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Cannabinoid Hyperemesis Syndrome

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1. Diagnosis and Management of Cannabinoid Hyperemesis Syndrome: Guidelines

Diagnosis and Management of Cannabinoid Hyperemesis Syndrome: Guidelines Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should (...) study only. It may not be copied, posted on a web site, redistributed by email or stored on an electronic system without the prior written permission of CADTH or applicable copyright owner. Links: This report may contain links to other information available on the websites of third parties on the Internet. CADTH does not have control over the content of such sites. Use of third party sites is governed by the owners’ own terms and conditions. TITLE: Diagnosis and Management of Cannabinoid Hyperemesis

2012 Canadian Agency for Drugs and Technologies in Health - Rapid Review

2. Cannabinoid Hyperemesis Syndrome Masquerading as Uremia: An Educational Case Report Full Text available with Trip Pro

Cannabinoid Hyperemesis Syndrome Masquerading as Uremia: An Educational Case Report With marijuana legalization, clinicians need to be aware of Cannabinoid Hyperemesis Syndrome (CHS), which may masquerade as other disease states such as uremia.A 37-year-old man with bipolar affective disease treated with lithium had progressive renal insufficiency presumably on the basis of interstitial fibrosis. He developed persistent and severe nausea and vomiting which was assumed to be on the basis (...) of uremia. Predating the nausea and vomiting was a history of daily marijuana use.Renal insufficiency, bipolar affective disease, and intractable nausea and vomiting.Dialysis was initiated but did not improve his symptoms and multiple investigations revealed no other cause. Abstinence from marijuana use resulted in complete resolution of symptoms.The patient elected to discontinue dialysis and was still alive 7 months later. We concluded the nausea and vomiting were not on a uremic basis but more likely

2018 Canadian journal of kidney health and disease

3. Successful Treatment of Cannabinoid Hyperemesis Syndrome with Topical Capsaicin Full Text available with Trip Pro

Successful Treatment of Cannabinoid Hyperemesis Syndrome with Topical Capsaicin Cannabinoid hyperemesis syndrome (CHS) is a clinical entity in which marijuana users develop nausea, vomiting, and abdominal pain that improves with hot water bathing or cannabis cessation. Previous models suggest that CHS arises solely from the derangement of cannabinoid receptor type 1 signaling. However, involvement of transient receptor potential vanilloid subtype 1 (TRPV1) receptor, which is activated

2018 ACG case reports journal

4. Cannabinoid Hyperemesis Syndrome: Pathophysiology and Treatment in the Emergency Department. (Abstract)

Cannabinoid Hyperemesis Syndrome: Pathophysiology and Treatment in the Emergency Department. Cannabinoid hyperemesis syndrome (CHS) is a challenging clinical disorder. CHS patients frequently present to the emergency department and may require treatment for intractable emesis, dehydration, and electrolyte abnormalities. Thought to be a variant of cyclic vomiting syndrome, CHS has become more prevalent with increasing cannabis potency and use, as enabled by various states having legalized

2018 Journal of Emergency Medicine

5. BET 1: Haloperidol in cannabinoid hyperemesis syndrome. (Abstract)

BET 1: Haloperidol in cannabinoid hyperemesis syndrome. A short-cut review was carried out to establish whether haloperidol is effective at treating the symptoms of cannabinoid hyperemesis syndrome (CHS). One study was directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of that paper were tabulated. The clinical bottom line was that no controlled studies exist to report on the use

2018 Emergency Medicine Journal

6. Capsaicin Cream for Treatment of Cannabinoid Hyperemesis Syndrome in Adolescents: A Case Series. Full Text available with Trip Pro

Capsaicin Cream for Treatment of Cannabinoid Hyperemesis Syndrome in Adolescents: A Case Series. Cannabinoid hyperemesis syndrome (CHS) is an underrecognized diagnosis among adolescents. In the adult literature, it is characterized as nausea, vomiting, and abdominal pain in patients with chronic marijuana use. CHS is often refractory to the standard treatment of nausea and vomiting. Unconventional antiemetics, such as haloperidol, have been successful in alleviating symptoms; however, even 1 (...) dose of haloperidol can lead to grave adverse effects, such as dystonia, extrapyramidal reactions, and neuroleptic malignant syndrome. The use of topical capsaicin cream to treat CHS has been well described in the adult literature. This treatment is cost-effective and is associated with few serious side effects. Here, we describe 2 adolescent patients with nausea, vomiting, and abdominal pain in the setting of chronic cannabis use whose symptoms were not relieved by standard antiemetic therapies

