October 8, 2022

1400H - 1500H
Via Zoom

Empowerment
objective - for
Swallowing laypeople to have an
Fruit Seeds understanding
- Cause or NO whether swallowing
Cause for fruit seeds is a cause
Alarm? or NO cause for
alarm in their health
management.
 Empowerment ROJoson PEP Talk
objective - for
Swallowing laypeople to have an I have a Patient
Fruit Seeds understanding Empowerment
Program in which I
- Cause or NO whether swallowing like to empower the
Cause for fruit seeds is a cause lay people or
Alarm? or NO cause for patients to take
alarm in their health control in the
management. management of
their health.
 There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.
 From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer.
 My PEP TALK today is
entitled:
Empowerment
objective - for
Swallowing laypeople to have an Swallowing Fruit
Fruit Seeds understanding Seeds – Cause or
- Cause or NO whether swallowing NO Cause for
Cause for fruit seeds is a cause Alarm?
Alarm? or NO cause for
alarm in their health
management.
 Contents:
Swallowing • What are fruit seeds?
Fruit Seeds • What are the different types of fruit seeds?
- Cause or NO • What are the concerns on swallowed fruit
Cause for seeds?
• What are the general advisories on eating /
Alarm? swallowing fruit seeds?
• What are ROJoson’s advocating statements
and advice on SWALLOWING FRUIT SEEDS?
 What are fruit seeds?
Swallowing
Fruit Seeds
- Cause or NO
Cause for
Alarm?
 What are fruit seeds?
Swallowing
Fruit seeds are seeds in a fruit or fruits.
Fruit Seeds
- Cause or NO Simply defined, these are not the fleshy parts of
Cause for the fruits.
Alarm?
 What are the different types of fruit seeds?
Swallowing
Fruit Seeds
- Cause or NO
Cause for
Alarm?
 What are the different types of fruit seeds?
Swallowing
Fruit seeds are of various types in terms of:
Fruit Seeds • EDIBILITY (fit to be eaten)
- Cause or NO • CONTAINING NUTRITIOUS AND HEALTH
Cause for BENEFITS
Alarm? • CONTAINING POISONS (AMYGDALIN -
CYANIDE)
• SIZE (MINUTE, SMALL to LARGE)
• CONFIGURATION (SHAPE- round, not round;
EDGES – smooth, sharp)
 What are the different types of fruit seeds?
Swallowing
Fruit seeds are of various types in terms of:
Fruit Seeds • EDIBILITY (fit to be eaten)
- Cause or NO E.g. Seeds in tomatoes, cucumbers, kiwis,
Cause for pomegranates, blackberries, strawberries and
Alarm? dragon fruits
 What are the different types of fruit seeds?
Swallowing
Fruit seeds are of various types in terms of:
Fruit Seeds • EDIBILITY (fit to be eaten)
- Cause or NO E.g. Seeds in tomatoes, cucumbers, kiwis,
Cause for pomegranates, blackberries, strawberries and
Alarm? dragon fruits

• Small seeds
• Not hard
• No sharp edges
• Can easily be
digested
 What are the different types of fruit seeds?
Swallowing
Fruit seeds are of various types in terms of:
Fruit Seeds • NON-EDIBILITY (not recommended to be
- Cause or NO eaten)
Cause for E.g. Seeds from apples, oranges, mangoes,
Alarm? rambutan, avocado, santol, etc.
 What are the different types of fruit seeds?
Swallowing
Fruit seeds are of various types in terms of:
Fruit Seeds • NON-EDIBILITY (not recommended to be
- Cause or NO eaten)
Cause for E.g. Seeds from apples, oranges, mangoes,
Alarm? rambutan, avocado, santol, etc.

