What topics does this cannabis study cover?

This study covers research on: THC, Nausea, Pain, Endocannabinoid.

Where was this research published?

Published in Clinical medicine insights. Case reports on January 1, 2026.

Topical capsaicin may calm severe cannabis-related vomiting

Q: What did this Case Study find?

In a case of refractory *cannabinoid hyperemesis syndrome*, topical capsaicin was followed by **rapid cessation of retching** and resolution of abdominal pain.

Successful Management of Refractory Cannabinoid Hyperemesis Syndrome With Topical Capsaicin: A Case Report With Proposed Mechanism of Action and Literature Review.

Clinical medicine insights. Case reports • January 1, 2026 • Case Study • Highly Relevant

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AI Summary

Cannabinoid hyperemesis syndrome (CHS) can cause repeated episodes of severe nausea, vomiting, and abdominal pain in people who use cannabis heavily over long periods. In this case, a 28-year-old man using high-potency cannabis daily experienced 48 hours of persistent vomiting, with symptoms that had previously improved during prolonged hot showers. Standard emergency treatments offered little relief, while the illness was accompanied by dehydration-related laboratory abnormalities.

After about 2 g of 0.1% topical capsaicin cream was applied to his abdomen, retching stopped within 10 minutes, pain decreased substantially within 30 minutes, and resolved by 90 minutes. He was able to eat and had returned to baseline laboratory values at follow-up. The authors propose that capsaicin activates and then desensitizes TRPV1 heat-sensitive channels, reproducing the benefit of hot water. The report supports topical capsaicin as an accessible adjunct for refractory CHS, but larger controlled studies are still needed to establish dosing, treatment duration, and long-term benefits. Cannabis cessation remains central to preventing recurrent episodes.

💡 Key Findings

In a case of refractory cannabinoid hyperemesis syndrome, topical capsaicin was followed by rapid cessation of retching and resolution of abdominal pain.

Moderate

50%

The patient’s symptoms improved after approximately 2 g of 0.1% capsaicin cream, with only transient local burning reported.

Moderate

50%

The proposed mechanism is activation followed by peripheral desensitization of TRPV1 channels, potentially reproducing the relief associated with hot showers.

Moderate

45%

The authors describe topical capsaicin as a potentially accessible adjunct, while emphasizing that larger controlled studies are needed.

Good

70%

Cannabis cessation counseling was part of the patient’s discharge plan, underscoring that stopping cannabis use remains important in CHS management.

Good

65%

📄 Original Abstract

Cannabinoid hyperemesis syndrome (CHS) is a debilitating disorder of chronic, heavy cannabis users characterized by cyclic severe nausea, vomiting, and abdominal pain that is classically relieved by hot baths. Standard antiemetics often fail, and dysregulation of endocannabinoid signaling with involvement of heat-sensitive TRPV1 channels has been proposed. Topical capsaicin - a TRPV1 agonist - has been reported in small series and case reports to reproduce the hot-water effect and rapidly relieve symptoms. A 28-year-old man with daily high-potency cannabis use (∼2 g/day for 7 years) presented to the emergency department with 48 hours of intractable non-bilious vomiting (∼20 episodes/day), severe periumbilical cramping (8/10), and a history of similar episodic flares relieved by prolonged hot showers. Initial ED therapy (IV fluids, ondansetron, metoclopramide, pantoprazole) produced minimal benefit; labs showed hypokalemic, hypochloremic metabolic alkalosis and pre-renal azotemia, with otherwise unremarkable imaging and enzymes. After informed consent, ∼2 g of 0.1% topical capsaicin cream was applied across the abdomen. The patient experienced an acute burning sensation for ∼15-30 minutes; retching ceased within 10 minutes, pain fell to 2/10 by 30 minutes and resolved by 90 minutes, and he tolerated oral intake. Vital signs normalized and electrolytes/renal function returned to baseline at 48-hour follow-up. He was discharged with counseling on cannabis cessation and a capsaicin tube for prodromal use. Topical capsaicin produced rapid, durable symptom resolution in this case of refractory CHS with only transient local discomfort. The effect is plausibly mediated by TRPV1 activation followed by peripheral desensitization, recapitulating the therapeutic hot-water response. Given consistent positive signals from case reports, series, and small pilot data, topical capsaicin is a low-risk, accessible adjunct for refractory CHS, but larger controlled studies are needed to define optimal dosing, duration, and long-term outcomes.

Paper Type

📋 Case Study

Publication

Journal: Clinical medicine insights. Case reports
Published: January 1, 2026
PMID: 42491286
DOI: 10.1177/11795476261470568

Authors (5)

Muhammad Ilyas King Edward Medical University, Lahore, Pakistan.
Anushka Fernando Department of Biological and Medical Sciences, Oxford Brookes University, Oxford, UK.
Abubakir Choriyev Department of Basic Medical Sciences, Termez University of Economics and Service, Termez, Uzbekistan.
Mohammad Adi Faculty of Medicine, Damascus University, Damascus, Syria.
Ahmed Ashraf Faculty of Medicine, Tanta University, Tanta, Egypt.