Nut poisoning

Nuts are a healthy and nutritious product that contains many vitamins and minerals. It is known that even a small handful of them can saturate the body and give an influx of energy, since they contain not only healthy fats, but also unique plant sterol, proteins and fibers. But we must not forget that nut poisoning can also occur - for example, when overeating them, improperly storing them or for other reasons. Why and how can you get poisoned by nuts, and what to do to avoid it?

Epidemiology

There are no clear statistics on the frequency and number of nut poisonings in the world. It is only known that such intoxications occur relatively rarely: no more than 5% of all food poisonings. But the most common cause of the disorder is considered to be overeating. However, people do not always turn to a doctor with this problem, preferring to "lie down" at home.

Experts warn: self-medication is dangerous, especially in severe cases of poisoning. Therefore, it is better to consult a doctor - even if only to prevent complications.

Causes nut poisoning

The causes of nut poisoning vary. According to statistics, the problem is most often associated with the following factors:

• overeating, eating a large amount of nuts at one time;
• eating certain raw nuts that can only be eaten after they have been cooked;
• eating spoiled nuts that have been stored incorrectly or for too long;
• consumption of nuts treated with chemicals for better preservation or to give them a marketable appearance.

Often the cause is a banal failure to observe hygiene rules (unwashed hands), or an incorrect combination of products (for example, nuts cannot be combined with milk).

Most nuts need to be roasted before eating, and not only to improve their taste. The raw product can become a source of dangerous infectious diseases due to the pathogenic microorganisms it contains – most often, such “nut” poisoning is caused by E. coli and salmonella. Microbial contamination of the raw product occurs during harvesting, and all the necessary conditions for further development of the infection can be created by improper storage – for example, in a too humid room, in damp, unventilated basements, etc.

Some raw nuts are dangerous in themselves. For example, the shell of unheated cashews contains a toxic component called cordol. When in contact with mucous tissue, cordol causes a burn-like reaction. [ 1 ] And raw bitter almond kernels contain the glycoside amygdalin, which, together with another nut substance, emulsin, becomes a source of hydrocyanic acid, a potent toxic agent. [ 2 ]

Risk factors

Of course, nut poisoning can happen to any of us. However, there are some categories of patients who are more prone to intoxication and complications than others:

• Pregnant women.

During pregnancy, the female body completely restructures its metabolic processes and circulatory system. In addition, women sometimes find it very difficult to cope with food cravings - for example, if you want nuts, then one handful will not do. As a result, overeating occurs and, as a consequence, nut poisoning.

• Old people.

In old age, the human digestive and immune systems work much worse and slower than in youth. Therefore, it is more difficult for an old person to cope with intoxication than for a young organism.

• Children.

In childhood up to 3 years old, nuts are generally contraindicated. They can be given little by little (literally 1-2 pieces), starting from the age of 4-5 years. This product is difficult for the child's digestive system to digest and can cause unpredictable pathological reactions - in particular, allergies or intoxication.

• Patients suffering from chronic diseases of the liver, kidneys, digestive system and endocrine system.

Pathogenesis

Nuts are a tasty, nutritious, but at the same time difficult to digest product, therefore they can disrupt the process of digestion of food, the production of enzymes, or cause an allergic process, which often takes the form of poisoning. [ 3 ] In addition, other pathogenetic causes of intoxication are also identified:

• in the shell and near the shell there may be mold in the form of fungal flora mycotoxin (at an early stage of development it is very difficult to notice);
• the nuts were collected in ecologically unfavorable areas, near cultivated fields or highways;
• The nuts were improperly roasted, stored in unacceptable conditions, or were additionally treated with chemicals.

Even with all the pathogenetic factors present, some people experience nut poisoning, while others do not. This depends on the general health of the person, the quality of his or her immunity, the individual characteristics of the body, and dietary preferences.

Symptoms nut poisoning

In most patients, nut poisoning is caused by overeating nuts. The clinical picture has much in common with ordinary food poisoning or with non-diabetic ketoacidosis.

The first signs appear regardless of the species of nuts: [ 4 ]

• dull pain in the stomach and intestines;
• impaired digestion, diarrhea and constipation;
• nausea with bouts of vomiting;
• irritation of the oral mucosa;
• general weakness, lethargy, loss of strength;
• dizziness, confusion.

