The IAKP is an evolving entity and continues to change its policies and procedures as needed when new information is gathered across various Kambo communities as well as our own. 

Just as we have changed our water guidelines over the years, due to a small number of increased incidents of hyponatremia outside of the IAKP, we now feel the need to include a level of increased awareness and new information on Oesophagus/Esophagus Rupture as two incidents have been reported. To the best of our knowledge there have only been 3 reported instances worldwide.

Oesophagus/Esophagus Rupture is an extremely rare occurrence, although it can potentially happen to anybody at any time. Because of the increase in individuals receiving Kambo, it seemed appropriate for us as an organisation to share the information we have gathered with you. 

It should be noted that that this paper is very much a live document and may change and evolve in the future, as we are only talking about 2 instances within the IAKP in which the clients presented different symptoms/signs.

WHAT WE KNOW

What we do know for certain is that Kambo is not the cause of an Oesophagus/Esophagus rupture on its own but it may point to a weakness within the body that may not have otherwise been known.

WHAT CAUSES OESOPHAGUS/ESOPHAGUS RUPTURE?

The most common cause of Oesophagus/Esophagus ruptures are endoscopies (Cameras inserted into the throat for medical procedures). They make up 50% of all ruptures, when diagnosed early there is a 10% mortality rate rising from 40-66% after 24 hours. (https://www.ncbi.nlm.nih.gov/books/NBK6892/).

Boerhaave’s Syndrome 

Boerhaave’s Syndrom is a rare condition that involves the spontaneous rupture of the Oesophagus/Esophagus. 

Today, Boerhaave’s syndrome accounts for approximately 15% of all cases of esophageal rupture. Although the actual incidence of esophageal perforation worldwide is unclear, some studies estimate an incidence of approximately 3.1 per 1,000,000 per year.  The patient population who suffer from Boerhaave’s syndrome varies, but the risk is highest in middle-aged males.  The condition is highly associated with alcohol ingestion. (https://www.ncbi.nlm.nih.gov/pmc/articles/.)


Because Kambo causes violent vomiting we need to have caution around some conditions that could weaken the Oesophagus/Esophagus

*From an article in health line “Projectile vomiting is often no more harmful than other types of vomiting but could be a sign of more serious issues”.

OTHER POTENTIAL CAUSES INCLUDE

Violent/Projectile vomiting

Severe liver disease

  Severe injury or trauma to the Oesophagus/Esophagus from endoscopy

Tumors in the throat

Ulcers in the throat

Physical trauma or injury to the neck (OFTEN CAUSED BY CAR OR MOTORBIKE ACCIDENTS)

Those who have or have had bulimia

Gastro-intestinal Reflux

History of smoking

Chronic inflammatory response syndrome due to mold exposure

Untreated eosinophilic esophagitis

          Oesophagus/Esophagus Varices

          Portal Hypertension

ALL THE ABOVE ARE NOW THEREFORE CAUTIONS

THE TWO INSTANCES WITHIN THE IAKP

Instance 1 was in 2017. The client, a male in his late 30’s, with a disabled right arm and a history of several car and motorbike accidents. The client was receiving Kambo for the first time and was given 3 points of Kambo. Within 5 minutes of application he complained of pain moving up and down his body and an inability to purge despite wanting to. He was in great discomfort. The practitioner believes that the inability to purge was caused by a preexisting tear that may have been exacerbated by the pressure that Kambo placed on his Oesophagus/Esophagus. The client was taken to the emergency room immediately where he was put in intensive care and fed intravenously for two weeks. A mesh was placed on the tear to repair it. Doctors treating the client said they believed the tear had been caused by the clients history of motor accidents. The client made a full recovery.

Instance 2 was in 2021 when a fit and healthy 37 year old man who received 3 points of Kambo. His only medical history was a broken ankle from a skateboard accident that had required orthopedic surgery. Client purged normally for the first 15 minutes but with his final purge he cried out in pain and grabbed his stomach and under the right ribs/liver, when asked he said he had felt the same pain a week earlier. Client was taken to the emergency room where he received a thoracotomy and repair of dissection surgery. As of 2/27/2 – six weeks after the incident, the client is slowly recovering. He is still eating pureed foods and continues to have tubes hooked up to him. However, he is going to see a surgeon soon to see about having the tubes removed.

There has been a 3rd reported instance of Oesophagus/Esophagus rupture outside of the IAKP. When a 62–year-old woman, with a past medical history of major depressive disorder, alcohol, and nicotine dependence, presented to the emergency department with shortness of breath, epigastric abdominal pain, nausea, and non-bloody emesis for one day after receiving Kambo 

All three instances above presented differently, but based on these and research we have undertaken we believe that these are symptoms to watch out for.

SYMPTOMS TO WATCH FOR:

Severe chest pain
Severe abdominal pain that may also radiate to the shoulder
Purging blood
Difficulty swallowing
Neck Pain
Swelling of the neck post-Kambo
Difficulty Breathing
Crackling Sound when breathing
Shock

With violent vomiting look for severe upper abdominal, neck or upper chest pain, pain when swallowing, fever or chills

Inability to purge accompanied by pain moving through the body.

Shortness of breath or shallow breathing
*If individuals are experiencing any of these symptoms, do not allow intake of foods or liquids and contact the emergency services.

 THE FOLLOWING CONDITIONS ARE NOW CONTRAINDIGATED

Any previous Oesophagus/Esophagus bleeding or rupture.

INFORMED CONSENT 

Given this new information it is imperative that we give our clients the ability to make an informed decision before taking Kambo. This is called informed consent. Informed consent is the process in which a practitioner/provider educates a client about the risks and benefits of receiving Kambo. 

We believe the risk is very small, two cases among the many tens, if not hundreds of thousands treatments that we have given as an organization. 

However, the impact could obviously be very serious. Therefore make sure your clients are aware that there is a very small risk of Oesophagus/Esophagus Rupture, make them aware of the potential risk factors stated above.

And do not hesitate to contact emergency services, if a client presents with the ‘symptoms to watch for’ listed above.