A 28-year-old chronic cannabis user presents with recurrent episodes of severe nausea, vomiting, and abdominal pain that are relieved by taking hot showers. What is the most likely diagnosis?
- A Cyclical vomiting syndrome
- B Cannabinoid hyperemesis syndrome ✓
- C Gastroparesis
- D Acute pancreatitis
Correct answer: B. Cannabinoid hyperemesis syndrome
Explanation
Cannabinoid hyperemesis syndrome is characterized by cyclic vomiting, abdominal pain, and compulsive hot bathing in chronic cannabis users. The hot water exposure is thought to counteract the thermoregulatory dysregulation caused by chronic cannabinoid use. Cyclical vomiting syndrome lacks the cannabis association and hot shower relief. Gastroparesis and pancreatitis do not present with this pattern.
Reference: Harrison's Principles of Internal Medicine, 20th ed.
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