Pediatric Cannabinoid Hyperemesis

Abstract

Cannabinoid hyperemesis has recently been described in the literature. It is a syndrome characterized by severe nausea and hyperemesis in the setting of chronic marijuana abuse and, to date, has been described only in adults. We describe the syndrome in 2 pediatric patients, for whom extensive gastrointestinal workups failed to identify a clear cause and cessation of marijuana use resulted in the alleviation of their symptoms. As in most published adult cases, compulsive bathing was present in both of these cases.

Cannabinoid Hyperemesis Syndrome

“…In one study the average duration of cannabis use prior to onset of recurrent vomiting was 16.3 ± 3.4 years [62]. There are at least four reported cases where the time lag was equal to or less than three years [54,59,60]. Daily marijuana use is characteristic and often reported as exceeding three to five times per day.…”

“…[69,70]. Esophagogastroduodenoscopy findings from several patients with CHS have revealed varying grades of esophagitis and gastritis [6,54,57,60–62]. As a result, acid suppression therapy with medications such as proton pump inhibitors should be given routinely.…”

“…The effects of this learned behavior are temperature-dependent [6], fast acting [6], but short-lived [6,56,62]. Hot showers improve symptoms of nausea and vomiting [6,52–56,60,62,68,71], abdominal pain [6,56,71], and decreased appetite [68] during the hyperemetic phase. The precise mechanism by which hot bathing produces a rapid reduction in the symptoms of CHS is unknown.…”

“…The majority of reported cases that have provided follow-up included a period of less than one year [6,52,54,56–60,62,68,71]. A greater understanding of the natural course of the syndrome and response to marijuana cessation may be gained with longer lengths of follow-up.…”

Cannabinoid hyperemesis syndrome: Unknown diagnosis with miraculous shower

“…Elles sont parfois compulsives et ruineuses chez la majorité des patients sans qu'ils aient fait le lien avec l'intoxication [4]. Ce syndrome peut aussi exister lors de l'utilisation de cannabinoïdes de synthèse contenus dans les nouvelles drogues [7], et dans la population pédia-trique [8].…”