Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline

Journal of Clinical Oncology, Год журнала: 2024, Номер 42(13), С. 1575 - 1593

Опубликована: Март 13, 2024

To guide clinicians, adults with cancer, caregivers, researchers, and oncology institutions on the medical use of cannabis cannabinoids, including synthetic cannabinoids herbal derivatives; single, purified cannabinoids; combinations ingredients; full-spectrum cannabis.

Язык: Английский

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

Neurogastroenterology & Motility, Год журнала: 2019, Номер 31(S2)

Опубликована: Июнь 1, 2019

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

Язык: Английский

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Diagnosis and Management of Cyclic Vomiting Syndrome: A Critical Review

The American Journal of Gastroenterology, Год журнала: 2023, Номер 118(7), С. 1157 - 1167

Опубликована: Фев. 15, 2023

Cyclic vomiting syndrome (CVS) is a chronic disorder of gut-brain interaction characterized by recurrent disabling episodes nausea, vomiting, and abdominal pain. CVS affects both children adults with prevalence approximately 2% in the United States. more common female individuals all races. The pathophysiology unknown combination genetic, environmental, autonomic, neurohormonal factors believed to play role. also closely associated migraine headaches likely have shared pathophysiology. diagnosis based on Rome criteria, minimal recommended testing includes an upper endoscopy imaging studies abdomen. frequently anxiety, depression, autonomic dysfunction. Patients commonly use cannabis therapeutically for symptom relief. By contrast, cannabinoid hyperemesis be subset heavy leading hyperemesis. Due recalcitrant nature illness, patients often visit emergency department are hospitalized acute flares. Guidelines management recommend biopsychosocial approach. Prophylactic therapy consists tricyclic antidepressants (amitriptyline), antiepileptics (topiramate), aprepitant refractory patients. Abortive triptans, antiemetics (ondansetron), sedation. Treatment comorbid conditions extremely important improve overall patient outcomes. has significant negative impact patients, families, healthcare system, future research understand its develop targeted therapies needed.

Язык: Английский

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AGA Clinical Practice Update on Diagnosis and Management of Cannabinoid Hyperemesis Syndrome: Commentary

Gastroenterology, Год журнала: 2024, Номер 166(5), С. 930 - 934.e1

Опубликована: Март 5, 2024

Язык: Английский

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Cannabis for Chronic Pain: Mechanistic Insights and Therapeutic Challenges

Stresses, Год журнала: 2025, Номер 5(1), С. 7 - 7

Опубликована: Янв. 15, 2025

Chronic pain represents a complex and debilitating condition that affects millions of people worldwide, significantly compromising their quality life. The conventional approach to treating this type often relies on the use opioid analgesics anti-inflammatory drugs. While these agents are effective in short term, they present several limitations, including risk dependence, severe side effects, and, some cases, ineffectiveness reducing pain. In context, medical cannabis has emerged as promising therapeutic alternative, given its potential ability relieve effectively with favorable safety profile. This work aims provide comprehensive up-to-date review existing literature effects treatment chronic Cannabis sativa contains pharmacologically active compounds, most prominent which delta-9-tetrahydrocannabinol (∆9-THC) cannabidiol (CBD), interact body’s endocannabinoid system, thereby modulating response. Clinical evidence shown cannabinoids can reduce intensity pain, particularly cases neuropathy, multiple sclerosis, arthritis, other painful conditions unresponsive treatments. However, full integration into clinical practice faces significant obstacles, need for standardized dosing, long-term data, regulatory frameworks. These issues, alongside concerns over adverse drug interactions, must be addressed unlock cannabinoids, patients, who endure both physical suffering added burden stress.

Язык: Английский

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Increasing trends of cannabinoid hyperemesis syndrome in youth: The grass is not always greener

Journal of Pediatric Gastroenterology and Nutrition, Год журнала: 2025, Номер unknown

Опубликована: Янв. 27, 2025

Abstract This study investigated trends in suspected cannabinoid hyperemesis syndrome (CHS)‐related emergency department visits among youth (15–24 years old) the United States between 2006 and 2020. Using data from Nationwide Emergency Room Sample, over 55,000 CHS‐related were identified, with an average annual increase of 28.1% per year. aligns rising cannabis use potency across nation. Subjects western region, males, those public insurance more likely to present CHS. These findings highlight growing health concern CHS emphasize need for increased awareness healthcare providers, particularly regarding potential link chronic youth. Further research is needed understand underlying mechanisms risk factors associated as well impact policy on outcomes.

Язык: Английский

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Cannabis hyperemesis syndrome: an update on the pathophysiology and management

Annals of Gastroenterology, Год журнала: 2020, Номер unknown

Опубликована: Янв. 1, 2020

Cannabis hyperemesis syndrome (CHS) is a form of functional gut-brain axis disorder characterized by bouts episodic nausea and vomiting worsened cannabis intake.It considered as variant cyclical seen in users especially compulsive hot bathing/showers to relieve the symptoms.CHS was reported for first time 2004, since then, an increasing number cases have been reported.With use throughout world threshold legalization becomes lower, its user numbers are expected rise over time.Despite this trend, strict criterion diagnosis CHS lacking.Early recognition essential prevent complications related severe volume depletion.The recent body research recognizes that patients with impose burden on healthcare systems.Understanding pathophysiology endocannabinoid system (ECS) remains central explaining clinical features potential drug targets treatment CHS.The frequency prevalence change accordance doses tetrahydrocannabinol other cannabinoids various formulations cannabis.CHS unique presentation, because cannabis's biphasic effect anti-emetic at low pro-emetic higher doses, association pathological water bathing.In narrative review, we elaborate role ECS, management, identification gaps our current knowledge further enhance understanding future.

