Q. I started to have symptoms of jaundice, diarrhea and fatigue after cannabis smoking. What to do?

Answered by
Dr. Vasavada Bhavin Bhupendra
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Feb 01, 2021

Hi doctor,

I am a male with normal weight. I do not drink alcohol but I have a habit of cannabis smoking. It did it for a couple of years with short intermittent pauses for two to three weeks. I started to have symptoms of jaundice, diarrhea, and fatigue at the end of the month. I do not had any other previous symptoms on that month. I do not have any other diseases. My transaminase was normal and it was checked during the routine blood work. I have attached the reports. I did an abdominal CT with contrast and the result was normal. Plasmapheresis was done and a liver function test was also done. I had an AST of 800, ALT of 450, and total bilirubin was 12 mg/dL. After three days, I had an AST of 1010, an ALT of 505, and had total bilirubin of 14 mg/dL. During this period, I had a weight loss of 10 to 15 kilograms and my appetite was normal. I want to know my differential diagnosis and prognosis. Please suggest.



Welcome to

Please send the reports of prothrombin time and international normalized ratio. You can have a diagnosis of acute or chronic liver failure where the acute component can occur due to cannabis and the chronic component can be due to hepatitis B induced with chronic liver disease. Please send your HBV (hepatitis B) DNA (deoxyribonucleic acid) quantitative report.

Thank you doctor,

I have sent the reports asked by you. I am willing to add an upper GI endoscopy report and it was with normal results.



Welcome back to

The reports are good. You have acute or chronic liver failure due to acute HBV infection or due to the use of cannabis. I suggest you stop using Cannabis and wait for 15 days. Repeat liver function test. If there is no decrease, then you need to do a liver biopsy to confirm the diagnosis. Liver biopsy is done with the liver USG (ultrasound) guided with a needle and the removed tissue is examined under a microscope. Report to the doctor when you have a change in consciousness or drowsiness or an increase in sleepiness.

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