Bitter bottle gourd poisoning

Abstract

Bottle gourd juice is considered a panacea in traditional Indian medicine and used in various chronic diseases. Increased levels of Cucurbitacin can turn it bitter causing toxic effects in gastrointestinal system. We report the case of an elderly female who presented with shock in few hours after consumption of bitter bottle gourd juice. After proper evaluation we considered the possibility of bottle gourd poisoning as a probable diagnosis due to the Naranjo adverse drug reactions probability scale. Since there is no specific antidote available, management is mostly supportive with intravenous fluids, control of bleeding and management of shock.

Health Drink Poisoning – An Unusual Case of Bottle Gourd Toxicity

“…Sepsis with multi-organ dysfunction with septic shock – foci of infection in the GI tract[ 1 7 ] – due to abdominal symptoms and systemic inflammatory response syndrome response with shock. [ 8 ] Food poisoning or foodborne illness[ 1 7 ] and GI bleeding (bleeding peptic ulcer, esophageal variceal bleeding, etc.) with hemorrhagic shock and organ dysfunction[ 1 8 ] were also thought and considered differentials.…”

Bottle gourd toxicity: the bitter truth of being green-thumbed

“…2 When the gourd is over ripe or stored improperly, they accumulate cucurbitacins, which are toxic at high concentrations. 1 There is a preponderance of case reports from India, 1,3,4,6 though a Canadian case has been reported relating to juice toxicity. 7 Severe toxicity causes upper gastro-intestinal bleeding.…”

“…Toxicity mediated by the accumulation of cucurbitacins is most commonly associated with the ingestion of the juice as a tonic in India, where it is thought to provide health benefits in diabetes, hypertension, liver disease and depression. [1][2][3][4] More recently, there is significant interest in the use of cucurbitacins in the treatment of cancer. 5 We report a case of a patient admitted with bottle gourd toxicity following ingestion of the vegetable as a home-grown, home-cooked meal.…”

Bottle Gourd Juice: Poison or Panacea

“…Upper gastrointestinal symptoms like vomiting, hematemesis, abdominal pain and diarrhoea are the most common symptoms of bottle gourd poisoning [6][7][8][10][11][12][13][14]. In some cases, tachycardia, hypotension, and tachypnoea are also noted.…”