Figure - uploaded by Paul Newton
Content may be subject to copyright.
Source publication
We investigated the significance and risk factors of bowel obstruction caused by the consumption of wild bananas (BOWB) in Laos. Of six patients with BOWB in Luang Namtha, North Laos, five required enterotomy for phytobezoars. All had eaten wild banana (WB) seeds.
Of 227 other patients/relatives: 91.2% had eaten WB; 46.3% had also eaten the seeds a...
Context in source publication
Citations
... Food-related SBO was described for many fruits including citrus fruit, persimmons, orange pith, mango, carrots, Brussels sprouts, wild banana and dried fruits. However, all those reports described phytobezoars as the mechanism of obstruction (3)(4)(5). ...
Objective: Small-bowel obstruction is a common emergency worldwide. Oleaster-leafed pear (Pyrus elaeagnifolia Pall.) is an endemic wild pear species in Anatolia. The wild pear fruits are consumed for the treatment of diarrhea in traditional medicine. Here, we describe adhesive small-bowel obstruction following consumption of wild pear.Material and Methods: The medical records of patients who were followed with a diagnosis of adhesion-related small-bowel obstruction between May 2018 and September 2019 were reviewed retrospectively. Patients were divided into two groups as wild pear-related small-bowel obstruction (Group 1) and patients with not wild pear-related small-bowel obstruction (Group 2). Patient characteristics, blood parameters and clinical features were compared between groups.Results: A total of 74 patients including 16 in Group 1 and 58 in Group 2 were included. The median age in Group 1 and Group 2 was 55 and 60.5, respectively. Increased levels of leukocyte, C-reactive protein, blood urea nitrogen were significantly more frequent in Group 2 (all p<0.05). Group 1 was associated with a shorter duration of complaints and faster recovery (all p<0.05). Surgical intervention was required in only Group 2.Conclusion: The potential adverse effects of over-consumed traditional medicines should be kept in mind. Questioning the last food consumed before the complaints started may be a clue for food-induced small-bowel obstruction.
... However, all those reports described phytobezoars as the mechanism of obstruction. [3][4][5] Pear (Pyrus) is one of the most bred and consumed fruits in the world. There are hundreds of Pyrus species but only 23 wild species were described, all native to Europe, northern Africa and temperate regions of Asia. ...
Background: Small-bowel obstruction (SBO) is a common emergency worldwide and adhesions are the main cause. Oleaster-leafed pear (Pyrus elaeagnifolia Pall.) is an endemic wild pear species in Anatolia. The wild pear fruits are consumed for the treatment of diarrhea in traditional medicine in Turkey. Here, we aimed to describe SBO caused by excessive consumption of wild pear and compare clinical features of it with those in adhesive SBO. Methods: The medical records of patients who were followed with a diagnosis of SBO between May 2018 and September 2019 were reviewed. Patients with wild pear-related SBO (Group 1) and patients with adhesive SBO (Group 2) were included in the study. Patient characteristics, blood parameters and clinical features were compared. Results: A total of 74 patients including 16 in Group 1 and 58 in group 2 were included. Amount of wild pear consumed was median 600 grammes (range, 450-800 gr). The median age in Group 1 and Group 2 was 55 and 60.5, respectively. History of previous SBO was more common in Group 2 (p=0.032). Increased levels of WBC, CRP and BUN were significantly more frequent in Group 2 (all p<0.05). Group 1 was associated with a shorter duration of complaints and faster recovery (all p<0.05). Surgical intervention was required for six patients (10.3%) in only Group 2. Conclusion: The potential adverse effects of over-consumed traditional medicines should be kept in mind. Questioning the last food consumed before the complaints start may be a clue for food-induced SBO.
... Ingestion of the fruit seeds is known to cause intestinal complications, including constipation, appendicitis, and small bowel obstruction, most commonly in rural, impoverished populations because of limited access to safe nutrition. [1][2][3][4] Despite local wisdom to avoid these dangerous fruits and multiple reports of wild banana ingestion-related bowel obstruction, cases like this demonstrate the impact that food insecurity and starvation can have on impoverished populations. ...
