A case report of a severe
cannabis hyperemesis syndrome (CHS) is presented, which had worsened during
dronabinol administration and was associated with intestinal dysmotility (pseudo-obstruction). Because
dronabinol is an isomer of
THC (delta-9-tetrahydrocannabinol), the main psychotropic constituent of cannabis, this case provides first direct clinical evidence on the key role of
THC in the obscure pathogenesis of CHS. Another peculiarity of this case was that the patient had an odyssey of
hospital stays with extensive workups before the patient herself found via Internet the right diagnosis for her cyclic
vomiting and
abdominal pain. This is typical for CHS, which is often overlooked because physicians refer to the widely known
antiemetic properties of cannabis, for example, in
cancer chemotherapy but were not always aware of a possible paradoxical
emetic reaction of recreational cannabis use. Being pathognomonic of CHS, the patient became symptom-free while abstaining from her cannabis use, meanwhile being in her 12th month of controlled abstinence.