Cannabinoid Hyperemesis Syndrome: A Case Series and Review of Previous Reports

Nicolson, Stephen E.; Denysenko, Lex; Mulcare, J. Loretta; Vito, Jose; Chabon, Brenda

doi:10.1016/j.psym.2012.01.003

Cited by 59 publications

(50 citation statements)

References 27 publications

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“…8 Alternatively, the main active ingredient of cannabis (THC) is highly lipophilic; long-term use likely causes THC to accumulate in cerebral fat, which may lead to toxicity and emesis in sensitive patients. 11 Nausea and vomiting are influenced by the balance between enteric and central nervous system effects. Cannabis binds to cannabinoid receptors in the brain and the enteric nervous system.…”

Section: Etiology Of Chsmentioning

confidence: 99%

“…Subsequent cases have been published worldwide in the medical literature. [5][6][7][8][9][10][11][12][13] 14 It is important for health care providers and pharmacists to conduct focused history taking and consider CHS in the differential diagnosis of patients presenting with intractable cyclic nausea and vomiting plus abdominal pain as this may reduce the need for costly and invasive testing. The purpose of this brief review is to present a practical overview of CHS and to provide appropriate information to clinical pharmacists to effectively manage the hyperemetic phase of CHS in patients presenting to the emergency department (ED).…”

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confidence: 99%

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Cannabinoid Hyperemesis Syndrome

Sun

Zimmermann

2013

Hosp Pharm

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Background: The purpose of this review is to describe cannabinoid hyperemesis syndrome (CHS), which is thought to be induced by long-term cannabis use, and provide clinical pharmacists with information to manage the hyperemetic phase of CHS. Method: Published literature was searched and reviewed using PubMed. Results: CHS is characterized by intractable nausea and vomiting without an obvious organic cause and associated learned compulsive hot water bathing behavior. Patients often seek care in the emergency department (ED) for symptomatic relief. Conclusion: CHS is potentially underrecognized and underdiagnosed in the ED, and it should be considered in the differential diagnosis in long-term cannabis use patients with CHS symptoms to avoid unnecessary extensive diagnostic workup including invasive radiologic imaging. Pharmacists have an important role in CHS recognition, education, and symptom management.

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Section: Etiology Of Chsmentioning

confidence: 99%

mentioning

confidence: 99%

Cannabinoid Hyperemesis Syndrome

Sun

Zimmermann

2013

Hosp Pharm

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Learning points

Diagnostic tests (CT, MRI, X-ray, colonoscopies, gastric emptying study, ultrasound and barium swallow) have consistently been shown to be of no benefit in the diagnosis of cannabinoid hyperemesis syndrome (CHS). In spite of this, the majority of patients are still subject to multiple costly investigations and are eventually unable to reach a diagnosis.

Chronic, heavy cannabis use may cause cannabinoid receptors in the gut to override the effect of cannabinoid receptor stimulation in the brain, thereby leading to paradoxical hyperemesis 1 29

Our literature review found that 99% of patients with CHS had symptom relief with hot water showers or baths.

…”

Section: Discussionmentioning

confidence: 99%

Cannabinoid hyperemesis syndrome

et al. 2016

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SUMMARYThe antiemetic properties of marijuana are well known, but there is increasing evidence of its paradoxical hyperemetic effects on the gastrointestinal tract and central nervous system, known as 'cannabinoid hyperemesis syndrome' (CHS). We report a case of CHS encountered in our outpatient clinic. We also completed a review of the literature using PubMed in patients over 18 years of age with CHS. Understanding the diagnostic criteria and risk factors associated with CHS may reduce the ordering of unnecessary and expensive investigations, and pursuing inappropriate medical and surgical treatments. Ultimately, abstaining from cannabis use leads to resolution of symptoms in the majority of patients. BACKGROUND

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“…Preclinical studies suggest that endocannabinoids and THC may evoke bradycardia, hypotension, and decreased contractility of the myocardial tissue [149]. The mechanism by which THC and cannabinoids might decrease myocardial contractility remains to be elucidated.…”

Section: Complications Secondary To Chsmentioning

confidence: 99%

Cannabinoid Hyperemesis

Pergolizzi Jr.,

LeQuang,

Bisney

2018

Med Cannabis Cannabinoids

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Cannabinoid hyperemesis syndrome (CHS) is a paradoxical condition in which a long-term cannabis user suffers an episode of intractable vomiting that may last days separated by longer asymptomatic periods of weeks or months. Cannabinoids are often utilized for their antiemetic properties, so CHS can be a puzzling condition, and the diagnosis of CHS may be disputed by patients. Unlike other cyclic vomiting syndromes, CHS can be relieved by hot showers or topical capsaicin. Abstinence from cannabinoids causes CHS to resolve, sometimes in a matter of days or hours. Marijuana users as well as many clinicians are not aware of CHS, and patients may undergo unnecessary tests, scans, and other procedures to get an accurate diagnosis. Symptoms may be severe enough to require hospitalization. With liberalization of marijuana laws and favorable public opinion about the healing properties of cannabis, CHS may be more frequently observed in clinical practice.

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Cannabinoid Hyperemesis Syndrome: A Case Series and Review of Previous Reports

Cited by 59 publications

References 27 publications

Cannabinoid Hyperemesis Syndrome

Cannabinoid Hyperemesis Syndrome

Cannabinoid hyperemesis syndrome

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