Cannabinoid hyperemesis syndrome: Difference between revisions
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==Workup== | ==Workup== | ||
Diagnosis of exclusion after complete workup for [[ | Diagnosis of exclusion after complete workup for [[Nausea and Vomiting]] | ||
==Management== | ==Management== | ||
Revision as of 01:31, 3 May 2014
Background
Cannabis is the most widely used drug in the US and the world. The syndrome, first described by Allen et al. in 2004 consists of nausea, vomiting, and abdominal pain in a patient with no other organic cause who frequently uses marijuana and has relief of symptoms with hot showers[1]
Clinical Features[2]
Essential Features
- Long term cannabis use (typically > 2years)
Major Features
- severe cyclical nausea, vomiting
- weekly use of marijuana
- relief of symptoms with hot showers or baths
- abdominal pain: epigastric or periumbilical
- resolution of cannabis cessation
Supportive Features
- Age < 50y
- Weight loss > 5kg
- Symptoms greater in morning
- Normal bowel habits
- Neg lab, imaging and endoscopy
Differential Diagnosis
Workup
Diagnosis of exclusion after complete workup for Nausea and Vomiting
Management
Symptomatic treatment: antiemetics, IV/PO hydration
Cessation of marijuana use
Current Controversies
- The pathophysiology and exact cause of the syndrome remains under question, especially since cannabis acts as an antiemetic [3]
Disposition
Home once Nausea and Vomiting is Controlled
See Also
Sources
- ↑ 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
- ↑ Simonetto, Douglas A.; Oxentenko, Amy S.; Herman, Margot L.; Szostek, Jason H. (2012). "Cannabinoid Hyperemesis: A Case Series of 98 Patients". Mayo Clinic Proceedings 87 (2): 114–9. doi:10.1016/j.mayocp.2011.10.005. PMID 22305024
- ↑ Byrne, A; Hallinan, R; Wodak, A (2006). "'Cannabis hyperemesis' causation questioned". Gut 55 (1): 132; author reply 132. PMC 1856368