The Union health ministry today warned that bottle gourd juice should not be consumed if it comes from bitter-tasting pulp in an advisory on a practice promoted by yoga and Ayurveda evangelist Baba Ramdev among others.
“Bitter-tasting bottle gourd juice should not be consumed at all,” the ministry said, urging that a small piece of the pulp of bottle gourd, lauki in Hindi, should be tasted before the extraction of its juice to ensure that it is not bitter.
The advisory reflects the recommendations of an expert panel set up by the ministry last year after a man died in New Delhi after consuming bottle gourd juice. Doctors say bottle gourds may sometimes contain potentially-toxic, bitter-tasting compounds called cucurbitacins.
These compounds can lead to gastrointestinal bleeding, liver damage, inflammation of the pancreas and eventually multi-organ failure, said Anita Sharma, professor of medicine at the Himalayan Institute of Medical Sciences, Dehra Dun, and a member of the expert panel.
Doctors believe the consumption of bottle gourd juice has increased significantly after the practice was promoted by Ramdev through his television speeches. “Sometimes, people mix bottle gourd juice with bitter gourd juice which makes it difficult to distinguish the bitter taste,” said Sharma who, in a twist of circumstances, found herself called on to treat Ramdev earlier this year when he became ill after fasting against black money.
Ramdev landed in Sharma’s hospital with dehydration after a few days of fasting, protesting against corruption and black money, first at the Ramlila grounds from where he was forcibly removed by Delhi police, and later in his own yoga propagation complex near Haridwar.
Sharma and her colleagues were the first to document bottle gourd poisoning in India five years ago when they treated a 59-year-old senior police officer in Dehra Dun who developed diarrhoea and vomited blood within half an hour of consuming fresh bottle gourd juice.
“We managed to save the police officer — he had unknowingly poisoned himself with bottle gourd,” Sharma told The Telegraph. “The message was conveyed to Ramdev and, since then, he has been urging people not to consume bitter-tasting juice,” she said.
The ministry’s advisory says any person who experiences discomfort, nausea, vomiting or any feeling of uneasiness after consumption of raw bottle gourd juice should be immediately taken to a nearby hospital.
The advisory is also intended for physicians practising traditional medicine. Bottle gourd juice is prescribed by Ayurveda as a therapy against high cholesterol and diabetes and as a general tonic. “It is seen as having multiple benefits — but Ayurveda also says bitter-tasting juice should not be consumed,” said Biren Shah, professor of pharmacology at the Vidyabharti Trust College of Pharmacy in Umrakh, Gujarat.
Not all bottle gourds have the bitter compounds. Plant physiologists believe stresses such as extreme temperature swings, too little water, poor soil fertility, over-maturation of vegetables may lead to high levels of cucurbitacins in bottle gourd.
“The toxins bring an extreme bitter taste which is retained even on cooking which makes people stop eating even cooked bottle gourd with cucurbitacins,” Sharma said. “The problem is likely to occur when people mix it with other bitter substances like bitter-gourd or neem,” she said.
The ministry has also issued guidelines for clinical management of bottle gourd poisoning. In the absence of specific antidote, doctors are being asked to provide general supportive care such as maintaining fluid and electrolyte balance, management of gastrointestinal bleeding, and the use of medications to treat complications in various organs.
Cucurbitacins are found in plants belonging to the cucumber family such as cucumbers, gourds, pumpkins, and squashes.
Medical literature documents a few rare cases of poisoning — in 1994 several schoolchildren in London developed gastrointestinal illness that was attributed to a toxic chemical present in cucumber served at lunch. In 2003, a farmer in the US developed diarrhoea for several days after he ate extremely bitter zucchini squash.