Epidemiology, Clinical Characteristics, and Associations for Rome IV Functional Nausea and Vomiting Disorders in Adults

Aziz, Imran; Palsson, Olafur S.; Whitehead, William E.; Sperber, Ami D.; Simrén, Magnus; Törnblom, Hans

doi:10.1016/j.cgh.2018.05.020

Cited by 124 publications

(116 citation statements)

References 32 publications

Supporting

Mentioning

111

Contrasting

Unclassified

Order By: Relevance

“…This hot water bathing behavior has been observed in preadolescent children and adolescents with no exposure to cannabis (BUK Li and D Fleisher, personal communication). Thus, although the majority of studies show that chronic cannabis use is significantly associated with hot water bathing, this association is not pathognomonic of cannabis use …”

Section: Is Chs a Separate Entity?mentioning

confidence: 99%

“…A recent population-based study identified only seven cases of CHS when the newer Rome IV diagnostic criteria were applied. 5 In stark contrast, another study reported that nearly a third of daily or near-daily cannabis users presenting to the emergency department were identified as having CHS. 6 A major flaw in this particular study was that the authors defined CHS primarily on the reported use of hot showers/baths to relieve symptoms of nausea and vomiting.…”

Section: Introductionmentioning

confidence: 96%

See 1 more Smart Citation

Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome

Venkatesan

Levinthal

et al. 2019

Neurogastroenterology Motil

View full text Add to dashboard Cite

Cannabis is commonly used in cyclic vomiting syndrome (CVS) due to its antiemetic and anxiolytic properties. Paradoxically, chronic cannabis use in the context of cyclic vomiting has led to the recognition of a putative new disorder called cannabinoid hyperemesis syndrome (CHS). Since its first description in 2004, numerous case series and case reports have emerged describing this phenomenon. Although not pathognomonic, a patient behavior called “compulsive hot water bathing” has been associated with CHS. There is considerable controversy about how CHS is defined. Most of the data remain heterogenous with limited follow‐up, making it difficult to ascertain whether chronic cannabis use is causal, merely a clinical association with CVS, or unmasks or triggers symptoms in patients inherently predisposed to develop CVS. This article will discuss the role of cannabis in the regulation of nausea and vomiting, specifically focusing on both CVS and CHS, in order to address controversies in this context. To this objective, we have collated and analyzed published case series and case reports on CHS in order to determine the number of reported cases that meet current Rome IV criteria for CHS. We have also identified limitations in the existing diagnostic framework and propose revised criteria to diagnose CHS. Future research in this area should improve our understanding of the role of cannabis use in cyclic vomiting and help us better understand and manage this disorder.

show abstract

Section: Is Chs a Separate Entity?mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome

Venkatesan

Levinthal

et al. 2019

Neurogastroenterology Motil

View full text Add to dashboard Cite

show abstract

“…Many CVS patients self‐medicate with cannabis to alleviate the symptoms; hence, the distinction between these conditions becomes difficult to diagnose. However, both CVS and CHS are diagnostically distinct entities as classified by Rome IV criteria . The mainstay of basic management in both conditions is symptomatic care with intravenous hydration and control of nausea and vomiting.…”

Section: Introductionmentioning

confidence: 99%

“…8 There is a significant phenotypic overlap between cyclic vomiting syndrome and cannabinoid hyperemesis syndrome (CHS). 10,11 Many CVS patients self-medicate with cannabis to alleviate the symptoms; hence, the distinction between these conditions becomes difficult to diagnose. However, both CVS and CHS are diagnostically distinct entities as classified by Rome IV criteria.…”

mentioning

confidence: 99%

“…However, both CVS and CHS are diagnostically distinct entities as classified by Rome IV criteria. 6,[11][12][13][14] The mainstay of basic management in both conditions is symptomatic care with intravenous hydration and control of nausea and vomiting. In addition to symptomatic and supportive care, there is documented effectiveness of the tricyclic antidepressants for the pharmacological management in cyclic vomiting syndrome.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of cannabis use has significantly increased in patients with cyclic vomiting syndrome

Siddiqui

Bilal

Singh

et al. 2020

Neurogastroenterology Motil

View full text Add to dashboard Cite

Introduction Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder which leads to multiple hospitalizations and causes significant impairment of quality of life. Cannabis use is common in patients with CVS, and there are limited data on the national trends in the prevalence of its use in the United States. Methods We used the National Inpatient Sample (NIS) database from 2005 to 2014 and identified hospitalizations with a primary diagnosis of CVS by utilizing the International Classification of Diseases, 9th revision Clinical Modification (ICD‐9 CM) coding system. The primary objective of the study was to analyze the prevalence and trends in cannabis use in CVS patients. We also assessed healthcare resource utilization associated with cannabis use. Results A total of 129 090 hospitalizations with a primary diagnosis of CVS were identified and included in the study. In the United States, the overall rate of cannabis use among these patients was 104 per 1000 hospitalizations (N = 13 460). Over the last decade, the prevalence of cannabis use increased by 10‐fold, from 2.2% in 2005 to 21.2% in 2014. Conclusion Our analysis of the national database suggests that nearly 1 in 5 CVS hospitalizations have concurrent cannabis use. This prevalence is significantly rising over the last decade, perhaps due to changing legislation and increased utilization of cannabis. Age younger than 35, male gender, African American and Native American race, personal history of alcohol abuse and tobacco use were some of the strongest predictors of cannabis use.

show abstract

Cannabis use in the United States and its impact on gastrointestinal health

Alshaarawy,

Balasubramanian,

Venkatesan

2023

Nut in Clin Prac

View full text Add to dashboard Cite

In recent years, the legalization and social acceptability of cannabis use have increased in the United States. Concurrently, the prevalence of cannabis use has continued to rise, and cannabis products have diversified. There are growing concerns regarding the health effects of regular and high‐potency cannabis use, and new research has shed light on its potentially negative effects. Here, we review evidence of the gastrointestinal (GI) effects of cannabis and cannabinoids. Dysregulation of the endocannabinoid system might contribute to various GI disorders, including irritable bowel syndrome and cyclic vomiting syndrome, and endocannabinoids have been found to regulate visceral sensation, nausea, vomiting, and the gut microbiome. Cannabis has been shown to have antiemetic properties, and the US Food and Drug Administration has approved cannabis‐based medications for treating chemotherapy‐induced nausea and vomiting. Yet, chronic heavy cannabis use has been linked to recurrent episodes of severe nausea and intractable vomiting (cannabinoid hyperemesis syndrome). Given the considerable heterogeneity in the scientific literature, it is unclear if cannabinoid hyperemesis syndrome is truly a distinct entity or a subtype of cyclic vomiting that is unmasked by heavy cannabis use and the associated dysregulation of the endocannabinoid system. The changes in cannabis legalization, availability, and public risk perceptions have outpaced research in this area and there is a need for robust, prospective, large‐scale studies to understand the effects of cannabis use on GI health.

show abstract

Epidemiology, Clinical Characteristics, and Associations for Rome IV Functional Nausea and Vomiting Disorders in Adults

Cited by 124 publications

References 32 publications

Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome

Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome

Prevalence of cannabis use has significantly increased in patients with cyclic vomiting syndrome

Cannabis use in the United States and its impact on gastrointestinal health

Contact Info

Product

Resources

About