More Than Just A Gastroenteritis - Bottle gourd (Lagenaria Siceraria) Toxicity Diagnosed in the Emergency Department

BackgroundBottle gourd (Lagenaria siceraria) is sometimes used in complementary medicine practice for the treatment of chronic ailments. It belongs to the Cucurbitaceae family. However, there have been reports of toxicity due to consumption of bottle gourd juice leading to severe abdominal upset and upper gastrointestinal bleeding. As emergency physicians we need to be aware of such complementary medicine induced haemorrhagic gastroenteritis as possible etiology of gastrointestinal haemorrhage. Case presentationWe present a case of a 41-year-old gentleman who presented to the emergency department (ED) with multiple episodes of vomiting, hematemesis and diarrhoea after consuming bottle gourd juice. The patient was resuscitated and stabilized with fluids, proton pump inhibitors and antiemetics. He was subsequently admitted to General Medicine ward for further management. He continued to receive symptomatic treatment in the ward and underwent esophagogastroduodenoscopy (OGD) during his hospitalization stay. His symptoms improved and he was discharged stable five days later. ConclusionEarly recognition of this rare presentation of bottle gourd toxicity is important in our local context especially where traditional medicine is widely prevalent nowadays. Treatment is supportive. Public awareness of dangerous effects from the consumption of bitter bottle gourd juice and complementary medicine without proper consultation with practitioner plays a crucial role to prevent further cases. Physicians need to advise patients on the use of traditional medicine and their potential side effects.