Are Red Stools after Red Dragon Fruit (Selenicereus costaricensis) Ingestion a Red Herring? – Case Report and Clinical Pearls for Recognition

Haematochezia is the most common presentation of lower gastrointestinal bleeding and is a frequent diagnosis resulting in admission or outpatient attendance to gastroenterology and colorectal services. We report the first case of hospital admission with a benign presentation of blood-red stools following red dragon fruit ingestion and details of his evaluation, including biochemistries and endoscopy. We review the available literature regarding the fruit and betacyanins and offer clinical pearls to aid in differentiating this benign occurrence from more common and dangerous causes of red-colored stools.