Wednesday, August 30, 2017

Chronic Vomiting Syndrome

If the title doesn't scare you this 8/30/17 Atlantic article should:
Cyclic vomiting syndrome is, I think, the best and worst clinical term for a condition that I’ve ever heard. Most clinical terms somewhat obscure the grossness of the thing described (think “incontinence” for diarrhea), but not cyclic vomiting syndrome (or CVS). It is pretty clear, pretty immediately, that what you are in for here is nonstop puking, in episodes lasting anywhere from a few hours to several days at a time. The exact cause is unknown, though there are a number of factors thought to contribute: emotional stress (particularly in children), hot weather, overeating, fatigue, migraines. A diagnosis of CVS is most common among young children, though the number of diagnoses among adults is increasing—and one of the reasons for that increase may be pot. A study published in 2012 found that marijuana use may be as high as 40 to 50 percent among male CVS patients. (While studies show that the typical patient for CVS linked to marijuana use is a middle-aged white man, women and minorities are also susceptible.) So, because I fear throwing up about as much as I fear drugs, I decided to speak to a medical professional to find out how likely it is that the average casual pot smoker will develop CVS.
Remember: marijuana is health food! The comments over there from pot worshippers are as you might expect: There is no hazard from inhaling psychoactive burning vegetables! And here's a paper on it.
Coinciding with the increasing rates of cannabis abuse has been the recognition of a new clinical condition known as Cannabinoid Hyperemesis Syndrome. Cannabinoid Hyperemesis Syndrome is characterized by chronic cannabis use, cyclic episodes of nausea and vomiting, and frequent hot bathing. Cannabinoid Hyperemesis Syndrome occurs by an unknown mechanism. Despite the well-established anti-emetic properties of marijuana, there is increasing evidence of its paradoxical effects on the gastrointestinal tract and CNS. Tetrahydrocannabinol, cannabidiol, and cannabigerol are three cannabinoids found in the cannabis plant with opposing effects on the emesis response. The clinical course of Cannabinoid Hyperemesis Syndrome may be divided into three phases: prodromal, hyperemetic, and recovery phase. The hyperemetic phase usually ceases within 48 hours, and treatment involves supportive therapy with fluid resuscitation and anti-emetic medications. Patients often demonstrate the learned behavior of frequent hot bathing, which produces temporary cessation of nausea, vomiting, and abdominal pain. The broad differential diagnosis of nausea and vomiting often leads to delay in the diagnosis of Cannabinoid Hyperemesis Syndrome. Cyclic Vomiting Syndrome shares several similarities with CHS and the two conditions are often confused. Knowledge of the epidemiology, pathophysiology, and natural course of Cannabinoid Hyperemesis Syndrome is limited and requires further investigation.

1 comment:

  1. When I was a child I would vomit uncontrollably every couple of months till my stomach was empty,and only bile would come up. I wad to be given Prochlorperazine to cease vomiting. Eventually I started experiencing the side effect of muscles seizing. After the worst case of this (even my diaphragm was uncontrollably contracting) the Docs recognized what was going on and put me on a different med.

    Throughout this period (about five years, from age 10-15) my doc was treating me as if it was an ulcer. He couldn't find any evidence of an ulcer after multiple different tests, but he did not know what else it could be.

    We never did satisfactorily figure it out, but I grew out of it. Anxiety and depression are issues in my family and I have delt with such myself, especially during winter, which may mean Seasonal Affective Disorder. I understand this may put me on the bi-polar spectrum, but it is very mild.

    Regardless, it is interesting to see this information about CVS. This is the first I've heard about anyone else experiencing something similar to what I went through.