2017 Pediatrics

7. The Importance of Recognizing Cannabinoid Hyperemesis Syndrome from Synthetic Marijuana Use Full Text available with Trip Pro

The Importance of Recognizing Cannabinoid Hyperemesis Syndrome from Synthetic Marijuana Use 28353201 2018 10 09 2018 11 13 1937-6995 13 2 2017 06 Journal of medical toxicology : official journal of the American College of Medical Toxicology J Med Toxicol The Importance of Recognizing Cannabinoid Hyperemesis Syndrome from Synthetic Marijuana Use. 199-200 10.1007/s13181-017-0612-x Liu Xibei X University of Nevada School of Medicine, Las Vegas, NV, USA. Villamagna Angela A University of Nevada (...) School of Medicine, Las Vegas, NV, USA. Yoo Ji J University of Nevada School of Medicine, Las Vegas, NV, USA. jwyoo@medicine.nevada.edu. eng Letter Comment 2017 03 28 United States J Med Toxicol 101284598 1556-9039 0 Cannabinoids IM J Med Toxicol. 2017 Mar;13(1):71-87 28000146 J Med Toxicol. 2017 Jun;13(2):201 28382464 Cannabinoids Humans Marijuana Abuse Marijuana Smoking Marijuana Use Nausea Vomiting 2017 03 09 2017 03 21 2017 3 30 6 0 2018 10 10 6 0 2017 3 30 6 0 ppublish 28353201 10.1007/s13181

2017 Journal of Medical Toxicology

8. Cannabinoid hyperemesis and the cyclic vomiting syndrome in adults: recognition, diagnosis, acute and long-term treatment Full Text available with Trip Pro

Cannabinoid hyperemesis and the cyclic vomiting syndrome in adults: recognition, diagnosis, acute and long-term treatment The cannabinoid hyperemesis syndrome (CHS) and the cyclic vomiting syndrome in adults (CVS) are both characterized by recurrent episodes of heavy nausea, vomiting and frequently abdominal pain. Both syndromes are barely known among physicians. Literature is inconsistent concerning clinical features which enable differentiation between CVS and CHS. We performed a literature (...) review using the LIVIVO search portal for life sciences to develop a pragmatic approach towards these two syndromes. Our findings indicate that complete and persistent resolution of all symptoms of the disease following cannabis cessation is the only reliable criterion applicable to distinguish CHS from CVS. Psychiatric comorbidities (e.g. panic attacks, depression), history of migraine attacks and rapid gastric emptying may serve as supportive criteria for the diagnosis of CVS. Compulsive bathing

2017 GMS German Medical Science

9. Cannabinoid Hyperemesis Syndrome: Public Health Implications and a Novel Model Treatment Guideline Full Text available with Trip Pro

Cannabinoid Hyperemesis Syndrome: Public Health Implications and a Novel Model Treatment Guideline Cannabinoid hyperemesis syndrome (CHS) is an entity associated with cannabinoid overuse. CHS typically presents with cyclical vomiting, diffuse abdominal pain, and relief with hot showers. Patients often present to the emergency department (ED) repeatedly and undergo extensive evaluations including laboratory examination, advanced imaging, and in some cases unnecessary procedures. They are exposed

2017 Western Journal of Emergency Medicine

10. In Reply: “The importance of recognizing cannabinoid hyperemesis syndrome from synthetic marijuana use” Full Text available with Trip Pro

In Reply: “The importance of recognizing cannabinoid hyperemesis syndrome from synthetic marijuana use” 28382464 2018 10 09 2018 11 13 1937-6995 13 2 2017 06 Journal of medical toxicology : official journal of the American College of Medical Toxicology J Med Toxicol In Reply: "The importance of recognizing cannabinoid hyperemesis syndrome from synthetic marijuana use". 201 10.1007/s13181-017-0613-9 Sorensen Cecilia J CJ Denver Health Residency in Emergency Medicine, Denver Health (...) and Hospital Authority, Denver, CO, 80204, USA. Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA. Rocky Mountain Poison & Drug Center, Denver Health and Hospital Authority, Denver, CO, USA. eng K23 GM110516 GM NIGMS NIH HHS United States UL1 TR001082 TR NCATS NIH HHS United States Editorial Comment 2017 04 05 United States J Med Toxicol 101284598 1556-9039 0 Cannabinoids IM J Med Toxicol. 2017 Jun;13(2):199-200 28353201 J Med Toxicol. 2017 Mar;13(1):71-87