Язык: Английский

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Endocannabinoid signaling in stress, nausea, and vomiting

Neurogastroenterology & Motility, Год журнала: 2024, Номер unknown

Опубликована: Сен. 2, 2024

Abstract Background Classical antiemetics that target the serotonin system may not be effective in treating certain nausea and vomiting conditions like cyclic syndrome (CVS) cannabinoid hyperemesis (CHS). As a result, there is need for better therapies to manage symptoms of these disorders, including nausea, vomiting, anxiety. Cannabis often used its purported antiemetic anxiolytic effects, given regulation processes by endocannabinoid (ECS). However, considerable evidence cannabinoids can also produce increase anxiety instances, especially at higher doses. This paradoxical effect on due dysregulation ECS, altering how it maintains contributing pathophysiology CVS or CHS. Purpose The purpose this review highlight involvement ECS stress, vomiting. We discuss prolonged cannabis use, such as case CHS heightened dysregulate affect modulation functions. examines roles stress systems' dysfunction understand underlying mechanisms conditions.

Язык: Английский

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Cyclic Vomiting Syndrome in Children

Frontiers in Neurology, Год журнала: 2020, Номер 11

Опубликована: Ноя. 2, 2020

Cyclic Vomiting Syndrome (CVS) is an underdiagnosed episodic syndrome characterized by frequent hospitalizations, multiple comorbidities, and poor quality of life. It often misdiagnosed due to the unappreciated pattern recurrence lack confirmatory testing. CVS mainly occurs in pre-school or early school-age, but infants elderly onset have been also described. The etiopathogenesis largely unknown, it likely be multifactorial. Recent evidence suggests that aberrant brain-gut pathways, mitochondrial enzymopathies, gastrointestinal motility disorders, calcium channel abnormalities, hyperactivity hypothalamic-pituitary-adrenal axis response a triggering environmental stimulus are involved. acute, stereotyped recurrent episodes intense nausea incoercible vomiting with predictable periodicity return baseline health between episodes. A distinction other differential diagnoses challenge for clinicians. Although extensive invasive investigations should avoided, testing toward identifying organic causes recommended all children CVS. management requires individually tailored therapy. Management acute phase based on supportive symptomatic care. Early intervention abortive agents during brief prodromal can used attempt terminate attack. During interictal period, non-pharmacologic measures as lifestyle changes use reassurance anticipatory guidance seem effective preventive treatment. indication prophylactic pharmacotherapy depends attack intensity severity, impairment QoL if treatments ineffective cause side effects. When remain refractory treatment, episode differs from previous ones, clinician consider possibility underlying disease further mono- combination therapy psychotherapy guided accompanying comorbidities specific sub-phenotype. This review was developed joint task force Italian Society Pediatric Gastroenterology Hepatology Nutrition (SIGENP) Neurology (SINP) identify relevant current issues propose future research directions pediatric

Язык: Английский

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Cyclic vomiting syndrome: A narrative review and guide to management

Headache The Journal of Head and Face Pain, Год журнала: 2021, Номер 61(2), С. 231 - 243

Опубликована: Фев. 1, 2021

Abstract Objectives/Background Cyclic vomiting syndrome (CVS) is a disabling disorder of gut–brain interaction manifested by stereotypical and severe episodes nausea vomiting. Prevalence data indicate that CVS affects 1–2% children there has been recent dramatic rise in diagnosed adults. Methods This narrative review summarizes relevant literature pertaining to pediatric adult provides guide management based on extensive clinical experience. Results More timely diagnosis facilitated an expert consensus diagnostic approach limited testing. Some tests exclusion remain essential. These include upper gastrointestinal (GI) contrast study exclude intestinal malrotation basic laboratory screening. An abdominal ultrasound recommended renal hydronephrosis biliary disease Exclusion metabolic/genetic conditions warranted those with specific warning signs, presentation infants/toddler age, refractory disease. In the absence chronic GI symptoms, referral specialist for endoscopy generally not necessary but A large subset termed migraine‐equivalent display strong genetic features migraine. unifying pathophysiologic core concept involves neuronal hyperexcitability aberrant central modulation autonomic signals. coupled multiple susceptibility factors including mitochondrial dysfunction/cellular energy deficits, hyper‐responsive hypothalamic–pituitary–adrenal axis many comorbidities increase vulnerability triggering events. are frequently triggered stressors intercurrent illnesses. Lifestyle non‐pharmacological interventions thus play pivotal role successful management. Pharmacological therapies categorized into abortive, supportive/rescue, prophylactic treatments. The majority respond particularly well migraine‐focused treatment strategies. Conclusion Despite improved characterization understanding, remains classified as functional brain–gut often disjointly managed generalists subspecialists. Early recognition, evaluation, will facilitate care improve outcomes. Further research its natural history common progression migraine headaches, neuroendocrine mechanisms, relation diathesis much needed.

Язык: Английский

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