hospital visit. But smoking didn't ease her symptoms; in fact, the only thing that made her feel better was taking hot baths at home.
Many people use cannabis to reduce nausea, whether it's for a hangover or symptoms of chronic illness.
At low doses, the drug has been shown to be effective in helping to treat nausea, especially for patients undergoing chemotherapy.
But in high doses, that's not always the case. In this situation, doctors realized that the drug was actually causing the patient's gastrointestinal distress.
Doctors diagnosed the woman with cannabinoid hyperemesis syndrome (CHS), a condition characterized by bouts of severe nausea and vomiting in people who frequently use high doses of cannabis for long periods of time.
One of the key features of CHS is that patients report hot baths or showers can help relieve symptoms. Sufferers have been known to spend hours in hot water to soothe their nausea.
The patient's symptoms stopped when she quit cannabis
While hot showers and baths can help, the only permanent cure for CHS is quitting cannabis.
Once she was diagnosed with CHS, the patient got counseling to help her stop using cannabis. She was successful for two months, during which she remained symptom-free, but the nausea and vomiting came back when she started using cannabis again.
The authors of the case report said that this patient's case underscores the importance of considering a complete drug history for all patients, especially those experiencing severe nausea and vomiting that only subsides in a hot shower or bath.
They say that since recreational cannabis use has been legalized in 21 states and Washington, DC, in the past 10 years, doctors may be seeing more patients with CHS in emergency rooms as cannabis use becomes more widespread.
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