2017 Journal of Medical Toxicology

11. Coronary vasospasm complicating cannabinoid hyperemesis syndrome Full Text available with Trip Pro

Coronary vasospasm complicating cannabinoid hyperemesis syndrome Cannabinoid hyperemesis syndrome (CHS) is a clinical condition that was first described in 2004. The syndrome may occasionally be observed in long-term cannabis users and is characterized by a set of features: severe cyclic nausea and vomiting, recurrent epigastric or periumbilical pain, relief of symptoms with hot baths, and cannabis use cessation. The pathophysiology is not fully understood but is probably related to Cannabinoid (...) consistent with takotsubo cardiomyopathy. However, the patient was readmitted very soon with a ST-elevation myocardial infarction related to coronary vasospasm. While the link between CHS and ACS is not established, CHS patients with atypical pain should be investigated carefully to exclude any serious cardiac event. Cannabinoid hyperemesis syndrome is a rare medical entity than can be observed in some long-term heavy cannabis users. While most patients usually complain of recurrent

2017 Journal of cardiology cases

12. Cannabinoid Hyperemesis Syndrome

Cannabinoid Hyperemesis Syndrome Cannabinoid Hyperemesis Syndrome Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Cannabinoid (...) Hyperemesis Syndrome Cannabinoid Hyperemesis Syndrome Aka: Cannabinoid Hyperemesis Syndrome , Cannabis Hyperemesis Syndrome From Related Chapters II. Pathophysiology Associated with chronic use Proposed mechanisms Cerebral fat deposition of lipophilic metabolites with frequent use THC binding to vanilloid receptors in the (transient receptor potential vanilloid receptor, TRPV1) Low THC concentrations and warmer s (>109.4 F or 43 C) are High THC concentrations are pro-emetic III. Diagnosis Essential

2018 FP Notebook

13. Can cannabinoid hyperemesis syndrome be fatal?

Can cannabinoid hyperemesis syndrome be fatal? Can cannabinoid hyperemesis syndrome be fatal? » The Poison Review Can cannabinoid hyperemesis syndrome be fatal? May 30, 2018, 1:22 pm shutterstock.com/Stanimir G. Stoev Cannabinoid Hyperemesis Syndrome: Reports of Fatal Cases. Nourbakhsh M et al. J Forensic Sci 2018 May 15 [Epub ahead of print] This paper reports on 2 fatal cases that the authors argue were attributable to the effects of (CHS). CASE #1: A 27-year-old woman is brought to hospital (...) and vomiting, and discharged home after symptomatic improvement. Gross and histologic findings at autopsy did not reveal a specific causes of death. Extensive toxicology testing was positive for Delta-9-THC and Carboxy-THC. Tests of vitreous humor showed hyponatremia, hypochloremia, hypoglycemia, and elevated urea and creatinine. (Strangely, no electrolyte results are reported on pre-mortem blood.) The death was attributed to complications of cannabinoid hyperemesis syndrome. CASE #2: A 27-year-old man

2018 The Poison Review blog

14. Cannabinoid Hyperemesis Syndrome: A Case Report of Cyclic Severe Hyperemesis and Abdominal Pain with Long-Term Cannabis Use Full Text available with Trip Pro

Cannabinoid Hyperemesis Syndrome: A Case Report of Cyclic Severe Hyperemesis and Abdominal Pain with Long-Term Cannabis Use Introduction. Cannabinoid Hyperemesis Syndrome (CHS) is a rare condition that includes cyclic severe vomiting in subjects who have been consuming large doses of cannabis for several years. One of the major diagnostic criteria is the alleviation of symptoms by hot showers. The syndrome was first described in 2004 and is so far neither completely understood nor well known (...) severe nausea and vomiting ceased by hot showers and resistant to all other treatments. The final diagnosis was not established until his third visit to the ER. Conclusion. CHS is an important differential diagnosis in patients who present with cyclic vomiting and abdominal pain with a history of long-term cannabis use. Recognition of this syndrome is important in order to avoid unnecessary clinical testing and to help the patients break the cycle of drug use.

2016 Case reports in gastrointestinal medicine

15. Treatment of cannabinoid hyperemesis syndrome: a systematic review

Treatment of cannabinoid hyperemesis syndrome: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address: Timing and effect measures (...) A sensitivity analysis is conducted to assess the impact of decisions taken in the review process on the meta-analysis outcome. These decisions may have been made in various stages of the review, e.g. the decision to exclude certain disease models, the decision to pool certain units of measurement for an outcome, the choice of effect measure, how subgroup variables are stratified etc. In order to assess the robustness of the findings of the meta-analysis, the analyses are re-run using the alternative