• Usually big seeds

• Hard seeds
• With sharp edges
• Cannot be easily
digested
 What are the concerns on swallowed fruit seeds?
Swallowing
Fruit Seeds
- Cause or NO
Cause for
Alarm?
 What are the concerns on swallowed fruit seeds?
Swallowing
Fruit Seeds • Can we swallow all kinds of fruit seeds? If not,
what fruit seeds can be swallowed or what
- Cause or NO
should not be swallowed?
Cause for • What are the potential ill-consequences if we
Alarm? swallow fruit seeds which should not be
swallowed?
• What should we do when we swallow fruit
seeds which should not be swallowed?
 What are the concerns on swallowed fruit seeds?
Swallowing
Fruit Seeds Can we swallow all kinds of fruit seeds?
- Cause or NO • NO. NO. NO.
Cause for
Alarm?
• Eat / swallow only fruit seeds which are
known to be edible and safe.
• The rest, avoid and do not swallow as much as
possible.
 What are the different types of fruit seeds?
Swallowing
Fruit seeds are of various types in terms of:
Fruit Seeds • EDIBILITY (fit to be eaten)
- Cause or NO E.g. Seeds in tomatoes, cucumbers, kiwis,
Cause for pomegranates, blackberries, strawberries and
Alarm? dragon fruits

• Small seeds
• Not hard
• No sharp edges
• Can easily be
digested
 What are the different types of fruit seeds?
Swallowing
Fruit seeds are of various types in terms of:
Fruit Seeds • NON-EDIBILITY (not recommended to be
- Cause or NO eaten or swallowed)
Cause for E.g. Seeds from apples, oranges, mangoes,
Alarm? rambutan, avocado, santol, etc.

• Usually big seeds

• Hard seeds
• With sharp edges
• Cannot be easily
digested
 What are the concerns on swallowed fruit seeds?
Swallowing
Fruit Seeds What are the potential ill-consequences if we
swallow fruit seeds which should not be
- Cause or NO
swallowed?
Cause for
Alarm?
 What are the concerns on swallowed fruit seeds?
Swallowing NO CAUSE FOR
Fruit Seeds Seeds do NO germinate in the stomach and grow ALARM!
plants.
- Cause or NO
Cause for
Alarm? MYTH & FACT
 What are the concerns on swallowed fruit seeds?
Swallowing
Swallowing fruit seeds does not cause
Fruit Seeds
appendicitis. MYTH & FACT
- Cause or NO
Cause for The National Library Medicine reports that out of
Alarm? 1,969 cases of acute appendicitis that required
surgery between 2002 and 2009, only one was
because of a fruit seed lodged in the appendix.

This does not automatically mean that the seed

was the cause of the appendicitis. The seed NO CAUSE FOR
could just be an incidental finding. ALARM!
If causative, RARE!
 What are the concerns on swallowed fruit seeds?
Swallowing
Swallowing fruit seeds does not cause
Fruit Seeds appendicitis. MYTH & FACT
- Cause or NO
Cause for In 1988, it was reported that among 1 409
appendectomy materials, fruit seed was
Alarm?
observed only in one of the cases.(1/1 409,
0.07%)[17].

This does not automatically mean that the seed

NO CAUSE FOR
was the cause of the appendicitis. The seed
ALARM!
could just be an incidental finding.
If causative, RARE!
 What are the concerns on swallowed fruit seeds?
Swallowing
Swallowing fruit seeds does not cause colonic
Fruit Seeds
diverticulitis. MYTH & FACT
- Cause or NO
Cause for In the past, people with small pouches
Alarm? (diverticula) in the lining of the colon were told
to avoid nuts, seeds and popcorn.
It was thought that these foods could lodge in
diverticula and cause inflammation
(diverticulitis).
But there's no evidence that these foods cause
diverticulitis. NO CAUSE FOR
ALARM!
 What are the concerns on swallowed fruit seeds?
Swallowing
Fruit Seeds What are the potential ill-consequences if we
swallow fruit seeds which should not be
- Cause or NO
swallowed?
Cause for
Alarm? • Intestinal Obstruction
• Intestinal Perforation
 What are the concerns on swallowed fruit seeds?
Swallowing
Fruit Seeds Can swallowing fruit seeds cause intestinal
- Cause or NO obstruction?
Cause for
Alarm?
 What are the concerns on swallowed fruit seeds?
Swallowing
Fruit Seeds Can swallowing fruit seeds cause intestinal
- Cause or NO obstruction?
YES, in two conditions.
Cause for
Alarm? FIRST CONDITION:
There is a preexisting disease in the
gastrointestinal tract that narrows the lumen.
With swallowed fruit seeds, especially plenty, big
hard seeds, intestinal obstruction can occur.
 What are the concerns on swallowed fruit seeds?
Swallowing
Fruit Seeds Can swallowing fruit seeds cause intestinal
- Cause or NO obstruction?
YES, in two conditions.
Cause for
Alarm? SECOND CONDITION:
There is NO preexisting disease in the
gastrointestinal tract that narrows the lumen.
Big hard seeds can cause intestinal obstruction.
 What are the concerns on swallowed fruit seeds?
Swallowing
Fruit Seeds
- Cause or NO
Cause for
Alarm?

