Cannabinoid hyperemesis syndrome (CHS) is recurrent nausea, vomiting, and cramping abdominal pain that can occur due to prolonged, high-dose cannabis use. These symptoms may be relieved temporarily by taking a hot shower or bath. Complications may include kidney failure and electrolyte problems, and the condition can be fatal if not properly managed.Weekly cannabis use is generally required for the syndrome to occur; synthetic cannabinoids can also cause CHS. The underlying mechanism is unclear, with several possibilities proposed. Diagnosis is based on the symptoms, as well as the history of cannabis use (including a urine screen test if necessary). The condition is typically present for some time before the diagnosis is made. Another condition that presents similarly is cyclic vomiting syndrome (CVS).The only known effective treatment for CHS is to stop using cannabis. Two weeks (or possibly more) may be required to see a benefit. The primary differentiation between CHS and CVS is that cessation of cannabis use only relieves CHS.Treatments during an episode of vomiting are generally supportive in nature (e.g., hydration). There is tentative evidence for the use of capsaicin cream on the abdomen during an acute episode.The syndrome was first described in 2004, and simplified diagnostic criteria were published in 2009. Signs and symptoms
The long-term and short-term effects of cannabis use are associated with behavioral effects leading to a wide variety of effects on the body systems and physiological states. CHS is a paradoxical syndrome characterized by hyperemesis (persistent vomiting), as opposed to the better known antiemetic properties of cannabinoids.
An obturator hernia is a rare type of hernia of the pelvic floor in which pelvic or abdominal contents protrudes through the obturator foramen. Because of differences in anatomy, it is much more common in women, especially multiparous and older women who have recently lost much weight. The diagnosis is often made intraoperatively after presenting with bowel obstruction. The Howship–Romberg sign is suggestive of an obturator hernia, exacerbated by thigh extension, medial rotation and abduction. It is characterized by lancinating pain in the medial thigh/obturator distribution, extending to the knee; caused by hernia compression of the obturator nerve. References


== External links ==