... The process of domestication involved selection for parthenocarpy and seed sterility, transforming wild banana from bitter seedy fruits into fleshy seedless parcels of sugar and starch. Wild 1 3 bananas are not only ill-tasting and seedy but they are a poor food, as sugars cause the fruit's large seeds to bind together, leading to alimentary tract obstruction if consumed, but records of consumption do exist and some societies may grind seeds into flour or collect them for beads (Johnston 1904a;Rossel 1998;Schöffl et al. 2004;Slesak et al. 2011). The unpalatability of wild bananas suggests that if they were important in their centre of domestication or elsewhere, it was originally as a source of fibre for cordage, leaves for shelters and basketry, or seed use (Fuller and Madella 2009;Kennedy 2009). ...
Occupation of the humid tropics by Late Holocene food producers depended on the use of vegetative agricultural systems. A small number of vegetative crops from the Americas and Asia have come to dominate tropical agriculture globally in these warm and humid environments, due to their ability to provide reliable food output with low labour inputs, as well as their suitability to these environments. The prehistoric arrival in Africa of Southeast Asian crops, in particular banana, taro and greater yam but also sugar cane and others, is commonly regarded as one of the most important examples of transcontinental exchanges in the tropics. Although chronologies of food-producer expansions in Central Africa are increasingly gaining resolution, we have very little evidence for the agricultural systems used in this region. Researchers have recovered just a handful of examples of archaeobotanical banana, taro and sugar cane remains, and so far none from greater yam. Many of the suggested dispersal routes have not been tested with chronological, ecological and linguistic evidence of food producers. While the impact of Bantu-speaking people has been emphasised, the role of non-Bantu farmers speaking Ubangi and Central Sudanic languages who have expanded from the (north)east has hardly been considered. This article will review the current hypotheses on dispersal routes and suggest that transmissions via Northeast Africa should become a new focus of research on the origins of Asian vegeculture crops in Africa.
... Its size may grow with the persistent ingestion of food rich in cellulose and the indigestible materials. Its impaction is most common at terminal ileum and before ileocaecal valve [3]. ...
... acuminata subsp. burmannica) seed phytobezoars being most commonly seen in Laos [3,4]. This is due to the distribution of the plants and dietary habits of the local community. ...
... In contrast, wild bananas (M. acuminata) keep their astringency and tannin even when ripe [3]. In combination with its abundant hard and indigestible seeds, tannin became the medium that congregated the seeds. ...
Wild banana (Musa acuminata subsp. microcarpa) seed phytobezoar rectal impaction in adult is a rare entity. Here, we report a 75-year-old male with dementia who presented with lower abdominal pain, per-rectal bleeding and overflow faecal incontinence. Our investigation discovered a large wild banana seed phytobezoar impacted in the rectum causing intestinal obstruction, stercoral ulcer and faecal overflow incontinence. In this article, we discuss the patient’s clinical findings, imaging and management. The culprit plant was identified and depicted. This may be the first report of its kind. Public consumption of these wild bananas should be curtailed. It is hoped that this report would increase the awareness of such condition and its identification.
... Bowel obstruction from edible items may occur in those with gastrointestinal motility disorders, Guillian-Barre syndrome, hypothyroidism and fast eaters [3]. Food items that have been reported to cause obstruction include dried fruit, apricot, coconut, raw banana and a whole lemon [3][4][5]. We report a case of acute small bowel obstruction requiring operative intervention in a 59-year-old lady caused by undigested vegetable. ...
Small bowel obstruction is a general surgical emergency usually
caused by adhesions or herniae. Malignancy, inflammatory bowel
disease and ingested foreign bodies (bezoars) are rarer causes. Bezoars
can occur at any point in the gastrointestinal tract (GIT) depending
on the type of bezoar and the point of impaction. Abdominal
CT scan can assist in making an accurate and timely diagnosis
of bezoar-induced small bowel obstruction. Bezoar-induced acute
bowel obstruction requires either endoscopic or surgical extraction
to avoid the complications of hemorrhage, perforation or fistula formation.
... Bowel obstruction from food items usually happen in people with poor gastrointestinal motility, Guillian-barre syndrome, hypothyroidism and fast eaters [4,5,6]. Food items that have been reported to cause obstruction include dried fruits, apricot, persimmon, coconut and raw banana [5,7,10]. We present a case of bowel obstruction due to dried apple. ...
Small bowel obstruction in a virgin abdomen is an uncommon surgical condition. While malignancy, inflammatory bowel disease and foreign body are the main reported causes, undigested food bezoar causing bowel obstruction is a rare entity. We report a case of small bowel obstruction secondary to dried preserved apple having re-expanded within the gastrointestinal tract.