15-yo-Japanese male
Peach seed (3.5 cm)
Cureus. 2018 Dec; 10(12):
e3767.
 What are the concerns on swallowed fruit seeds?
Swallowing
Fruit Seeds
- Cause or NO 13-yo Laos male
Cause for Wild banana seeds
Alarm? Am J Trop Med Hyg. 2019
Dec; 101(6): 1195–1196.
 What are the concerns on swallowed fruit seeds?
Swallowing
Fruit Seeds
- Cause or NO
Cause for
Alarm?

40-yo Sri Lanka male

Mango seed
https://
bmcresnotes.biomedcen
tral.com/articles/
10.1186/s13104-017-
 What are the concerns on swallowed fruit seeds?
Swallowing
Fruit Seeds
- Cause or NO
Cause for
Alarm?

41-yo Filipino male

Santol seeds
https://www.eurorad.org/case/14072
 What are the concerns on swallowed fruit seeds?
Swallowing
Fruit Seeds Can swallowing fruit seeds cause intestinal
- Cause or NO perforation?
Cause for
Alarm?
 What are the concerns on swallowed fruit seeds?
Swallowing
Fruit Seeds Can swallowing fruit seeds cause intestinal
- Cause or NO perforation?
Cause for
YES.
Alarm?
Especially big hard seeds with sharp edges.
 What are the concerns on swallowed fruit seeds?
Swallowing
Fruit Seeds Can swallowing fruit seeds cause intestinal
- Cause or NO perforation?
Cause for
YES.
Alarm?
Especially big seeds with sharp edges.

88-yo Chinese Female

Jujube seed
Sigmoid colon perforation due to a jujube pit
https://www.alliedacademies.org/articles/sigmoid-colon-perforation-due-to-a-
jujube-pit.html
 What are the concerns on swallowed fruit seeds?
Swallowing
Fruit Seeds Can swallowing fruit seeds cause intestinal
- Cause or NO perforation?
Cause for
YES.
Alarm?
Especially big stone seeds with sharp edges.

