OpenHealth Q&A

30 Year Old Woman Experiences Unusual Symptoms After Eating Cucumber

**Age/Gender:** 30, Female **Height/Weight:** 5’2”, currently weighing between 115 and 118 lbs, down 10 lbs in the last six weeks **Medications:** PPI prescribed since August 24, using MiraLAX **Medical Background:** No previous gastrointestinal issues, athletic history with a clean eating regimen --- **Symptom Timeline:** - **July 21:** Consumed a homegrown bitter squash, suspected to be contaminated with cucurbitacin (toxic squash syndrome). This led to immediate bloating, a burning sensation throughout the abdomen, discomfort in the right upper quadrant, and a single episode of bloody stool, with no occurrences of vomiting or diarrhea. - **Subsequent Weeks:** Experienced ongoing burning in the epigastric region after consuming most foods (with rice being an exception), yellowing of stools, and escalating constipation, resulting in prolonged periods without a bowel movement. - **August 6 & 22:** Visited the emergency room twice, the second after consuming blueberries. An ultrasound returned normal results, and lipase levels were low at 23 on August 6. - **August 22 Blood Test:** Lipase slightly increased to 29, still below the normal range. - **August 24:** Initiated a daily PPI regimen, which yielded improvement in burning sensations (reduced from 6-8/10 to 1-4/10), although triggering episodes persisted after fatty meals. - **Throughout August:** Constipation continued to worsen; stools displayed a mustard-yellow color. Currently, only able to consume rice and broth, occasionally supplemented with minimal ghee or coconut oil. Even benign foods like steamed veggies or boiled chicken caused significant discomfort. Eliminated fats from the diet for the last ten days due to increased nausea. - **From September 1 Onwards:** Started MiraLAX, resulting in stools transitioning to brown with yellow hints. Regularity improved but remained sluggish. --- **Additional Observations:** - Despite maintaining a diet of rice and broth, there has been a notable weight loss of 10 lbs over six weeks. - Experiencing persistent cramping and queasiness in the right upper quadrant after any fat intake, even in minimal amounts. - Morning symptoms include a sour taste in the mouth and oral thrush. - Heart palpitations predominantly occur in the morning or following meals. Currently collaborating with a naturopath while awaiting an appointment with a primary care physician (planned for September 5) and an endoscopy/colonoscopy on September 30: - Comprehensive blood tests are pending, evaluating thyroid function, iron and ferritin levels, B12 and folate, vitamin D, cortisol levels, reverse T3, TGF-β1, VEGF, MSH, homocysteine, HLA genotyping, etc. - An upcoming GI Map stool test is also pending. --- **Inquiries:** 1. Is it possible for cucurbitacin poisoning to lead to long-term issues with bile or pancreatic function (evidenced by low lipase levels and RUQ pain post fat consumption) even after six weeks? Most literature suggests acute symptoms with quick recovery within days to a couple of weeks. 2. Should I propose getting a fecal elastase (pancreatic function test) or a HIDA scan (gallbladder function test) to my PCP while waiting for further evaluations? 3. Are there specific laboratory tests or symptoms that I should prioritize, given my recent weight loss and diminished food intake?

Answers (1)

9/4/2025, 12:03:03 AM

OpenHealth AI

It's understandable that you’re feeling concerned given your unusual symptoms and recent weight loss. Here’s a structured response to your inquiries and some guidance on how to manage your situation.

Main Points

1. Cucurbitacin poisoning can lead to persistent digestive issues, but long-term effects should not be assumed without further evaluation.
2. Testing for pancreatic and gallbladder function could be wise, given your symptoms.
3. Prioritize tests that evaluate your digestive health and nutritional status due to weight loss.

Explanation

• Cucurbitacin Poisoning: This is linked to gastrointestinal symptoms, but chronic issues are less common. It is possible that your body is still recovering, particularly if there was damage to the digestive lining or function that needs time to heal. Your ongoing symptoms may also suggest other underlying issues unrelated to the initial incident, particularly related to your bile or pancreatic function.

• Pancreatic and Gallbladder Function: Testing such as fecal elastase (which indicates how well the pancreas is functioning) and a HIDA scan (to assess gallbladder function) may provide important insights. Symptoms like burning after fat intake suggest potential gallbladder issues or pancreatic dysfunction.

• Prioritizing Tests: Given your significant symptoms and weight loss (10 lbs in six weeks), tests that focus on nutrient absorption and digestion are critical. Keep communication open with your healthcare team about your symptoms and recent changes.

Actionable Next Steps

1. Talk to Your PCP: Request a fecal elastase test and a HIDA scan to evaluate pancreatic and gallbladder function. Discuss your abdominal pain pattern after fat consumption; this may guide your doctor towards these investigations.

2. Monitor Symptoms: Keep a detailed symptom diary, noting what you eat and how you feel afterward. This helps identify food triggers and may assist your healthcare team in diagnosing your issues.

3. Support Nutritional Needs: Given your significant weight loss and limited diet, consider integrating liquid nutritional supplements (like smoothies or meal replacement drinks) if tolerated. These can help manage calorie intake while you navigate your digestive symptoms.

4. Stay Hydrated: Ensure you’re drinking enough fluids, especially with increased MiraLAX use, as hydration is crucial for bowel health.

5. Document All Changes: Keep your primary care physician informed about all changes, including new symptoms like oral thrush or heart palpitations, which may signify underlying conditions.

Don’t hesitate to reach out for further advice if your symptoms change or worsen while you wait for your upcoming evaluations. You are taking proactive steps in your health journey by seeking care and planning further tests, which is commendable.