Vegetables and fruit juices are always considered as healthy! It is often said that juices consumed on an empty stomach has many health benefits.
Yet the recent case of a 41-year-old woman from the city has sparked alarm among the citizens. The woman had no underlying medical condition but died after consuming the bitter bottle gourd juice.
This incident has sparked a debate on whether such juices are healthy or harmful.
Pune365 spoke to Dr Sirisha Nagalla, MBBS & MEM, Columbia Asia Emergency Department, who has carried a research after encountering a similar case a few years ago.
“Bottle gourd juice is advocated by traditional healers for flatulence, diabetes mellitus, hypertension, liver diseases and as a diuretic,” says Dr Nagalla.
The juice, in certain circumstances, turns bitter with increased levels of cytotoxic compounds called Cucurbitacins. If the bitter juice is consumed, it causes a toxic reaction in the gut, leading to abdominal discomfort/pain, vomiting, hematemesis and hypertension.
Dr Nagalla recalls a similar case of a patient consuming bitter bottle gourd juice.
A 45-year-old male and his wife habitually consumed bottle gourd juice every morning, she said.
“One morning, however, they noticed the juice to be unusually bitter. His wife did not consume any more due to the bitter taste, but the man finished the glass.
“Within 15 minutes of consumption of the juice, he had multiple episodes of vomiting, profuse sweating associated with mild epigastric discomfort and headache.
“On arrival to the hospital, the patient was taken to the emergency room where he was hemodynamically stable but within 15 minutes, he suddenly became restless with altered sensorium. The patient became hypotensive, tachycardia, with cold and clammy extremities and feeble peripheral pulses. The systemic examination was unremarkable except for mild epigastric tenderness on lower abdomen examination.
Initial blood work showed leucocytosis, deranged LFT’S with Renal and Coagulation profile within normal limits. Upper Gastrointestinal Endoscopy showed diffuse erythema in the stomach with fluid collection in the fundus. A suspicious ulcer was seen on lesser curvature with a clot, she added.
“The patient was saved as he was rushed immediately to the emergency room. Intravenous fluids, inotropic support, antibiotics, antiemetics and proton pump inhibitors helped showed steady improvement over 2 days,” she said.
“This incident made me do research on bottle gourd, and it was finally concluded that Tetracyclic Triterpenoid Cucurbitacins compounds are responsible for the bitterness in vegetables like cucumber, squash, eggplants, melon, pumpkin, gourds and are highly toxic to mammals.”
“They are hydrophobic derivatives, compared with other Cucurbitaceae bottle gourds and they have unusual levels of Cucurbitacins in particular types B, D, G and H.”
Dr Nagalla further added that, “The symptoms start within 30 minutes of consumption, and patients often tend to confuse it with regular gastrointestinal sepsis, vomiting and diarrhoea which have similar symptoms.”
There is no known antidote for this but only supportive management treatment that too if the patient is admitted immediately can help.
Physicians should be suspicious of Cucurbitacin poisoning in patients who present with symptoms within 1 hour of consumption of plant from Cucurbitaceae family, she says.
“Awareness among people is essential, Bottle gourd juice should be only consumed if prescribed by a doctor and if bitter one should completely avoid it,” she added.
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