Gastrointestinal toxicity due to bitter bottle gourd (Lagenaria siceraria)--a report of 15 cases.

Traditional medicine is widely practiced in tropical countries. Bottle gourd (Lagenaria siceraria) fruit juice is advocated as a part of complementary and alternative medicine. If the bottle gourd juice becomes bitter it is considered toxic. We report 15 patients, who developed toxicity due to drinking bitter bottle gourd juice. Patients presented with abdominal pain, vomiting, hematemesis, diarrhea and hypotension within 15 min to 6-h after ingestion of bottle gourd juice. Endoscopy showed esophagitis, gastric erosions, ulcers and duodenitis. Hypotension was treated with crystalloids and inotropic support. All patients recovered in 1-4 days. Endoscopically the lesions healed in 2 weeks. Bitter bottle gourd can cause gastrointestinal toxicity with hematemesis and hypotension. Supportive management is the treatment and all patients recover within 1 week.