A 69 year old male presented with severe abdominal distension, generalized abdominal tenderness and obstipation for 1 week. Small bowel obstruction (SBO) was confirmed on plain abdominal X-ray and CT imaging. An emergency explorative laparatomy identified a sausage-shaped intra-luminal foreign body obstructing the distal ileum. An enterotomy was performed which revealed a rehydrated, donut-shaped piece of dried apple.
Swallowed items that pass through the pylorus rarely cause obstruction as they are usually small enough to pass through the rest of the bowel without difficulty. We postulate that in our patient that the dried apple was originally small enough to pass through the pylorus. However during small bowel, its' highly absorbable nature resulted in an increase in size that prevented its' passage through the ileocecal valve. A simple in-vitro experiment discovered that dried apple has a potential to reabsorb fluid and expand up to 35% of its initial size within 72h.
This report illustrates the potential for dried food substances to cause intra-luminal SBO after significant expansion with rehydration.
Copyright © 2015 Z. Published by Elsevier Ltd.. All rights reserved.
... Bowel obstruction from edible items may occur in those with gastrointestinal motility disorders, Guillian-Barre syndrome, hypothyroidism and fast eaters [3]. Food items that have been reported to cause obstruction include dried fruit, apricot, coconut, raw banana and a whole lemon [3][4][5]. We report a case of acute small bowel obstruction requiring operative intervention in a 59-year-old lady caused by undigested vegetable. ...
Small bowel obstruction is a general surgical emergency usually caused by adhesions or herniae. Malignancy, inflammatory bowel disease and ingested foreign bodies (bezoars) are rarer causes. Be-zoars can occur at any point in the gastrointestinal tract (GIT) depending on the type of bezoar and the point of impaction. Abdominal CT scan can assist in making an accurate and timely diagnosis of bezoar-induced small bowel obstruction. Bezoar-induced acute bowel obstruction requires either endoscopic or surgical extraction to avoid the complications of hemorrhage, perforation or fistula formation .
... Banana, for example, is listed amongst the medicinal plants of western Africa, and the pharmaceutical properties of its ripe and unripe fruit, flowers and leaves discussed (Oliver-Bever 1986; see also Neuwinger 1996). The wild banana plants that were translocated at some unknown period to Pemba and Madagascar may have had particular medicinal qualities, as suggested by modern studies (Kennedy 2009;Slesak et al. 2011). In parts of western Africa, taro is seen primarily as a medicinal plant rather than a food source (Grimaldi 2013), and Medieval Islamic sources also emphasise its pharmaceutical qualities alongside its role as a food (Grimaldi 2013). ...
While Africa has sometimes been peripheral to accounts of the early Indian Ocean world, studies of food globalisation necessarily place it centre stage. Africa has dispatched and received an extraordinary range of plants, animals and foodstuffs through Indian Ocean trade and other avenues. Here we explore these patterns of food globalisation vis-A -vis Africa, focusing in particular on the arrival of new food crops and domesticated animals in Africa, but also touching on flows from Africa to the broader Indian Ocean world. We look at archaeological evidence, drawing in particular on new datasets emerging through the increasing application of archaeobotanical and zooarchaeological methods in African and Indian Ocean archaeology, and also draw on historical and ethnographic sources. We argue that the evidence points to a broadly Medieval and post-Medieval pattern of introduction, with little evidence for the earlier arrivals or culinary impacts argued by some. We also undertake consideration of questions about how and why new crops, animals, spices, and agricultural and culinary technologies come to be accepted by African societies, issues that are often overlooked in the literature.
The islands of Oceania contain many different types of ecosystems from saltwater sea grass beds, coastal strands, and mangrove forests to grasslands, freshwater wetlands, and upland rainforests. Plants that arrived on the islands without human intervention are considered native. This chapter lists several traditional native crops of Oceania. It also includes the ethnobotany of Australasia (Australia, New Zealand, and New Guinea). Banana (Musa spp.) (Musaceae) are herbaceous perennials native to Southeast Asia and Melanesia. There are numerous studies reporting the positive effects of consuming bananas for management of acute diarrhea. Kava (Piper methysticum) is a tropical shrub native to Oceania. Chemotype and kavalactone content are responsible for kava's physiological effect. Multiple mechanisms have been suggested to explain kava's anxiolytic (anti-anxiety) and sedating properties. Kava can block calcium ion channels, thereby diminishing excitatory neurotransmitter release, and suppress the synthesis of thromboxane A2, which antagonizes γ-aminobutyric acid type A receptor function.
