Role of chronic cannabis use

Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome

Thangam Venkatesan*, David J. Levinthal, B. U.K. Li, Sally E Tarbell, Kathleen A. Adams, Robert M. Issenman, Irene Sarosiek, Safwan S. Jaradeh, Ravi N. Sharaf, Shahnaz Sultan, Christopher D. Stave, Andrew A. Monte, William L. Hasler

*Corresponding author for this work

Research output: Contribution to journalReview article

Abstract

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

Original languageEnglish (US)
Article numbere13606
JournalNeurogastroenterology and Motility
Volume31
Issue numberS2
DOIs
StatePublished - Jun 1 2019

Fingerprint

Cannabinoids
Cannabis
Vomiting
Compulsive Behavior
Antiemetics
Anti-Anxiety Agents
Familial cyclic vomiting syndrome
Nausea
Water

Keywords

  • cannabis
  • cyclic vomiting
  • endocannabinoids
  • hot water bathing
  • hyperemesis
  • systematic review

ASJC Scopus subject areas

  • Physiology
  • Endocrine and Autonomic Systems
  • Gastroenterology

Cite this

Venkatesan, T., Levinthal, D. J., Li, B. U. K., Tarbell, S. E., Adams, K. A., Issenman, R. M., ... Hasler, W. L. (2019). Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome. Neurogastroenterology and Motility, 31(S2), [e13606]. https://doi.org/10.1111/nmo.13606
Venkatesan, Thangam ; Levinthal, David J. ; Li, B. U.K. ; Tarbell, Sally E ; Adams, Kathleen A. ; Issenman, Robert M. ; Sarosiek, Irene ; Jaradeh, Safwan S. ; Sharaf, Ravi N. ; Sultan, Shahnaz ; Stave, Christopher D. ; Monte, Andrew A. ; Hasler, William L. / Role of chronic cannabis use : Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome. In: Neurogastroenterology and Motility. 2019 ; Vol. 31, No. S2.
@article{ec74c3b483964ae49d5417b167f865fa,
title = "Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome",
abstract = "Cannabis is commonly used in cyclic vomiting syndrome (CVS) due to its antiemetic and anxiolytic properties. Paradoxically, chronic cannabis use in the context of cyclic vomiting has led to the recognition of a putative new disorder called cannabinoid hyperemesis syndrome (CHS). Since its first description in 2004, numerous case series and case reports have emerged describing this phenomenon. Although not pathognomonic, a patient behavior called “compulsive hot water bathing” has been associated with CHS. There is considerable controversy about how CHS is defined. Most of the data remain heterogenous with limited follow-up, making it difficult to ascertain whether chronic cannabis use is causal, merely a clinical association with CVS, or unmasks or triggers symptoms in patients inherently predisposed to develop CVS. This article will discuss the role of cannabis in the regulation of nausea and vomiting, specifically focusing on both CVS and CHS, in order to address controversies in this context. To this objective, we have collated and analyzed published case series and case reports on CHS in order to determine the number of reported cases that meet current Rome IV criteria for CHS. We have also identified limitations in the existing diagnostic framework and propose revised criteria to diagnose CHS. Future research in this area should improve our understanding of the role of cannabis use in cyclic vomiting and help us better understand and manage this disorder.",
keywords = "cannabis, cyclic vomiting, endocannabinoids, hot water bathing, hyperemesis, systematic review",
author = "Thangam Venkatesan and Levinthal, {David J.} and Li, {B. U.K.} and Tarbell, {Sally E} and Adams, {Kathleen A.} and Issenman, {Robert M.} and Irene Sarosiek and Jaradeh, {Safwan S.} and Sharaf, {Ravi N.} and Shahnaz Sultan and Stave, {Christopher D.} and Monte, {Andrew A.} and Hasler, {William L.}",
year = "2019",
month = "6",
day = "1",
doi = "10.1111/nmo.13606",
language = "English (US)",
volume = "31",
journal = "Neurogastroenterology and Motility",
issn = "1350-1925",
publisher = "Wiley-Blackwell",
number = "S2",

}

Venkatesan, T, Levinthal, DJ, Li, BUK, Tarbell, SE, Adams, KA, Issenman, RM, Sarosiek, I, Jaradeh, SS, Sharaf, RN, Sultan, S, Stave, CD, Monte, AA & Hasler, WL 2019, 'Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome', Neurogastroenterology and Motility, vol. 31, no. S2, e13606. https://doi.org/10.1111/nmo.13606

Role of chronic cannabis use : Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome. / Venkatesan, Thangam; Levinthal, David J.; Li, B. U.K.; Tarbell, Sally E; Adams, Kathleen A.; Issenman, Robert M.; Sarosiek, Irene; Jaradeh, Safwan S.; Sharaf, Ravi N.; Sultan, Shahnaz; Stave, Christopher D.; Monte, Andrew A.; Hasler, William L.

In: Neurogastroenterology and Motility, Vol. 31, No. S2, e13606, 01.06.2019.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Role of chronic cannabis use

T2 - Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome

AU - Venkatesan, Thangam

AU - Levinthal, David J.

AU - Li, B. U.K.

AU - Tarbell, Sally E

AU - Adams, Kathleen A.

AU - Issenman, Robert M.

AU - Sarosiek, Irene

AU - Jaradeh, Safwan S.

AU - Sharaf, Ravi N.

AU - Sultan, Shahnaz

AU - Stave, Christopher D.

AU - Monte, Andrew A.

AU - Hasler, William L.

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Cannabis is commonly used in cyclic vomiting syndrome (CVS) due to its antiemetic and anxiolytic properties. Paradoxically, chronic cannabis use in the context of cyclic vomiting has led to the recognition of a putative new disorder called cannabinoid hyperemesis syndrome (CHS). Since its first description in 2004, numerous case series and case reports have emerged describing this phenomenon. Although not pathognomonic, a patient behavior called “compulsive hot water bathing” has been associated with CHS. There is considerable controversy about how CHS is defined. Most of the data remain heterogenous with limited follow-up, making it difficult to ascertain whether chronic cannabis use is causal, merely a clinical association with CVS, or unmasks or triggers symptoms in patients inherently predisposed to develop CVS. This article will discuss the role of cannabis in the regulation of nausea and vomiting, specifically focusing on both CVS and CHS, in order to address controversies in this context. To this objective, we have collated and analyzed published case series and case reports on CHS in order to determine the number of reported cases that meet current Rome IV criteria for CHS. We have also identified limitations in the existing diagnostic framework and propose revised criteria to diagnose CHS. Future research in this area should improve our understanding of the role of cannabis use in cyclic vomiting and help us better understand and manage this disorder.

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

KW - cannabis

KW - cyclic vomiting

KW - endocannabinoids

KW - hot water bathing

KW - hyperemesis

KW - systematic review

UR - http://www.scopus.com/inward/record.url?scp=85067957417&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85067957417&partnerID=8YFLogxK

U2 - 10.1111/nmo.13606

DO - 10.1111/nmo.13606

M3 - Review article

VL - 31

JO - Neurogastroenterology and Motility

JF - Neurogastroenterology and Motility

SN - 1350-1925

IS - S2

M1 - e13606

ER -