Nutmeg poisoning causes characteristic symptoms similar to alcohol or marijuana intoxication. Patients complain of a feeling of pain and pressure in the temporo-occipital region, difficulty thinking, and apathy. In cases of severe poisoning, the victim must be hospitalized. [ 5 ]

When overeating nuts, signs of pancreatic dysfunction appear:

• pain under the ribs on the right;
• discomfort in the abdomen;
• bloating, belching, nausea;
• vomiting with bile, bitter taste in the mouth.

In case of poisoning with a low-quality and moldy product, patients note the appearance of frequent loose stools, abdominal pain, loss of appetite, thirst, trembling and weakness in the arms and legs. Painful symptoms increase within a few hours after the meal.

Forms

[ 7 ], [ 6 ]

In most cases, Brazil nut poisoning is associated with the fact that this exotic product is a strong trigger of allergic reactions. In addition, it contains a toxic carcinogenic substance - aflatoxin, which is present in the nut skin, but if stored incorrectly, it penetrates the kernel. When entering the human body, aflatoxin has a negative effect on the structure of the liver and kidneys. If you eat Brazil nuts too often, the risk of diseases of the nervous and respiratory systems also increases.

Poisoning with hazelnuts does not happen often. However, if you eat more than 60 g, it is easy to overload the digestive tract: digestion will be disrupted, various hypersensitivity reactions may occur in the form of a rash on the body, itching and redness of the skin. Some people experience severe headaches similar to migraine attacks. Increased bile secretion is often observed, which immediately affects the functioning of the intestines.

Hazelnut poisoning is caused by eating large amounts of raw nuts, which significantly complicates the digestive tract, slows down intestinal motility, leads to bile stagnation, and causes pain in the pancreas. Even roasted nuts, when overeating, can cause arthritis, arthrosis, and gout. Excessive consumption of nuts in childhood is especially dangerous.

Complications and consequences

The overwhelming majority of cases of nut poisoning end positively for the patient. For example, nut overeating most often goes away on its own, provided that a restrictive diet is followed.

Complications from nutmeg poisoning are dangerous, since it contains the psychotropic component myristicin, which impairs the transmission of nerve impulses and has a hallucinogenic effect. Nutmeg intoxication can result in spasms and convulsions, dehydration and death. An epileptic seizure occurs after eating 5.6 g of the nut. [ 8 ], [ 9 ]

Raw cashew nuts cause a burn when touched due to the allergotoxin urushiol (also found in poison ivy).

Other adverse effects may include:

• pneumonia;
• pyelonephritis, renal failure;
• hepatitis, liver failure;
• paralysis of the respiratory muscles;
• acute heart failure.

Some complications result in death.

Diagnostics nut poisoning

Before making a correct diagnosis, the doctor will need to collect detailed anamnesis data. Therefore, he will perform the following steps:

• interviews the victim;
• measures temperature (and blood pressure, if necessary), feels and evaluates the pulse;
• examines the body for allergic reactions, palpates the abdominal area, examines the mucous membranes of the oral cavity.

Next, tests are prescribed that must be taken in the laboratory:

• general blood test;
• stool analysis (coprogram).

Other laboratory tests may be ordered at the discretion of the physician:

• urine analysis;
• examination of vomit, etc.

Instrumental diagnostics are used rarely, depending on the indications:

• fibroesophagoscopy, gastroduodenoscopy;
• colonoscopy;
• rectoscopy;
• X-ray examination.

If several people are poisoned by nuts at once, then representatives of the sanitary and epidemiological service will additionally examine the products that caused the intoxication.

Differential diagnosis

Differential diagnostics are carried out with other types of intoxication, acute appendicitis, pancreatitis, and diseases of the hepatobiliary system.

Treatment nut poisoning

If you suspect poisoning with nuts, you need to wash your stomach as soon as possible. To do this, use a weak soda solution, or a very weak solution of potassium permanganate. After washing, drink any sorbent preparation and drink a lot of liquid.

If necessary, medications are prescribed by a doctor.

