Can Oral Allergy Syndrome Cause Hives

The Mystery Of Trigger Foods And Allergies

For example, there are certain foods they know people should flag if they are allergic to certain pollen or substances. In recent years, researchers concluded that people with birch pollen allergies might react to coriander, fennel or parsley. They also discovered that like pollen allergy, people allergic to latex rubber may react poorly to exposure to bananas, avocados, chestnuts and papaya, but they arent certain why. Lastly, if ragweed is an issue for you, dandelions, echinacea and chamomile tea might also cause an allergic reaction.

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What Foods Cause Symptoms Of Pollen Food Syndrome

Pollen food syndrome is usually triggered by eating fresh fruit, raw vegetables and raw nuts. Some people are affected by only one or two foods and others can react to a wide range of foods. The most common foods involved are apples, peaches, kiwi, hazelnuts and almonds, but just about any fruit, vegetable or nut can cause a reaction.

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What Causes Food Allergies

Food allergies happen when the immune system the body’s defence against infection mistakenly treats proteins found in food as a threat.

As a result, a number of chemicals are released. It’s these chemicals that cause the symptoms of an allergic reaction.

Almost any food can cause an allergic reaction, but there are certain foods that are responsible for most food allergies.

Foods that most commonly cause an allergic reaction are:

• milk
• shellfish
• some fruit and vegetables

Most children that have a food allergy will have experienced eczema during infancy. The worse the child’s eczema and the earlier it started, the more likely they are to have a food allergy.

It’s still unknown why people develop allergies to food, although they often have other allergic conditions, such as asthma, hay fever and eczema.

How Do I Manage Pollen Food Syndrome

Avoidance of the foods that cause your reactions is most important, there is no need to avoid foods that do not cause any symptoms. Usually, you will only need to avoid the allergenic food in its raw form as cooking destroys the allergens. It is worth trying the food cooked, canned or microwaved to see if it is tolerated. Some people find that different varieties of fruits or vegetables can be tolerated, for example it is worth checking to see whether you can tolerate one type of apple, even if another type causes symptoms.

Most people with pollen food syndrome can tolerate well-cooked fruits and vegetables. It is worth noting that lightly cooked vegetables such as stir-fried vegetables, for example bean sprouts, mange tout and carrots, and nuts both raw and cooked have been known to induce symptoms.

It is really important to continue to take any medication your healthcare professional has prescribed for other allergies, including asthma and hay fever, as this will help you to maintain control of symptoms of pollen food syndrome. If you have experienced any severe reactions, such as breathing difficulties or anaphylaxis, your healthcare professional may prescribe adrenaline autoinjectors and advise you to avoid the foods that caused the allergic reaction.

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How Long Does Oral Allergy Syndrome Last

Oral allergy syndrome typically leads to a short, acute manifestation of symptoms. Generally speaking, any reactions triggered by oral allergy syndrome disappear after the triggering fruit is no longer near the patient. It is extremely rare for symptoms of OAS to last very long or cause serious harm.

How Common Is Oral Allergy Syndrome

Oral allergy syndrome is quite common. It is estimated that as many as 75 percent of people with pollen allergies have an associated oral allergy syndrome. Anyone with a diagnosed allergy to pollen who has experienced some discomfort when consuming certain fruits or vegetables should consider contacting a doctor or allergist to confirm whether or not they have OAS.

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How Oral Allergy Syndrome Is Diagnosed

As with diagnosing any condition, diagnosing oral allergy syndrome involves multiple steps. Diagnosing the condition can be challenging given the multiple factors involved. A doctor will likely begin with a physical exam and medical history.

When taking the medical history, the doctor will ask after a family history of allergies as well as if the patient has any diagnosed allergies. A doctor or allergist may also recommend testing. Testing options for oral allergy syndrome can include both skin tests and blood tests to confirm a diagnosis. The presence of a confirmed test for a pollen allergy can, of course, help in the diagnostic process.

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What Is Food Intolerance

A food intolerance isn’t the same as a food allergy.

People with food intolerance may have symptoms such as diarrhoea, bloating and stomach cramps. This may be caused by difficulties digesting certain substances, such as lactose. However, no allergic reaction takes place.

Important differences between a food allergy and a food intolerance include:

• the symptoms of a food intolerance usually occur several hours after eating the food
• you need to eat a larger amount of food to trigger an intolerance than an allergy
• a food intolerance is never life threatening, unlike an allergy

Read more about food intolerance.

Page last reviewed: 15 April 2019 Next review due: 15 April 2022

Symptoms Of Oral Allergy Syndrome

The symptoms vary and they also change in different stages of life. Mild symptoms of oral allergy syndrome are:

• Swelling of the lips and tongue
• Numb lips
• Itching of the tongue, lips, mouth, and even throat
• Itching or tingling in the roof of your mouth

In severe cases, symptoms can include:

• Nausea and vomiting
• Swelling of the throat
• Hives and asthma .

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How Preparing Foods Different Ways Can Stop Allergies

If you have allergies to a certain food there is still the possibility you can eat it in a different form. Take the apple as an example. While people who are allergic to apples will want to avoid eating a fresh apple, they may not have any reaction to apple juice or applesauce. This is because the allergy causing protein is broken down during the cooking process.

In some cases, just peeling the fruit can make it possible for people, who are normally allergic to the food, to go ahead and consume it. Dieticians tell us that this happens because in some fruit and vegetables the allergen is actually concentrated in the skin.

