A 22-year male presented with recurrent episodes of nausea, refractory vomiting, and colicky epigastric pain for one week. The symptoms were characterized by treatment-resistant nausea in the morning, continuous vomiting, and colicky epigastric abdominal pain. Each episode lasted 2 to 3 h and increased with food intake. He often had two or more episodes a day during the symptomatic period. He had been treated for the severe nausea and vomiting in the emergency room on two occasions in the preceding two months. He also reported having learned to help himself by taking a hot bath each time the symptoms appeared, which dramatically improved his symptoms. This habit had become a compulsion for him for symptom relief with each episode of hyperemesis. On physical examination his mucous membranes were dry, his pulse rate was 102/min and blood pressure was 140/100 with positive orthostasis. The remainder of the physical examination was unremarkable. His complete blood count and comprehensive metabolic panel were unremarkable. In addition, serum amylase and lipase levels were within the normal range. His urine drug screen was positive for tetrahydrocannabinol (THC). Abdominal X-ray series and ultrasonography were within normal limits. Oesophagogastroduodenoscopy revealed Grade 2 distal oesophagitis and hiatal hernia. On further interviewing, he admitted to consistent marijuana abuse for the past 6 years, often smoking cannabis every hour or two on a daily basis. The patient and his mother did not recall any significant past illnesses or recurrent vomiting when he was a child. He was treated with intravenous fluids with steady improvement in symptoms, and metoclopramide, pantoprazole and morphine for the abdominal pain. It was explained that marijuana was the cause of his symptoms and he was advised not to resume marijuana abuse. On subsequent follow-up, he had abstained from cannabis and remained symptom-free. (Cannabinoid hyperemesis syndrome: Clinical diagnosis of an underrecognised manifestation of chronic cannabis abuse) Abstract Background and aims: To explore the association between chronic cannabis abuse and a cyclical vomiting illness that presented in a series of cases in South Australia. Methods: Nineteen patients were identified with chronic cannabis abuse and a cyclical vomiting illness. For legal and ethical reasons, all patients were counselled to cease all cannabis abuse. Follow up was provided with serial urine drug screen analysis and regular clinical consultation to chart the clinical course. Of the 19 patients, five refused consent and were lost to follow up and five were excluded on the basis of confounders. The remaining nine cases are presented here and compared with a published case of psychogenic vomiting. Results: In all cases, including the published case, chronic cannabis abuse predated the onset of the cyclical vomiting illness. Cessation of cannabis abuse led to cessation of the cyclical vomiting illness in seven cases. Three cases, including the published case, did not abstain and continued to have recurrent episodes of vomiting. Three cases rechallenged themselves after a period of abstinence and suffered a return to illness. Two of these cases abstained again, and became and remain well. The third case did not and remains ill. A novel finding was that nine of the 10 patients, including the previously published case, displayed an abnormal washing behaviour during episodes of active illness. Conclusions: We conclude that chronic cannabis abuse was the cause of the cyclical vomiting illness in all cases, including the previously described case of psychogenic vomiting. (Cannabinoid hyperemesis: cyclical hyperemesis in association with chronic cannabis abuse -- Allen et al. 53 (11): 1566 -- Gut) Abstract Background and aims: To explore the association between chronic cannabis abuse and a cyclical vomiting illness that presented in a series of cases in South Australia. Methods: Nineteen patients were identified with chronic cannabis abuse and a cyclical vomiting illness. For legal and ethical reasons, all patients were counselled to cease all cannabis abuse. Follow up was provided with serial urine drug screen analysis and regular clinical consultation to chart the clinical course. Of the 19 patients, five refused consent and were lost to follow up and five were excluded on the basis of confounders. The remaining nine cases are presented here and compared with a published case of psychogenic vomiting. Results: In all cases, including the published case, chronic cannabis abuse predated the onset of the cyclical vomiting illness. Cessation of cannabis abuse led to cessation of the cyclical vomiting illness in seven cases. Three cases, including the published case, did not abstain and continued to have recurrent episodes of vomiting. Three cases rechallenged themselves after a period of abstinence and suffered a return to illness. Two of