Excessive Bleeding Associated with Chronic High-Dose Bitter Gourd Supplementation

Background: Herbal supplement use has been reported to be widespread and often not disclosed in patient medical history reviews. Too much supplementation and/or interaction(s) with other prescribed drug(s) can be a real danger and should always be investigated in the patient’s record. Some supplements have been described in the literature that could potentially affect bleeding and hemostasis during and after surgical procedures. Methods and Results: This case describes a surgical patient who was taking daily supplemental bitter gourd powder and exhibited excessive bleeding intraoperatively, in addition to prolonged coagulopathy postsurgically. The postoperative hemorrhage did require additional intervention to help ensure stable clotting. Based on a scientific literature review, this is the first case of bleeding complications reported from excessive bitter gourd (melon) consumption in the dental/oral surgical/periodontal literature that could be found. Conclusions: Clinicians should be aware of any herbal supplementation that a patient ingests, to include the amount/dosage of such medicinal intake. Any supplement usage that could possibly affect coagulation during/after surgery should be investigated, and the patient advised to stop the supplement (most supplements) for at least 2 weeks before the procedure. Consultation, if indicated, should always be pursued before treatment.