Jiménez-Castillo R A, Arumugam S, Remes-Troche J M, Venkatesan T
Servicio de Gastroenterología y Endoscopía, «Dr. José E. González» Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico; Laboratorio de Fisiología Digestiva y Motilidad Gastrointestinal, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Veracruz, Veracruz, Mexico.
Departamento de Medicina Interna de la Universidad de California, Escuela de Medicina de Riverside, California, United States.
Rev Gastroenterol Mex (Engl Ed). 2025 Apr-Jun;90(2):214-226. doi: 10.1016/j.rgmxen.2025.02.002. Epub 2025 Jun 13.
Cannabinoid hyperemesis syndrome (CHS) is a chronic disorder characterized by episodes of severe vomiting, alternating with asymptomatic or minimally symptomatic periods. The episodes of emesis tend to be disabling, negatively affecting quality of life. The disorder's main characteristic is that it is associated with previous chronic heavy cannabis use. CHS is similar to cyclic vomiting syndrome (CVS), with the exception that the sustained cessation of cannabis use is expected to resolve the vomiting episodes. The average time between the onset of acute CHS episodes and diagnosis ranges from three to six years, based on previously published cases. This delay in the diagnosis reflects a lack of awareness of the condition on the part of physicians. Delayed diagnosis of CHS results in frequent emergency room visits and increased healthcare costs, and the lack of effective treatment leads to poor patient outcomes. The diagnosis is challenging, and some authors have diagnosed CHS when patients had cyclic vomiting, in the context of chronic cannabis use, regardless of the duration of use or the potency of the product used. The aim of this narrative review is to provide a detailed and critical analysis of current knowledge about CHS. The present document focuses on a thorough review of the literature on worldwide cannabis use, the role of the endocannabinoid system in the pathophysiology of CHS, diagnostic criteria, and current management of CHS.
大麻素呕吐综合征（CHS）是一种慢性疾病，其特征为严重呕吐发作，与无症状或症状轻微期交替出现。呕吐发作往往使人丧失能力，对生活质量产生负面影响。该疾病的主要特征是与先前长期大量使用大麻有关。CHS与周期性呕吐综合征（CVS）相似，但持续停止使用大麻有望缓解呕吐发作。根据先前发表的病例，急性CHS发作至诊断的平均时间为三至六年。这种诊断延迟反映出医生对该病症认识不足。CHS的延迟诊断导致患者频繁前往急诊室就诊并增加医疗费用，而缺乏有效治疗则导致患者预后不良。诊断具有挑战性，一些作者在患者长期使用大麻且出现周期性呕吐时诊断为CHS，而不论使用时长或所用产品的效力如何。本叙述性综述的目的是对目前关于CHS的知识进行详细且批判性的分析。本文献着重对全球大麻使用的文献、内源性大麻素系统在CHS病理生理学中的作用、诊断标准以及CHS的当前管理进行全面综述。