Diet is considered an obligatory part of the treatment of nut poisoning. It is advisable to completely exclude food intake during the first day or two. At the very least, it is necessary to refuse fatty, spicy, heavy dishes, dairy products, and alcoholic beverages.

Further nutrition should be organized in small portions: eat dishes boiled or cooked in a steamer. It is necessary to drink a lot, gradually restoring the impaired functions of the body.

To speed up recovery, you should follow these recommendations:

• in the acute period of nut poisoning, the patient should stay in bed and drink a lot (water, green tea, rosehip or chamomile infusions are excellent);
• on the second day, when the symptoms of poisoning have subsided, you can eat a little mashed boiled food, but in very small quantities;
• Over the next few days, the diet is gradually expanded, but continue to drink a lot of water and avoid eating fatty and spicy foods.

Medicines that a doctor may prescribe

To speed up the removal of toxic substances from the digestive system, sorbents are used - for example, Enterosgel, Polysorb, activated carbon. Such drugs minimize the flow of toxins from the digestive system into the bloodstream, promote the removal of alkaloids, heavy metal salts, etc. from the body. [ 10 ]

Enterosgel is taken in the amount of 1 tbsp. with water, three times a day. Activated carbon is prescribed at the rate of 1 tablet per 10 kg of the victim's weight. Tablets of "white coal" are taken 2-3 pcs. three times a day, until the state of health is normalized. Side effects of such treatment can be thirst, constipation.

After cleansing the digestive tract, it is important to take measures to replenish the fluid lost by the body. Most often, experts advise drinking regular boiled water, weak tea, chamomile or rosehip infusion. You can also use special pharmacy products:

• Regidron - prepare a solution based on one packet of the drug and one liter of water, drink during the day. Duration of treatment is 3-4 days.
• Oralit - dilute one packet of the drug in 200 ml of water, take after each case of loose stools.
• Ionica - taken in the same way as Oralit. An allergic reaction occurs extremely rarely during the intake of oral rehydrants, no other side effects are detected.

If restoration of intestinal flora and pancreatic functionality is required, then one of the following drugs is additionally prescribed:

• Hilak forte – oral drops that are taken with food, approximately 40-60 drops per dose, three times a day. Possible side effects: allergy, discomfort in the abdomen.
• Linex is a combination drug, it is prescribed 2 capsules three times a day with food. Side effects in the form of allergies are found only in isolated cases.
• Festal is an enzyme that improves digestion. Take one pill with water after the main meal. Long-term use of the drug is possible. Side effects are rare and are usually associated with the underlying disease.
• Mezim is a polyenzyme preparation, which is prescribed 1-2 tablets before each meal. Treatment can be long-term, side effects are isolated.

Taking painkillers, anti-inflammatory drugs and antibiotics is possible only with a doctor's prescription. Thus, in some cases sulfanilamide drugs (Phthalazol, Biseptol), antibiotics (Levomycetin), non-steroidal anti-inflammatory drugs (Ibuprofen, Paracetamol) may be indicated.

Prevention

To avoid nut poisoning, you need to follow a few simple rules:

• Always wash your hands before any meal and eat from clean dishes;
• never overeat nuts, it is enough to eat a small handful - that is, no more than 50 g per day;
• Avoid raw nuts, especially if you are unsure of their quality and storage conditions;
• never combine nuts with dairy products, fatty and high-calorie foods;
• Nut poisoning cannot be avoided if spoiled, foul-smelling, moldy specimens are eaten.
• It is imperative to consult a doctor if:
• pain and cramps in the abdomen, dizziness, headache, rash, and fever appeared;
• the heaviness in the stomach does not go away the next day;
• vomiting and diarrhea are present for more than one day;
• signs of poisoning are present in a child or an elderly person.

Forecast

Fortunately, most patients recover from nut poisoning without any negative consequences for the body. In particular, the signs of nut overeating disappear without a trace on the third or fourth day. However, prolonged consumption of raw almond kernels can lead to liver and pancreatic diseases. In severe cases, the patient is diagnosed with hepatitis, pyelonephritis, and nutmeg poisoning can even result in paralysis of the respiratory muscles or acute heart failure.