Department of Medicine, William Beaumont Hospital, 3535 W. Thirteen Mile Road, Royal Oak, MI 48073, USA.
Dig Dis Sci. 2010 Nov;55(11):3113-9. doi: 10.1007/s10620-010-1131-7. Epub 2010 Feb 4.
GOALS/BACKGROUND: The cannabis hyperemesis syndrome, which is associated with chronic cannabis use, was recently reported in seven case reports and one clinical series of ten patients from Australia. We further characterize this syndrome with eight well-documented cases in the United States and report results of cannabis discontinuation and cannabis rechallenge.
Patients were identified by the three investigators in gastroenterology clinic or inpatient wards at William Beaumont Hospital from January to August 2009 based on chronic cannabis use; otherwise unexplained refractory, recurrent vomiting; and compulsive bathing. Charts were retrospectively analyzed with follow-up data obtained from subsequent physician visits and patient interviews.
The eight patients on average were 32.4 ± 4.1 years old. Five were male. The mean interval between the onset of cannabis use and development of recurrent vomiting was 19.0 ± 3.7 years. Patients had a mean of 7.1 ± 4.3 emergency room visits, 5.0 ± 2.7 clinic visits, and 3.1 ± 1.9 admissions for this syndrome. All patients had visited at least one other hospital in addition to Beaumont Hospital. All patients had vomiting (mean vomiting episodes every 3.0 ± 1.7 h), compulsive bathing (mean = 5.0 ± 2.0 baths or showers/day; mean total bathing time = 5.0 ± 5.1 h/day), and abdominal pain. Seven patients took hot baths or showers, and seven patients experienced polydipsia. Four out of five patients who discontinued cannabis use recovered from the syndrome, while the other three patients who continued cannabis use, despite recommendations for cessation, continued to have this syndrome. Among those four who recovered, one patient had recurrence of vomiting and compulsive bathing with cannabis resumption.
Cannabis hyperemesis is characterized by otherwise unexplained recurrent nausea and vomiting, compulsive bathing, abdominal pain, and polydipsia associated with chronic cannabis use. This syndrome can occur in the United States as well as in Australia. Cannabis cessation may result in complete symptomatic recovery.
目的/背景：大麻呕吐综合征与慢性大麻使用有关，最近在澳大利亚的七份病例报告和一份十名患者的临床系列报告中有所报道。我们通过在美国的八个记录良好的病例进一步描述了这种综合征，并报告了大麻戒断和大麻再挑战的结果。
根据慢性大麻使用、无法解释的难治性、反复呕吐和强制性洗澡，三位胃肠病学临床医生或威廉·博蒙特医院住院病房的工作人员在 2009 年 1 月至 8 月期间从胃肠病学诊所或住院病房确定了这些患者。通过随后的医生就诊和患者访谈获得了随访数据，对病历进行了回顾性分析。
这 8 名患者的平均年龄为 32.4 ± 4.1 岁。其中 5 名男性。从开始使用大麻到出现反复呕吐的平均间隔时间为 19.0 ± 3.7 年。患者平均急诊就诊 7.1 ± 4.3 次，门诊就诊 5.0 ± 2.7 次，因该综合征住院 3.1 ± 1.9 次。除了 Beaumont 医院，所有患者还曾去过至少一家其他医院。所有患者都有呕吐（平均每 3.0 ± 1.7 小时呕吐发作一次）、强制性洗澡（平均每天 5.0 ± 2.0 次洗澡或淋浴；平均每天洗澡总时间为 5.0 ± 5.1 小时）和腹痛。7 名患者洗热水澡或淋浴，7 名患者出现多饮。停止使用大麻后，4/5 名患者的综合征得到缓解，而另外 3 名尽管建议停止使用大麻，但仍继续出现该综合征的患者则继续使用大麻。在恢复的 4 名患者中，有 1 名患者在恢复使用大麻后出现呕吐和强制性洗澡复发。
大麻呕吐综合征的特征是慢性大麻使用相关的无法解释的反复恶心和呕吐、强制性洗澡、腹痛和多饮。这种综合征不仅发生在澳大利亚，也发生在美国。停止使用大麻可能会导致完全症状缓解。
