M1324 Cyclic Vomiting Syndrome in Adults: Relationship to Cannabis use, Migraine Headaches, and Intervening Symptoms.

Oruganti, Vishnu; Sachdeva, Priyanka; Fisher, Robert S.; Parkman, Henry P.

doi:10.1016/s0016-5085(10)61748-9

Cited by 2 publications

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“…Our review of the literature identified a total of 25 case series (n = 271) and 105 individual case reports of patients identified with CHS (Table ) . Most of the reported case series and case studies predated the publication of Rome IV criteria for CHS.…”

Section: Resultsmentioning

confidence: 99%

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

Venkatesan

Levinthal

et al. 2019

Neurogastroenterology Motil

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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.

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Section: Resultsmentioning

confidence: 99%

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

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“…Kim et al demonstrated a near doubling of the prevalence of CVS following legalization of cannabis in Colorado (prevalence ratio 1.92, 95% confidence interval [CI] = 1.33 to 2.79), and these patients were more likely to have cannabis use documented (OR = 3.59, 95% CI = 1.44-9.00) [5]. Additionally, five observational studies were identified which reported a significant prevalence of cannabis use and compulsive hot baths/showers among CVS patients (see Table 4) [175][176][177][178][179]. For example, Venkatesan et al found that among 437 CVS patients, 81% were cannabis users and 67% reported using hot showers for symptom relief [179].…”

Section: Discussionmentioning

confidence: 99%

Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment—a Systematic Review

et al. 2016

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Cannabinoid hyperemesis syndrome (CHS) is a syndrome of cyclic vomiting associated with cannabis use. Our objective is to summarize the available evidence on CHS diagnosis, pathophysiology, and treatment. We performed a systematic review using MEDLINE, Ovid MEDLINE, Embase, Web of Science, and the Cochrane Library from January 2000 through September 24, 2015. Articles eligible for inclusion were evaluated using the G r a d i n g a n d R e c o m m e n d a t i o n s A s s e s s m e n t , Development, and Evaluation (GRADE) criteria. Data were abstracted from the articles and case reports and were combined in a cumulative synthesis. The frequency of identified diagnostic characteristics was calculated from the cumulative synthesis and evidence for pathophysiologic hypothesis as well as treatment options were evaluated using the GRADE criteria. The systematic search returned 2178 articles. After duplicates were removed, 1253 abstracts were reviewed and 183 were included. Fourteen diagnostic characteristics were identified, and the frequency of major characteristics was as follows: history of regular cannabis for any duration of time (100%), cyclic nausea and vomiting (100%), resolution of symptoms after stopping cannabis (96.8%), compulsive hot baths with symptom relief (92.3%), male predominance (72.9%), abdominal pain (85.1%), and at least weekly cannabis use (97.4%). The pathophysiology of CHS remains unclear with a dearth of research dedicated to investigating its underlying mechanism. Supportive care with intravenous fluids, dopamine antagonists, topical capsaicin cream, and avoidance of narcotic medications has shown some benefit in the acute setting. Cannabis cessation appears to be the best treatment. CHS is a cyclic vomiting syndrome, preceded by daily to weekly cannabis use, usually accompanied by symptom improvement with hot bathing, and resolution with cessation of cannabis. The pathophysiology underlying CHS is unclear. Cannabis cessation appears to be the best treatment

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M1324 Cyclic Vomiting Syndrome in Adults: Relationship to Cannabis use, Migraine Headaches, and Intervening Symptoms.

Cited by 2 publications

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

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

Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment—a Systematic Review

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