A 64-year-old woman in Canada was rushed to the emergency department after drinking homemade calabash (bottle gourd) juice and experiencing a terrifying cascade of symptoms. This case, while uncommon, highlights a rare but serious health risk linked to certain gourds.
Paramedics found the woman suffering from sudden weakness, nausea, vomiting, diarrhea, and severe lower abdominal pain. Within minutes of consuming two cups of her usual homemade calabash juice, the woman reported an unusual bitterness in its taste – a stark departure from the mild flavor she was accustomed to over years of regular consumption.
Her medical crisis unfolded rapidly. Doctors observed alarmingly high heart rate and breathing rate, blood pressure that initially spiked then plummeted dangerously low, and cold extremities indicating poor circulation. An echocardiogram further revealed significant strain on one of her heart chambers, suggesting potential heart problems.
Emergency treatment aimed to stabilize the woman’s blood pressure with intravenous fluids. However, despite this intervention, she continued to suffer episodes of severe hypotension (low blood pressure), persistent diarrhea, and even vomited blood on several occasions. The gravity of her condition necessitated a transfer to the intensive care unit (ICU).
Through gastroscopy, doctors found inflammation and bleeding within her stomach lining – likely triggered by oxygen deprivation at the tissue level. This pointed towards shock, a life-threatening condition where inadequate blood flow damages vital organs. In this instance, the shock stemmed from toxins present in the squash juice. This type of poisoning is categorized as “toxic squash syndrome,” a rare ailment caused by consuming toxic compounds found within certain squashes and gourds.
Calabash belongs to the Cucurbitaceae family – alongside familiar vegetables like cucumbers, pumpkins, watermelon, and zucchini. These plants naturally produce bitter-tasting chemicals called cucurbitacins. While domesticated varieties have been carefully bred to minimize these potentially harmful toxins, making them palatable for humans, there are instances where cucurbitacin levels rise as these gourds ripen, posing a risk if consumed.
“If ingested, cucurbitacin is toxic to humans by various purported albeit uncertain mechanisms,” noted the report authors, explaining that the toxin disrupts cellular signaling and increases blood vessel permeability, ultimately damaging mucous membranes throughout the body, particularly in the digestive tract.
Interestingly, the intensity of bitterness seems to correlate with cucurbitacin concentration – though this link isn’t definitively proven scientifically. The patient in this case reported an unusually bitter taste, a clear warning sign that might have alerted her to danger.
Treatment for this type of poisoning involves close monitoring and supportive care to stabilize vital signs as there is no specific antidote. Thankfully, after five days in the ICU, the woman’s shock subsided. However, she experienced sudden and progressive hair loss two weeks later – another known symptom associated with bitter gourd poisoning further solidifying the diagnosis.
This Canadian case stands out because toxic squash syndrome is extremely rare. Similar cases have been documented primarily in regions like India where calabash juice features in traditional medicine practices.
