Cannabinoid hyperemesis syndrome | |
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People with CHS often find some relief with hot showers[1] | |
Specialty | Toxicology |
Symptoms | Nausea, vomiting, stomach pain[2] |
Complications | Kidney failure, electrolyte problems, skin burns from hot water[1] |
Causes | Long term cannabis use[2] |
Diagnostic method | Based on the symptoms[1] |
Differential diagnosis | Cyclical vomiting syndrome[1] |
Treatment | Stopping cannabis, hot showers, capsaicin cream, haloperidol[2][1][3] |
Frequency | 2.7 million per year (US)[1] |
Cannabinoid hyperemesis syndrome (CHS) is recurrent nausea, vomiting, and cramping abdominal pain due to cannabis use.[3] These symptoms may improve temporarily by taking a hot shower or bath.[1] Complications may include kidney failure, electrolyte problems, and skin burns from hot water.[1] At least two deaths have been associated with CHS.[1][4][5]
Daily or weekly cannabis use for several years is generally required for the syndrome to occur.[1][3][6] The underlying mechanism is unclear, with several possibilities proposed.[1] Diagnosis is based on the symptoms.[1] The condition is typically present for some time before the diagnosis is made.[1] Another condition that may present similarly is cyclic vomiting syndrome.[1]
Definitive treatment involves stopping use of cannabis.[1] Up to two weeks may be required to see a benefit.[1] Treatments during an episode of vomiting is generally supportive in nature.[1] There is tentative evidence for the use of capsaicin cream on the abdomen and haloperidol during an acute episode.[1][3]
The number of people affected is unclear.[7] Of those who go to the emergency department in the United States with recurrent vomiting, about 6% have the condition.[1] While legalization did not affect the rates, commercialization of cannabis results in an increase.[8] The syndrome was first described in 2004, and simplified diagnostic criteria published in 2009.[9][10]
References
edit- ^ a b c d e f g h i j k l m n o p q r s Chocron, Y; Zuber, JP; Vaucher, J (19 July 2019). "Cannabinoid hyperemesis syndrome". BMJ (Clinical research ed.). 366: l4336. doi:10.1136/bmj.l4336. PMID 31324702.
- ^ a b c Sullivan, S (May 2010). "Cannabinoid hyperemesis". Canadian Journal of Gastroenterology. 24 (5): 284–5. doi:10.1155/2010/481940. PMC 2886568. PMID 20485701.
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: CS1 maint: unflagged free DOI (link) - ^ a b c d Sorensen, Cecilia J.; DeSanto, Kristen; Borgelt, Laura; Phillips, Kristina T.; Monte, Andrew A. (20 December 2016). "Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment—a Systematic Review". Journal of Medical Toxicology. 13 (1): 71–87. doi:10.1007/s13181-016-0595-z. PMC 5330965. PMID 28000146.
- ^ Rudavsky, Shari. "He loved weed. Then the vomiting began. Months later, he died". USA TODAY. Archived from the original on 1 November 2020. Retrieved 2 February 2020.
- ^ Soota, Kaartik; Lee, Ye-Jin; Schouweiler, Katie; Keeney, Matthew; Nashelsky, Marcus; Holm, Adrian (October 2016). "Cases of Death Secondary to Cannabinoid Hyperemesis Syndrome: 2217". American Journal of Gastroenterology. pp. S1063. Archived from the original on 15 January 2021. Retrieved 2 February 2020.
- ^ Chu, F; Cascella, M (January 2023). "Cannabinoid Hyperemesis Syndrome". StatPearls. PMID 31751105. Archived from the original on 2023-01-04. Retrieved 2023-05-25.
- ^ Lu, ML; Agito, MD (July 2015). "Cannabinoid hyperemesis syndrome: Marijuana is both antiemetic and proemetic". Cleveland Clinic Journal of Medicine. 82 (7): 429–34. doi:10.3949/ccjm.82a.14023. PMID 26185942.
- ^ Myran, Daniel Thomas; Roberts, Rhiannon; Pugliese, Michael; Taljaard, Monica; Tanuseputro, Peter; Pacula, Rosalie Liccardo (16 September 2022). "Changes in Emergency Department Visits for Cannabis Hyperemesis Syndrome Following Recreational Cannabis Legalization and Subsequent Commercialization in Ontario, Canada". JAMA Network Open. 5 (9): e2231937. doi:10.1001/jamanetworkopen.2022.31937.
- ^ Allen, J H; De Moore, GM; Heddle, R; Twartz, JC (2004). "Cannabinoid hyperemesis: Cyclical hyperemesis in association with chronic cannabis abuse". Gut. 53 (11): 1566–70. doi:10.1136/gut.2003.036350. PMC 1774264. PMID 15479672.
- ^ Sontineni, Siva-P; Chaudhary, S; Sontineni, V; Lanspa, SJ (2009). "Cannabinoid hyperemesis syndrome: Clinical diagnosis of an underrecognized manifestation of chronic cannabis abuse". World Journal of Gastroenterology. 15 (10): 1264–6. doi:10.3748/wjg.15.1264. PMC 2658859. PMID 19291829.
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: CS1 maint: unflagged free DOI (link)