these cases abstained again, and became and remain well. The third case did not and remains ill. A novel finding was that nine of the 10 patients, including the previously published case, displayed an abnormal washing behaviour during episodes of active illness. Conclusions: We conclude that chronic cannabis abuse was the cause of the cyclical vomiting illness in all cases, including the previously described case of psychogenic vomiting. Keywords: cannabis, cyclical vomiting syndrome, hyperemesis, marijuana, psychogenic vomiting South Australia has had more liberal laws than much of the Western World for some years now regarding the possession of small quantities of cannabis for domestic consumption. In the Adelaide Hills area, it has become apparent that what was previously described as “psychogenic vomiting” is often, in fact, cannabis related illness. This disorder, occurring in susceptible individuals, is characterised by: a history of several years of cannabis abuse, predating the onset of the vomiting illness; the hyperemesis follows a cyclical pattern every few weeks or months, often for many years, against a background of regular cannabis abuse; cessation of cannabis leads to cessation of the cyclical vomiting illness, as confirmed by a negative urine drug screen for cannabinoids; a return to regular cannabis use heralds a return of the hyperemesis many weeks or months later; and the patient will “compulsively bathe” (that is, will take multiple hot showers or baths only during the active phase of the illness). METHODS Nineteen patients were identified following an original clinical observation by Allen linking chronic cannabis abuse to a cyclical vomiting illness in several cases in South Australia in 2001. Patients were either referred by doctors (12 cases), self referred (two cases), or identified on the ward by the nursing staff (five cases) during acute admission for profuse vomiting. Of these 19 patients, five refused consent and were lost to follow up and 14 fully consented for publication and presentation. Each patient was allotted a letter of the alphabet to preserve anonymity. Patients were followed up with serial urine drug screens and regular clinical consultations to chart their clinical course. Inpatients were observed with particular reference to autonomic changes in body temperature (measured tympanically), blood pressure, heart rate, fluid intake, skin flushing, and perspiration. However, patient anxiety, compounded by the severity of the hyperemesis, made formal autonomic testing impossible. All reasonable efforts were made to exclude confounding causes for their cyclical vomiting given the resources at hand. As a result, five patients were excluded from the study for the following reasons: Polydrug use (patients O and C). Porphyria cutanea tarda (patient Z). Acute pancreatitis (patient B). Schizophrenia (patient T). The remaining nine cases are presented in tables 1▶–4▶. They were compared with a case of psychogenic vomiting described in 1996 by de Moore and colleagues.4 Table 1 Characteristics of the first five study subjects Table 4 Clinical characteristics of the remaining four study subjects and the case of psychogenic vomiting described in 1996 by de Moore and colleagues (Mr G*)4 In their article, de Moore and colleagues4 described in detail a man (Mr G), who had smoked marijuana as a teenager, developed a cyclical vomiting syndrome in his twenties, and was noted to have multiple showers on the ward. Marijuana was not proposed as a cause of his illness. (Cannabinoid hyperemesis: cyclical hyperemesis in association with chronic cannabis abuse) the best at WIKI: Cannabinoid hyperemesis syndrome - Wikipedia
I thought this was an allergic reaction but now I think this is poisoning from cannabis that has been sprayed with pesticides. The reason I say this is that the patients symptoms seem to be alleviated by taking a warm bath, this is common with neurological problems such as migraines and some types of seizures. Most pesticides attack the nervous system.
It's definitely not pesticides, keep reading the forums. It's not neem oil either. While we can't know exactly what is happening I think one of the best descriptions out there is that chronic habitual use causes your body to no longer produce some sort of a chemical that it needs for gastric motility. When you go to sleep at night, you cease to move, hence it makes perfect sense why that would be the point in time when your gastroparesis will set in. But really quitting is stupid. Nobody likes a quitter. you just need to find a schedule that works for you. It's definitely going to require not smoking at times when you want to smoke, and suffering withdrawal. For me the withdrawal suffering it's totally fine, worth the wait to get where I'm going. I wrote about some of my experiences with managing it here CHS, Cannabanoid Hyperemesis Syndrome, What's the science behind it?