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Cannabinoid hyperemesis: a case series of 98 patients
Douglas A Simonetto1, Amy S Oxentenko, Margot L Herman
1Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Insights
Cannabinoid hyperemesis (CH) affects younger adults with long-term cannabis use, causing recurrent vomiting and abdominal pain. Quitting cannabis often resolves symptoms, highlighting its importance in CH diagnosis and management.
Area of Science:
- Gastroenterology
- Toxicology
- Cannabis Research
Background:
- Cannabinoid hyperemesis (CH) is a condition associated with chronic cannabis use.
- Understanding CH is crucial for accurate diagnosis and effective patient management.
Purpose of the Study:
- To enhance recognition and understanding of cannabinoid hyperemesis (CH).
- To establish diagnostic criteria for CH based on a large case series.
Main Methods:
- A case series of 98 patients diagnosed with CH was compiled.
- Inclusion criteria involved recurrent unexplained vomiting and preceding cannabis use.
- Data were collected from electronic medical records between January 1, 2005, and June 15, 2010.
Main Results:
- All patients were under 50; most used cannabis long-term (over 2 years) and frequently (more than weekly).
- Abdominal pain was reported by 86% of patients.
- Hot water bathing provided relief for 91% of affected patients.
- Of 10 patients with follow-up, 7 stopped cannabis, and 6 achieved symptom resolution.
Conclusions:
- Cannabinoid hyperemesis should be suspected in young patients with chronic cannabis use presenting with recurrent nausea, vomiting, and abdominal pain.
- Proposed diagnostic criteria for CH are based on this extensive case series.
Objective:
To promote wider recognition and further understanding of cannabinoid hyperemesis (CH).
Patients And Methods:
We constructed a case series, the largest to date, of patients diagnosed with CH at our institution. Inclusion criteria were determined by reviewing all PubMed indexed journals with case reports and case series on CH. The institution's electronic medical record was searched from January 1, 2005, through June 15, 2010. Patients were included if there was a history of recurrent vomiting with no other explanation for symptoms and if cannabis use preceded symptom onset. Of 1571 patients identified, 98 patients (6%) met inclusion criteria.
Results:
All 98 patients were younger than 50 years of age. Among the 37 patients in whom duration of cannabis use was available, most (25 [68%]) reported using cannabis for more than 2 years before symptom onset, and 71 of 75 patients (95%) in whom frequency of use was available used cannabis more than once weekly. Eighty-four patients (86%) reported abdominal pain. The effect of hot water bathing was documented in 57 patients (58%), and 52 (91%) of these patients reported relief of symptoms with hot showers or baths. Follow-up was available in only 10 patients (10%). Of those 10, 7 (70%) stopped using cannabis and 6 of these 7 (86%) noted complete resolution of their symptoms.
Conclusion:
Cannabinoid hyperemesis should be considered in younger patients with long-term cannabis use and recurrent nausea, vomiting, and abdominal pain. On the basis of our findings in this large series of patients, we propose major and supportive criteria for the diagnosis of CH.
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