{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T18:43:20Z","timestamp":1770230600249,"version":"3.49.0"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T00:00:00Z","timestamp":1732060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Cannabinoid hyperemesis syndrome (CHS) is an increasingly recognized condition linked to chronic cannabis use, yet it remains frequently overlooked in clinical practice. The syndrome is characterized by cyclic episodes of severe nausea, vomiting, and abdominal pain, often relieved temporarily by hot showers or baths. With the rising prevalence of cannabis use following its legalization, the incidence of CHS has surged, presenting a significant challenge in both diagnosis and management within primary healthcare settings. Understanding the epidemiology, risk factors, and potential long-term sequelae of CHS is crucial for timely identification and intervention. This case report highlights the challenge of diagnosis and management of CHS in primary healthcare.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective(s)<\/jats:title>\n                  <jats:p>To emphasize the importance of proper counseling and the use of Rome IV criteria in diagnosing CHS. To illustrate how this may reduce patient suffering and unnecessary investigation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case<\/jats:title>\n                  <jats:p>A 22-year-old female with chronic, daily cannabis use presented with recurrent episodes of intense nausea, vomiting, and abdominal pain over a 2-year period. Extensive diagnostic evaluations were inconclusive. A tentative diagnosis of CHS was made by a medical student and family doctor based on published criteria. The Rome IV criteria were then applied for confirmation of diagnosis and management. In so doing, the patient was advised to cease cannabis use for a minimum of 3 months. Initially, symptom improvement was reported with cannabis cessation. However, symptoms recurred following a relapse in cannabis use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>To confirm the diagnosis of CHS, counseling should specify the need for a minimum of 3 months of cannabis cessation to achieve symptom relief. Increased physician and patient awareness of this minimal time period for drug cessation can help to avoid unnecessary investigations, and prolonged patient suffering. This case emphasizes the need for vigilance in recognizing CHS and consideration of cannabis as a potential cause of cyclic vomiting.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/fampra\/cmae067","type":"journal-article","created":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T22:13:41Z","timestamp":1732140821000},"source":"Crossref","is-referenced-by-count":2,"title":["Proper counseling for diagnosis and management of cannabinoid hyperemesis syndrome: a case report"],"prefix":"10.1093","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8056-1004","authenticated-orcid":false,"given":"Samuel","family":"Cholette-T\u00e9trault","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health Sciences, McGill University , 3605 Rue de la Montagne, Montreal H3G 2M1 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1591-613X","authenticated-orcid":false,"given":"Roland","family":"Grad","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, McGill University , 5858 Chem. de la C\u00f4te-des-Neiges, Montr\u00e9al, QC H3S 1Z1 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,11,20]]},"reference":[{"key":"2025021912252843800_CIT0001","doi-asserted-by":"publisher","first-page":"E1351","DOI":"10.1503\/cmaj.230808","article-title":"Outcomes associated with nonmedical cannabis legalization policy in Canada: taking stock at the 5-year mark","volume":"195","author":"Fischer","year":"2023","journal-title":"CMAJ"},{"key":"2025021912252843800_CIT0002","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1007\/s13181-016-0595-z","article-title":"Cannabinoid hyperemesis syndrome: diagnosis, pathophysiology, and treatment\u2014a systematic review","volume":"13","author":"Sorensen","year":"2016","journal-title":"J Med Toxicol"},{"key":"2025021912252843800_CIT0003","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1016\/j.mayocp.2011.10.005","article-title":"Cannabinoid hyperemesis: a case series of 98 patients","volume":"87","author":"Simonetto","year":"2012","journal-title":"Mayo Clin Proc"},{"key":"2025021912252843800_CIT0004","first-page":"33","article-title":"Cannabinoid hyperemesis syndrome","volume":"34","author":"Fleming","year":"2017","journal-title":"Fed Pract"},{"key":"2025021912252843800_CIT0005","author":"Rome Foundation","year":"2023"},{"key":"2025021912252843800_CIT0006","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1111\/bcpt.12962","article-title":"The prevalence of cannabinoid hyperemesis syndrome among regular marijuana smokers in an urban public hospital","volume":"122","author":"Habboushe","year":"2018","journal-title":"Basic Clin Pharmacol Toxicol"},{"key":"2025021912252843800_CIT0007","author":"Reid","year":"2023","journal-title":"Cannabinoid Hyperemesis Syndrome. 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