Ergot Poisoning- Symptoms and Treatment

Ergot is a type of fungus that grows on the grains and produces toxic alkaloids. The ergots can mix in healthy grain during the time of harvest contaminating any product made with this grain. Eating contaminated grains or the products made from them can lead to ergot fungus poisoning.

Ergot can affect the nervous system, digestive system, and cardiovascular system. It can also lead to gangrene.

Despite the toxicity, ergot was used in the past as a medicine. It was found that pregnant pigs got into premature labor after eating ergot. This made the midwives use ergot in humans. They used to give the whole ergot to females in labor and small doses for a restricted period of time.

Its use during childbirth came more into use during the 1800s and the doctors started using it to speed up labor even if there was no risk of complication.⁽¹⁾ This increased the stillbirths.

In the 20th century, ergot alkaloid was isolated from the fungus and turned into drugs. It is still being used by doctors as ergotamine and ergometrine, both of which are ergot alkaloids.

Ergotamine is used in the treatment of migraine. It stimulates the blood vessels to constrict, decreasing the dilatation of arteries.

Ergometrine is also a drug that constricts the blood vessels and is used to prevent bleeding after birth.

Research is going on to study the use of ergot-based medicines in Parkinson’s disease and dementia.

Ergot poisoning symptoms are categorized into 3 types:

1. Neurological Symptoms

   The neurological symptoms include:

   • Convulsions
   • Headache
   • Dizziness
   • Psychosis
   • Coma

   These symptoms caused due to ergot poisoning are also known as convulsive ergotism.

2. Gastrointestinal Symptoms

   The gastrointestinal symptoms include:

   • Nausea
   • Vomiting
   • Cramping
   • Abdominal pain
   • Diarrhea

3. Blood Vessel Symptoms

   Ergot alkaloids can lead to constriction of the blood vessels for prolonged periods, and the condition is known as vasospasm.

   Vasospasm occurs in large arteries i.e those of the kidney, retina, neck, and heart. Also, the legs and feet are affected in 60-70% of cases.⁽²⁾

   The vasospasm restricts the blood and oxygen supply to the areas the arteries supply blood to. This may lead to coolness, paleness, and muscle pain during activity.

   Sometimes when the tissues do not get enough oxygen for a long period of time, they die and become gangrenous. On rare occasions, there may be thrombosis i.e blockage of the blood vessel by a blood clot.

   The research was conducted that recounted 1844 cases where ergot was used for abortions, it was found that using it resulted in the death of the pregnant female.⁽³⁾

Ergot poisoning may present differently in different cases, therefore, the way to diagnose it may vary from person to person.

If a person develops cool legs and feet after taking ergot-based medication, a doctor may perform:

• Physical examination
• X-ray scans
• Blood tests
• Angiography

If the narrowing of arteries is shown in the angiography, ergot poisoning is indicated. The treatment may involve discontinuing the drug, as well as tobacco and caffeine as these substances can constrict the blood vessels.

For some people, the problem may resolve in 10 days. If the drug is used for prolonged periods the disappearance of symptoms may take several days.

Antiplatelet therapy is an additional treatment. Platelets promote normal clotting, so antiplatelet therapy may prevent clotting and reduce the risk.

Surgery may be needed if a person has pain at rest and gangrene.

Ergot poisoning can occur when a person ingests ergots through grains. The fungus turns the grain hard and black. It can lead to neurological, gastrointestinal, or cardiovascular symptoms. Since the discovery of ergot and its toxicity, the poisoning has become uncommon. Still, the outbreaks occur. If a person takes ergot-based medications for a long time, it can result in ergot poisoning. Hence before taking any such medication, a doctor should be consulted and the pros and cons of treatment should be discussed.