Cannabinoid hyperemesis syndrome
Background
Cannabis is the most widely used drug in the US and the world
Clinical Features
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 Vomitting
Criteria for the diagnosis of "cannabinoid hyperemesis syndrome"[1]
| Essential | Long-term cannabis use |
|---|---|
| Major | Severe cyclic nausea and vomiting
Resolution with cannabis cessation Relief of symptoms with hot showers or baths Abdominal pain, epigastric or periumbilical Weekly use of marijuana. |
| Supportive | Age less than 50 y
Weight loss of >5 kg Morning predominance of symptoms Normal bowel habits Negative laboratory, radiographic, and endoscopic test results |
Management
Symptomatic treatment: antiemetics, IV/PO hydration
Cessation of marijuana use
Disposition
Home
See Also
Sources
- ↑ 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