The Importance of Accurate Drug Use History in Diagnosing and Managing Cannabinoid Hyperemesis Syndrome: A Case Report

Cureus, Journal Year: 2025, Volume and Issue: unknown

Published: March 10, 2025

Cannabinoid hyperemesis syndrome (CHS) is a paradoxical condition characterized by recurrent episodes of nausea, vomiting, and abdominal pain in chronic cannabis users. Despite the increasing legalization widespread use cannabis, CHS remains underdiagnosed, often leading to unnecessary diagnostic tests ineffective treatments. The marked symptom relief through hot baths, behavioral pattern that can aid its identification. We report case 29-year-old male with five-year history vomiting significant weight loss. patient had multiple emergency department visits was misdiagnosed anxiety disorder due absence findings on tests. His further complicated concurrent Helicobacter pylori infection, which delayed clinical suspicion CHS. A detailed assessment revealed prolonged daily compulsive bathing. Upon cessation symptomatic treatment mirtazapine, quetiapine, lorazepam, showed complete resolution symptoms remained asymptomatic. This highlights challenges underscores importance targeted questioning about patients presenting cyclical vomiting. Clinicians should maintain high index suspicion, especially cases resistant conventional antiemetic therapy. Early recognition education regarding are critical preventing recurrence improving long-term outcomes.

Language: Английский

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North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition 2025 guidelines for management of cyclic vomiting syndrome in children

Journal of Pediatric Gastroenterology and Nutrition, Journal Year: 2025, Volume and Issue: unknown

Published: April 14, 2025

Abstract Background Cyclic vomiting syndrome (CVS) is a disorder recognized for its unique intensity of attacks and inordinate impact on quality life. There considerable symptom overlap with migraine. Due to the lack evidence‐based treatment algorithms, current management strategies vary. Objective These guidelines were formulated replace prior expert consensus recommendations assist patients clinicians in pediatric CVS. Methods Guidelines developed by multidisciplinary panel experts patient representative who prioritized questions relevant medical providers patients. The based systematic reviews assessment certainty evidence, following Grading Recommendations Assessment, Development, Evaluation (GRADE) approach, including indirect evidence from migraine headache literature strengthen areas limited evidence. used GRADE Evidence‐to‐Decision frameworks formulate recommendations, which subject public comment. Results 16 CVS using nonpharmacological pharmacological approaches. subdivided into abortive (acute) prophylactic (preventive) interventions. Conclusions A strong recommendation was use anti‐migraine agents aborting episodes personal or family history Conditional therapies included oral intravenous (IV) 5‐hydroxytryptamine 3 (5‐HT ) neurokinin 1 (NK‐1) receptor antagonists early presentation when requiring IV intervention. treatments such as trigger avoidance, supplements, various biobehavioral neuromodulation beta‐blockers, NK‐1 2A antagonists, tricyclic antidepressants. cautioned regarding potential side effects several anti‐convulsants only refractory Systematic Review Registration PROSPERO 2022 CRD42022310108; available at: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022310108 .

Language: Английский

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The Gi Tract

Published: Jan. 1, 2025

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A Pilot Trial of Topical Capsaicin Cream for Treatment of Cannabinoid Hyperemesis Syndrome

Academic Emergency Medicine, Journal Year: 2020, Volume and Issue: 27(11), P. 1166 - 1172

Published: June 22, 2020

Abstract Objectives Patients with cannabinoid hyperemesis syndrome (CHS) present frequently to the emergency department. Previous case studies suggest dramatic symptomatic improvement topical capsaicin treatment. This exploratory study examined potential effectiveness of in patients nausea and vomiting due a suspected CHS exacerbation. Methods was double‐blind, randomized placebo‐controlled pilot trial. Adults who presented be from were eligible for enrollment. We excluded pregnant women those resolution symptoms. Following randomization, 0.1% or placebo cream applied anterior abdomen uniform manner. The primary outcome severity on visual analog scale (VAS) 0 10 cm assessed at 30 minutes. Secondary outcomes adverse events, occurrence posttreatment vomiting, by VAS 60 minutes, hospital admission. Results trial enrolled patients, 17 arm 13 arm. One patient did not tolerate treatment skin irritation. Mean ± SD minutes 4.1 2.3 6.1 3.3 (difference = −2.0 cm, 95% confidence interval [CI] 0.2 −4.2 cm). At mean 3.2 versus 6.4 2.8 −3.2 CI −0.9 −5.4 percent reduction baseline 46.0% 24.9% 21.1%, −5.6% 47.9%). A higher proportion group (29.4% vs. 0%) had complete (relative risk 3.4, 1.6 7.1). Conclusion In this trial, application associated significant but provided more relief nausea.

Language: Английский

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Pharmacology, Clinical Effects, and Therapeutic Potential of Cannabinoids for Gastrointestinal and Liver Diseases

Clinical Gastroenterology and Hepatology, Journal Year: 2020, Volume and Issue: 19(9), P. 1748 - 1758.e2

Published: July 13, 2020

Language: Английский

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