2017 PROSPERO

16. Cannabinoid hyperemesis acute renal failure: a common sequela of cannabinoid hyperemesis syndrome. (Abstract)

marijuana. The patient was found to have a creatinine of 3.21 and admitted for acute renal failure secondary to cannabinoid hyperemesis syndrome. Cannabinoid hyperemesis syndrome (CHS) is a recently described condition affecting long-term marijuana users. We found 5 other case reports of acute renal failure secondary to CHS [1-5], and a total of 55 case reports of CHS. The unique combination of intractable vomiting and constant hot showers seems to put CHS patients at significant risk of severe (...) Cannabinoid hyperemesis acute renal failure: a common sequela of cannabinoid hyperemesis syndrome. We report the case of a 25-year-old man with an 8-year history of daily marijuana use diagnosed with acute renal failure secondary to cannabinoid hyperemesis syndrome. The patient presented with “constant” vomiting for over a day. His symptoms were completely relieved with compulsive hot showering and partially relieved by hot baths, by high ambient room temperature, and transiently after smoking

2014 American Journal of Emergency Medicine

17. Case series: treating cannabinoid hyperemesis syndrome with capsaicin cream

Case series: treating cannabinoid hyperemesis syndrome with capsaicin cream Case series: treating cannabinoid hyperemesis syndrome with capsaicin cream » The Poison Review Case series: treating cannabinoid hyperemesis syndrome with capsaicin cream December 5, 2017, 5:27 pm Resolution of cannabis hyperemesis syndrome with topical capsaicin in the emergency department: a case series. Dezieck L et al. Clin Toxicol 2017 Sep;55:908-913. (CHS) is a form of cyclic vomiting characterized by: chronic (...) painful. Second, several patients in this series carried a diagnosis or irritable bowel syndrome, and may have been on chronic opioids. I wonder if some component of their symptoms might properly be attributed to rather than to CHS. Finally, it is important to note that the majority of patients had previous ED visits and hospital admissions for their symptoms, and some had received extensive GI workups including laboratory tests, imaging, and endoscopy. It is possible that if more clinicians were

2017 The Poison Review blog

18. Cannabinoid hyperemesis syndrome Full Text available with Trip Pro

Cannabinoid hyperemesis syndrome The antiemetic properties of marijuana are well known, but there is increasing evidence of its paradoxical hyperemetic effects on the gastrointestinal tract and central nervous system, known as 'cannabinoid hyperemesis syndrome' (CHS). We report a case of CHS encountered in our outpatient clinic. We also completed a review of the literature using PubMed in patients over 18 years of age with CHS. Understanding the diagnostic criteria and risk factors associated

2016 BMJ case reports

19. Cannabinoid hyperemesis syndrome and the onset of a manic episode Full Text available with Trip Pro

Cannabinoid hyperemesis syndrome and the onset of a manic episode Cannabinoid hyperemesis syndrome is a rare, recently described, clinically diagnosed condition that is characterised by a chronic history of cannabis use, cyclic nausea and vomiting, symptomatic relief with hot water bathing, and resolution with cessation of use. We present a case of this syndrome concurrent in a patient with bipolar mania. We suggest that a 3-week period of vomiting in the context of this syndrome contributed (...) to the precipitation of a manic episode by lowering mood stabiliser serum levels, and that this syndrome will have significant consequences for the patient's mental health. 2016 BMJ Publishing Group Ltd.

2016 BMJ case reports

20. Cannabinoid Hyperemesis Syndrome Associated With Compulsive Showering and Acute Kidney Injury Full Text available with Trip Pro

Cannabinoid Hyperemesis Syndrome Associated With Compulsive Showering and Acute Kidney Injury 27247840 2018 04 23 2018 11 13 2155-7772 18 1 2016 The primary care companion for CNS disorders Prim Care Companion CNS Disord Cannabinoid Hyperemesis Syndrome Associated With Compulsive Showering and Acute Kidney Injury. 10.4088/PCC.15l01847 Srihari Priya P Virginia Tech Carilion School of Medicine, Roanoke, Virginia. Liu Mengyang M Virginia Tech Carilion School of Medicine, Roanoke, Virginia. Punzell (...) Steven S Virginia Tech Carilion School of Medicine, Roanoke, Virginia. Shebak Shady S SS Virginia Tech Carilion School of Medicine, Roanoke, Virginia. Rea William S WS Virginia Tech Carilion School of Medicine, Roanoke, Virginia. eng Case Reports Letter 2016 02 25 United States Prim Care Companion CNS Disord 101547532 2155-7780 IM Acute Kidney Injury chemically induced Adult Compulsive Behavior chemically induced Humans Male Marijuana Abuse complications Syndrome Vomiting chemically induced 2016 6 2

2016 The Primary Care Companion for CNS Disorders

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