Santol seeds causing intestinal perforations

Reports from Thailand (2001)
Reports from Philippines (ROJoson – since
2001 to present)
 What are the concerns on swallowed fruit seeds? In 2001, I discovered
Swallowing that swallowed
Fruit Seeds Can swallowing fruit seeds cause intestinal santol seeds can
- Cause or NO perforation? cause intestinal
Cause for perforations,
YES. especially in the
Alarm?
elderly persons,
Especially big stone seeds with sharp edges. usually in the distal
colon, even in the
absence of a
preexisting disease
in the intestines.
 What are the concerns on swallowed fruit seeds? From 2001 up to
Swallowing present, 21 years
Fruit Seeds Can swallowing fruit seeds cause intestinal now, I have been
- Cause or NO perforation? advising the public
Cause for NOT TO SWALLOW
YES. SANTOL SEEDS.
Alarm?
Especially big stone seeds with sharp edges. 2017 – there was still
this report of
perforation.
Most likely, there are
still cases today.
Even in 2022 – (+)
 What are the concerns on swallowed fruit seeds?
Swallowing
I don’t know why people swallow santol seeds. Patients have died
Fruit Seeds
The reason may be accidental or intentional from perforations
- Cause or NO because of some satisfaction derived from of the intestines
Cause for swallowing these seeds. which cause
Alarm? peritonitis and
Whatever be the reason, I advise the public NOT sepsis because of
to swalllow santol seeds if they want to avoid late diagnosis.
the complications that may result with
swallowing; if they want to avoid an operation;
and most important of all, if they want to avoid a
premature death.
 What are the concerns on swallowed fruit seeds?
Swallowing
I don’t know why people swallow santol seeds.
Fruit Seeds
The reason may be accidental or intentional
- Cause or NO because of some satisfaction derived from
Cause for swallowing these seeds.
Alarm?
Whatever be the reason, I advise the public NOT
to swalllow santol seeds if they want to avoid
the complications that may result with
swallowing; if they want to avoid an operation;
and most important of all, if they want to avoid a
premature death.
 What are the concerns on swallowed fruit seeds?
Swallowing
What should we do when we swallow fruit seeds
Fruit Seeds
which should not be swallowed?
- Cause or NO
Cause for
Alarm?
 What are the concerns on swallowed fruit seeds?
Swallowing
In case you accidentally swallowed fruit seeds
Fruit Seeds
that should not be swallowed,
- Cause or NO • PRAY and HOPE nothing bad happens to you – Majority will still be
Cause for obstruction / perforation! PRAY and HOPE the passed out
Alarm? seeds pass out through your anus. spontaneously
• OBSERVE your abdomen or belly closely for especially in those
abdominal pain and distention. If increasing, with few seeds and
consult a surgeon right away. He / she will young patients.
decide what to do (observe closely – do BUT DON’T GAMBLE!
diagnostic tests – operate or just observe)
• MONITOR your pooh to check if the
swallowed seeds come out already.
 What are the general advisories on eating /
Swallowing swallowing fruit seeds?
Fruit Seeds
- Cause or NO
Cause for
Alarm?
 What are the general advisories on eating /
Swallowing swallowing fruit seeds?
Fruit Seeds • Eat / swallow only fruit seeds which are
- Cause or NO known to be edible and safe.
Cause for • The rest, avoid and do not swallow as much as
Alarm? possible.
 What are the general advisories on eating /
Swallowing swallowing fruit seeds?
Fruit Seeds Can eat or swallow these edible fruit seeds:
- Cause or NO
Cause for E.g. Seeds in tomatoes, cucumbers, kiwis,
Alarm? pomegranates, blackberries, strawberries and
dragon fruits

• Small seeds
• Not hard
• No sharp edges
• Can easily be
digested
 What are the general advisories on eating /
Swallowing swallowing fruit seeds?
Fruit Seeds Avoid swallowing the non-edible and dangerous
- Cause or NO seeds, particularly SANTOL SEEDS.
Cause for Seeds from apples, oranges, mangoes,
Alarm? rambutan, avocado, santol, etc.

• Usually big seeds

• Hard seeds
• Cannot be easily
digested
 What are the general advisories on eating /
Swallowing swallowing fruit seeds?
Fruit Seeds • If you accidentally swallow any non-edible
- Cause or NO fruit seeds and those that are notorious to
Cause for cause obstruction and perforation, PRAY and
Alarm? HOPE; observe your abdomen; and monitor
your pooh to check if the seeds have already
been passed out.
 What are the concerns on swallowed fruit seeds?
Swallowing
SWALLOWING
Fruit Seeds Can swallowing fruit seeds cause intestinal SANTOL SEEDS IS A
- Cause or NO perforation? CAUSE FOR ALARM!
Cause for
YES.
Alarm? Particularly in elderly
persons!
Especially big stone seeds with sharp edges.
BEWARE!
AVOID!
DO NOT SWALLOW!
 Contents: Summary
Swallowing • What are fruit seeds?
Take Away
Fruit Seeds • What are the different types of fruit seeds?
- Cause or NO • What are the concerns on swallowed fruit
Cause for seeds?
• What are the general advisories on eating /
Alarm? swallowing fruit seeds?
• What are ROJoson’s advocating statements
and advice on SWALLOWING FRUIT SEEDS?
 Be always in touch with reliable medical Take Away in
Swallowing information on SWALLOWING FRUIT SEEDS. relation to
Fruit Seeds Patient
- Cause or NO Knowledge is power; it gives power. Empowerment
Cause for Use the 4Ks of Patient Empowerment:
Alarm? Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions in
swallowing fruit seeds – what can be
swallowed and what should not be
swallowed.
 Empowerment
objective - for
Swallowing laypeople to have an
Fruit Seeds understanding
- Cause or NO whether swallowing
Cause for fruit seeds is a cause
Alarm? or NO cause for
alarm in their health
management.