Cannabinoid hyperemesis syndrome (CHS) is recurrent nausea, vomiting, and cramping abdominal pain that can occur due to prolonged, high-dose cannabis use.[4][5] These symptoms may be relieved temporarily by taking a hot shower or bath. Complications are related to persistent vomiting and dehydration which may lead to kidney failure and electrolyte problems.[2]
Weekly cannabis use is generally required for the syndrome to occur; synthetic cannabinoids can also cause CHS.[6][5] The underlying mechanism is unclear, with several possibilities proposed.[2][5] Diagnosis is based on the symptoms, as well as the history of cannabis use (including a urine screen test if necessary).[6] The condition is typically present for some time before the diagnosis is made.[6]
The only known curative treatment for CHS is to stop using cannabis.[7][2] Two weeks (or possibly up to 3 months) may be required to see a benefit.[6][8] Treatments during an episode of vomiting are generally supportive in nature (e.g., hydration). There is tentative evidence for the use of capsaicin cream on the abdomen during an acute episode.[2]
Another condition that presents similarly is cyclic vomiting syndrome (CVS).[3] The primary differentiation between CHS and CVS is that cessation of cannabis use only resolves CHS. CVS does not resolve with the cessation of cannabis use.[5] Another key difference is that CVS symptoms typically begin during the early morning; predominant morning symptoms are not characteristic of CHS.[9][10] Distinguishing the two can be difficult since many people with CVS use cannabis, possibly to relieve their symptoms.[5]
The syndrome was first described in 2004, and simplified diagnostic criteria were published in 2009.[11][12]
^ abSullivan S (May 2010). "Cannabinoid hyperemesis". Canadian Journal of Gastroenterology. 24 (5): 284–5. doi:10.1155/2010/481940. PMC 2886568. PMID 20485701.
^ abcdefghCite error: The named reference korn was invoked but never defined (see the help page).
^ abGalli JA, Sawaya RA, Friedenberg FK (December 2011). "Cannabinoid hyperemesis syndrome". Current Drug Abuse Reviews. 4 (4): 241–9. doi:10.2174/1874473711104040241. PMC 3576702. PMID 22150623.
^Sorensen CJ, DeSanto K, Borgelt L, Phillips KT, Monte AA (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.
^ abcdeDeVuono M, Parker L (2020). "Cannabinoid Hyperemesis Syndrome: A Review of Potential Mechanisms". Cannabis and Cannabinoid Research. 5 (2): 132–144. doi:10.1089/can.2019.0059. PMC 7347072. PMID 32656345.
^ abcdCite error: The named reference BMJ2019 was invoked but never defined (see the help page).
^Sorensen CJ, DeSanto K, Borgelt L, Phillips KT, Monte AA (March 2017). "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. ISSN 1556-9039. PMC 5330965. PMID 28000146.
^Venkatesan T, Levinthal DJ, Tarbell SE, Jaradeh SS, Hasler WL, Issenman RM, et al. (June 2019). "Guidelines on management of cyclic vomiting syndrome in adults by the American Neurogastroenterology and Motility Society and the Cyclic Vomiting Syndrome Association". Neurogastroenterology & Motility. 31 (S2): e13604. doi:10.1111/nmo.13604. ISSN 1350-1925. PMC 6899751. PMID 31241819.
^Rotella JA, Ferretti OG, Raisi E, Seet HR, Sarkar S (August 2022). "Cannabinoid hyperemesis syndrome: A 6-year audit of adult presentations to an urban district hospital". Emergency Medicine Australasia. 34 (4): 578–583. doi:10.1111/1742-6723.13944. ISSN 1742-6731. PMC 9545654. PMID 35199462.
^Allen JH, 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 SP, 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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