Cannabinoid-induced Hyperemesis: A Misdiagnosis at Risk

Una medical teacher is concerned that the cannabis hyperemesis disorder (CHS) has been diagnosed without an adequate diagnostic evaluation.

Cannabis or Cannabinoid hyperemesis is sometimes called “scromiting”. It’s a relatively rare condition in which the patient experiences severe abdominal pain and continually vomits — and may scream while doing so. CHS symptoms are often reduced when marijuana is stopped.

The conventional anti-emetic drugs do not always work. Management options are very limited. Some patients may find relief from benzodiazepines and capsaicin. Others might benefit from long hot showers and baths.

Although rare, the use of marijuana for recreational or medicinal purposes (or both) is increasing in America. The reason behind this increase has to do with various initiatives that have legalised cannabis and changing perceptions about cannabis.

This article CHS has a prevalence of 0.1% in general, but is more prevalent among young adults between 18 and 39 years. CHS can be found in up to 32 percent of patients who have cannabis use disorder.

Was it possible that some of the cases were misdiagnosed by doctors? Jordan Tishler – a Harvard Medical School instructor of medicine, and President of the Association of Cannabinoid Specialists – is concerned about this.

Then, you can get in touch with us. article on Stat, Tishler says there’s a risk that clinicians may be attributing any vomiting in a cannabis user to CHS — and the risk is elevated in fast-paced environments such as emergency rooms.

“This sort of knee-jerk thinking is emblematic of the cognitive bias known as ‘anchoring’ — wherein a clinician fixates on an initial piece of information (in this case, cannabis use) and fails to consider alternative or concurrent diagnoses,” he says.

He cites the case of a young person with a history of cannabis use experiencing CHS-type symptoms — and his condition was attributed to that. A further examination revealed that the diagnosis was superior mesenteric syndrome (SMA). This is a life-threatening condition that’s also rare. The proper treatment wasn’t given.

Tishler says that to address the problem, he has:

The institutions should provide clear guidelines for how to correctly diagnose CHS. They must first rule out all other possible causes of vomiting. It is important to train physicians in recognizing and overcoming their implicit biases. This includes those related to substance abuse.