Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin.
Pharmacology and Toxicology, Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin.
Clin Gastroenterol Hepatol. 2020 May;18(5):1082-1090.e2. doi: 10.1016/j.cgh.2019.07.039. Epub 2019 Jul 25.
BACKGROUND & AIMS: Some patients with cyclic vomiting syndrome (CVS) use cannabis to relieve stress and for its antiemetic properties. However, chronic cannabis use has been associated paradoxically with cannabinoid hyperemesis syndrome (CHS) and some patients with CVS are thought to have CHS. We sought to characterize patterns of cannabis use by patients with CVS and identify those who could be reclassified as having CHS.
We performed a cross-sectional study of 140 patients with CVS (72% female; mean age, 37 ± 13 y) seen at a specialized clinic. Patients were screened for cannabis use with the cannabis use disorder identification test. Patients were classified as regular (use ≥4 times/wk) or occasional users (<4 times/wk).
Forty-one percent of patients were current cannabis users, with 21% reporting regular use. Regular users were more likely to be male and to report an anxiety diagnosis, and smoked cannabis with higher tetrahydrocannabinol content and for a longer duration. Most users reported that cannabis helped control CVS symptoms. Among all cannabis users, 50 of 57 (88%) reported that they had abstained for longer than 1 month, but only 1 user reported resolution of CVS episodes during the abstinence period. This patient subsequently resumed using cannabis but remains free of symptoms.
Cannabis is used commonly among patients with CVS-patients report relief of symptoms with use. We found 21% of patients with CVS to be regular users, but only 1 met the Rome IV criteria for CHS. Longitudinal studies are needed to determine the relationships among cannabis use, hyperemesis, and mood symptoms.
一些周期性呕吐综合征（CVS）患者使用大麻来缓解压力并利用其止吐特性。然而，慢性大麻使用与大麻素呕吐综合征（CHS）呈反常相关，一些 CVS 患者被认为患有 CHS。我们旨在通过 CVS 患者的大麻使用模式并确定可重新归类为 CHS 的患者来识别他们。
我们对在专门诊所就诊的 140 名 CVS 患者（72%为女性；平均年龄为 37 ± 13 岁）进行了横断面研究。患者使用大麻使用障碍识别测试进行大麻使用筛查。将患者分为常规（每周使用≥4 次）或偶尔使用者（每周使用<4 次）。
41%的患者为当前大麻使用者，其中 21%报告有规律使用。经常使用者更可能为男性，并且报告有焦虑症诊断，并且吸食大麻的四氢大麻酚含量更高，吸食时间更长。大多数使用者报告说大麻有助于控制 CVS 症状。在所有大麻使用者中，有 57 名中的 50 名（88%）报告说他们已经禁欲超过 1 个月，但只有 1 名患者在禁欲期间报告说 CVS 发作得到缓解。该患者随后恢复使用大麻，但症状仍未出现。
大麻在 CVS 患者中普遍使用-患者报告使用大麻可缓解症状。我们发现 21%的 CVS 患者为经常使用者，但只有 1 名符合罗马 IV 标准的 CHS。需要进行纵向研究来确定大麻使用、呕吐和情绪症状之间的关系。
