Manila Bulletin

The dangers of swallowing tomato, guava, and santol seeds

- EDUARDO GONZALES, MD

Is it true that swallowed tomato and guava seeds can give rise to appendicit­is? I also recently read a newspaper article that advises people against swallowing santol seeds. What sort of health problems do swallowed

santol seeds pose? —derma_lindy@gmail.com

That swallowed tomato or guava seeds can lead to appendicit­is is a myth. It is true that in rare instances the deceased appendix that is removed from people with appendicit­is contains a tomato seed, but the seed is not the reason for the appendicit­is. There is no scientific evidence that links tomato or guava seeds to appendicit­is or any health problem for that matter. These small seeds are therefore safe to swallow, besides, how can you avoid swallowing tomato seeds?

Santol seeds, however, are another matter. The santol (Sandoricum­koetjape), wild mangosteen, or cotton fruit is a tropical tree that grows in Southeast Asia. Its spherical fruit abound in fruit stalls all over the country between May and October. Many of these fruits are harvested from local trees, but some are imported, mostly from Thailand (Bangkok santol). The outer covering of the santol fruit consists of an edible fleshy rind that contains a thin and milky sweet to sour juice. Also edible and tastier is the white, translucen­t, juicy pulp (aril) that surrounds its three to five brown seeds. The pulp often clings tightly to the seeds such that we need to suck the seed to extract the pulp. Sometimes,we suck so hard that we accidental­ly swallow a seed or two. The seeds effortless­ly slide down our throat into our stomach. In the stomach, the seeds’ pulp is completely digested and stripped away exposing the sharp edges of the seeds, which can cause problems when they reach our intestines.

Serious conditions that are caused by santol seeds

Accidental­ly swallowed santol seed usually pass out harmlessly with the stool. But some people find pleasure in swallowing santol seeds and make it a habit. This is dangerous because sometimes the seeds form a mass that obstructs the intestine. At other times, they perforate the intestine. These are two serious conditions that necessitat­e surgery.

There is no countrywid­e data on the number of intestinal obstructio­ns and/or perforatio­ns secondary to santol seeds that occur in the Philippine­s. But Dr. Reynaldo

Joson, a surgeon at Manila Doctor’s Hospital, who has been issuing annual advisories against swallowing santol seeds for more than 15 years now, estimates that about 200 Filipinos are operated on because of this dangerous habit every year, and as many as 30 percent of those operated on later die of complicati­ons.

Obstructio­n of the intestine due to swallowed santol seeds occurs when the seeds stick together to form a hard bolus that completely clogs the intestinal cavity, while perforatio­n occurs when the sharp edges of the seeds jab and puncture the intestinal wall. Perforatio­n of the intestine results in spillage of feces into the peritoneal cavity causing peritoniti­s or infection of the abdominal cavity, a very serious and many times a fatal condition.

The segment of the intestine that is usually affected by swallowed santol seeds is the sigmoid colon, the terminal part of the colon that is near the rectum.

The Bangkok santol is more notorious than the native variety in causing intestinal obstructio­n and perforatio­n because its seeds are bigger and their edges sharper.

Food value of the santol fruit

Local analysis of the food value of the santol fruit has shown that the fruit

consists mostly of water (more than 85 percent by weight) followed by carbohydra­te (11.43 percent), fat (1.43 percent), and protein (0.89 percent). It is also a good source of dietary fiber and contains modest amounts of calcium, phosphorus, iron, thiamine, niacin, and ascorbic acid (vitamin C). Hence, eating the rind and pulp of the santol fruit is a healthy practice, but swallowing the seeds poses a health risk.

It’s a myth that swallowed tomato or guava seeds can lead to appendicit­is is a myth. Santol seeds, however, are another matter.

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