Mahmad Abdul I, Jehangir Waqas, Littlefield Jay M, John Sujith, Yousif Abdalla
Resident, Internal Medicine, Raritan Bay Medical Center, Perth Amboy, NJ, USA.
Medical Student, Ross University School of Medicine, USA.
Toxicol Rep. 2015 Jun 9;2:889-890. doi: 10.1016/j.toxrep.2015.05.015. eCollection 2015.
Cannabis is the most common illegal substance used in the world. The psychoactive nature of cannabis is primarily due to delta-9-tetrahydrocannabinol (THC). Some research suggests that prolonged cannabinoid use increases its half-life and fat solubility in the body, slowing gastric emptying, leading towards feelings of nausea and vomiting. We describe a case where a 32 year old male has excessive nausea and vomiting after prolonged use of daily cannabis.
A 32 year old Hispanic male with no significant past medical history presented to the emergency department with five days history of nausea and vomiting associated with abdominal pain. The vomitus is associated with diffuse abdominal pain and is alleviated by taking hot showers. Vital signs were normal and physical exam showed some abdominal tenderness. CBC and CMP were normal, and urine toxin screen revealed positivity for THC. The patient was admitted with possible diagnoses of cannabis induced hyperemesis. He was placed on Lorazepam and he took multiple hot showers, which improved his nausea. The next day he was discharged home in stable condition.
Our patient reported the vomiting episodes were associated with the regular usage of cannabis over 19 years. One theory on the effectiveness of hot showers states that it may correct the disequilibrium of the thermoregulatory system in the hypothalamus. Another theory suggests that the concept of peripheral vasodilation and redistribution of blood flow from the splanchnic circulation to peripheral musculature helps decrease vomiting. This research gap shows that further studying of cannabis and its effects are still needed.
大麻是世界上最常用的非法物质。大麻的精神活性主要归因于δ-9-四氢大麻酚（THC）。一些研究表明，长期使用大麻会增加其在体内的半衰期和脂溶性，减缓胃排空，导致恶心和呕吐感。我们描述了一例32岁男性在长期每日使用大麻后出现过度恶心和呕吐的病例。
一名32岁无重大既往病史的西班牙裔男性因伴有腹痛的恶心和呕吐5天病史就诊于急诊科。呕吐与弥漫性腹痛相关，洗热水澡可缓解。生命体征正常，体格检查显示有腹部压痛。血常规和生化检查正常，尿毒素筛查显示THC呈阳性。该患者因可能诊断为大麻所致的呕吐入院。给他使用了劳拉西泮，他多次洗热水澡，这改善了他的恶心症状。第二天他病情稳定后出院回家。
我们的患者报告呕吐发作与19年的大麻常规使用有关。关于洗热水澡有效性的一种理论认为，它可能纠正下丘脑体温调节系统的失衡。另一种理论认为，外周血管扩张以及血流从内脏循环重新分布到外周肌肉组织的概念有助于减少呕吐。这一研究空白表明仍需要对大麻及其影响进行进一步研究。
