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Saturday, February 22, 2014

Cannabinoid hyperemesis syndrome

*Note: Posting this because it could happen, not saying smoking cannabis responsibly will cause it to happen.


"Cannabinoid hyperemesis syndrome is a disorder that is characterized by recurrent nausea, vomiting and colicky abdominal pain. These symptoms have been reported to be alleviated temporarily by taking a hot shower or bath or more permanently by abstaining from the use of cannabis. The syndrome was described by Allen and colleagues (2004), and Sontineni and colleagues (2009) who offer simplified clinical diagnostic criteria.A subsequent, larger study reported a case series of 98 subjects with cannabinoid hyperemesis syndrome, confirming the earlier reported findings....

Sontineni et al. criteria for the diagnosis of "cannabinoid hyperemesis syndrome"

Essential            Cannabis use for years
Major           Severe nausea and vomiting
                          Vomiting that recurs in a cyclic pattern over months
                          Resolution of symptoms after stopping cannabis use.

Supportive Compulsive hot baths with symptom relief
                              Colicky abdominal pain
                              No evidence of gall bladder or pancreatic inflammation

Modified criteria for the diagnosis of "cannabinoid hyperemesis syndrome"

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

Pathogenesis
Various pathogenic mechanistic theories attempting to explain symptoms have been put forward. These theories fall into two themes: 1) dose dependent build up of cannabinoids and related effects of cannabinoid toxicity, and 2) the functionality of cannabinoid receptors in the brain and particularly in the hypothalamus (which regulates body temperature and the digestive system). But the mechanisms by which cannabis causes or controls nausea and the adverse consequences of long-term cannabis toxicity remain unknown and organic disease should not be ruled out as a possible cause.

See more...
@Wikipedia

More info...

  1. Medscape
  2. NCPIC