Cannabinoid hyperemesis syndrome

[Emergent]

Have you all encountered providers identifying this syndrome? I think it's under-identified. It's marijuana induced vomiting.

In my state, marijuana has been made legal. Pts are becoming more open about their usage. This makes it more comfortable to approach the subject. One, occasional side effect of cannabinoid usage is hyperemesis. I've been educating my pts regarding this, even if they don't admit that they use.

http://en.wikipedia.org/wiki/Cannabinoid_hyperemesis_syndrome

[IrishErin]

We have a cyclic vomiter that admits he only has his episodes when he has been smoking pot. This is very interesting...

[OCNRN63, RN]

Too many Cheetos.

[Anna Flaxis, BSN, RN]

I've seen this diagnosis a few times. It is distinct from CVS.

[JenNurse1972]

I agree. It is different, it simply has similar symptoms (hyperemesis). The same could be said for Hyperemesis gravidarium though. I've had cyclic vomiting in the past with gastroparesis (but the gastroparesis is only when acutely ill, intermittent) - try explaining that to a physician without them thinking you're crazy. Personally, I'm not happy at all about cyclic vomiting being associated with marijuana use since I never use marijuana.

Anyhow, one key point to watch for is that compulsive shower thing. That seems specific to the long term marijuana users. No one knows why they compulsively take showers, but most seem to have this behavior if asked about it.

[Christy1019, ASN, RN]

I agree. It is different, it simply has similar symptoms (hyperemesis). The same could be said for Hyperemesis gravidarium though. I've had cyclic vomiting in the past with gastroparesis (but the gastroparesis is only when acutely ill, intermittent) - try explaining that to a physician without them thinking you're crazy. Personally, I'm not happy at all about cyclic vomiting being associated with marijuana use since I never use marijuana.

Anyhow, one key point to watch for is that compulsive shower thing. That seems specific to the long term marijuana users. No one knows why they compulsively take showers, but most seem to have this behavior if asked about it.

I had a pt a few weeks ago for hyperemesis, that must have asked 20 times about taking a shower and how it would make her feel better. Unfortunately in the ED we don't have showers and the floor nurses said she wanted to shower like 15 times a day. Her family thought it was OCD but I wonder if thus was what was going on... Hmm...

[MunoRN, RN]

There's no shortage of pot smokers in my area and we see this every now and then. It takes pretty impressive amounts of chronic use to produce this effect. We have them drape a hot, moist towel over their had, after 5 or 10 minutes of that they're on their way and feeling just fine.

[CraigB-RN, MSN, RN]

Usually one of the key diagnostic signs is they have been to mayo clinic or the like and had the million dollar workup with no sig findings.

[CoffeeRTC, BSN, RN]

Interesting..I had hyperemesis gravidum an took lived in the shower. It was the only thing that made me feel human. I didn't realize it was a thing with hyperemesis.