Food experts also point out that some people with food allergies can still consume the offending fruit or vegetable without experiencing an allergic reaction if it is canned or frozen.

If you experience an itchy mouth after consuming food, speak to your doctor. A diagnosis of oral allergy syndrome can be determined following a clinical history review and after conducting skin prick tests, as well as oral food tests.

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Pollen And The Related Foods Which May Cause Symptoms

• Birch

Compounds in certain foods are similar to compounds on the surface of pollen grains, and they can trigger mouth and throat itching among sensitized people. Many compounds are concentrated near fruit skins, so a peeled apple may cause fewer symptoms than the unpeeled fruit.

Some food allergens degrade with cooking, so apple sauce may cause fewer symptoms than fresh apples cooked carrots may cause fewer symptoms than raw. Those on stomach acid blocking medications may experience more gastrointestinal symptoms, as these medications alter gastric digestion.

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Causes Of Oral Allergy Syndrome

Oral allergy syndrome is due to a cross-reactivity between plant proteins from pollen and fruits or vegetables. When a child or adult with pollen allergy eats a raw fruit or vegetable, the immune system sees the similarity and causes an allergic reaction.

Interestingly, many patients with oral allergy syndrome can eat the same fruits or vegetables when they are cooked. The cooking process changes the protein enough that the immune system does not recognize the food as being the same as the pollen anymore.

Sometimes foods in the same botanical family will also cause reactions. Examples are potato and carrot, parsley and celery, or apple and pear.

Will I Need Investigations For My Pollen Food Syndrome

Often your healthcare professional can diagnose pollen food syndrome from your consultation without any need for further testing. However, if your diagnosis is not clear your healthcare professional may recommend that you have a blood test or skin prick testing where facilities are available. In skin prick testing the skin is pricked with prepared allergen extracts, however, as fruit and vegetable allergens can be affected by processing, testing may also involve prick testing with the relevant fresh fruit or vegetable, rather than using a prepared extract. If you are allergic, an itchy bump will come up within minutes of the test. This can be very itchy in the first few minutes, but will settle down over about an hour. A blood test is not usually necessary if skin prick tests are available, but occasionally your allergy healthcare professional may request a specific blood test called component testing to confirm a diagnosis.

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What Is An Apple Allergy

An apple allergy is when your immune system overreacts to apples and causes a reaction.

The severity of the reaction after eating an apple or foods with apples in them can vary widely from person to person. Symptoms can range from a mild irritation or itchiness to a potentially life-threatening emergency.

Some people with OAS only react to raw apples while others, particularly those with apple allergies tied to peach allergies, may also react to all forms of cooked apples.

When To Seek Medical Advice

If you think you or your child may have a food allergy, it’s very important to ask for a professional diagnosis from your GP. They can then refer you to an allergy clinic if appropriate.

Many parents mistakenly assume their child has a food allergy when their symptoms are actually caused by a completely different condition.

Commercial allergy testing kits are available, but using them isn’t recommended. Many kits are based on unsound scientific principles. Even if they are reliable, you should have the results looked at by a health professional.

Read more about diagnosing food allergies.

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Things You Should Know About Oral Allergy Syndrome

Did you know pollen might be responsible for your allergic reactions to fruit or vegetables? If your mouth or throat itches when you eat certain fruit or vegetables, you could have oral allergy syndrome . And you would have a pollen allergy to thank for that.

1. Cross-reactivity is the reason for OAS symptoms. OAS is the result of a confused immune system. The pollen of some trees and grasses are similar to the proteins of certain raw fruits, vegetables, seed or nuts.

2. Birch, alder, ragweed, mugwort, Timothy grass and orchard grass pollen cause most OAS symptoms. These pollens are similar to the proteins of certain raw fruits, vegetables, seed or nuts. If you are allergic to any of these pollens, you may have OAS symptoms.

3. You may be able to eat foods that cause OAS symptoms if you remove their skins and/or cook them. Heat affects the proteins, so you may be able to eat these foods cooked instead of raw. For example, a fresh apple may cause symptoms, but a person with OAS may be able to eat applesauce without symptoms.

4. If youre allergic to these pollens but dont have symptoms when eating related foods, you can still eat them. But if you have severe OAS symptoms, avoid those foods and talk to your allergist.

Here is a list of some pollens and the foods they may cross-react with. You may not react to every food on the list.

How Do I Develop Pollen Food Syndrome

If you are susceptible to allergies you can become sensitised to airborne pollens by breathing them in. This is most commonly associated with the classic symptoms of hay fever including runny, itchy nose and itchy eyes. With pollen food syndrome many plant based foods fruit, vegetables, nuts and cereals, have a protein structure that is very similar to the pollens in trees, grasses and weeds . However, the immune system doesnt always recognise the difference between the pollens in the trees, grasses or weeds that you breathe in and the pollen structure in the plant based foods that you eat. With pollen food syndrome the immune system recognises the food protein that you eat as an allergen and creates an allergic responses.

A far more rare type of cross-reaction occurring between natural rubber latex and certain fruits may also cause symptoms in some individuals, this is because the protein structure of latex is very similar to the fruit pollen structure. However, since latex is no longer routinely found in most healthcare settings, this type of food allergy is rare.

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What Causes Oral Allergy Syndrome

The symptoms are caused by a reaction to plant proteins , which are similar to those in pollen. There are several allergens that can be responsible for the condition.

The most common allergen in the UK is birch pollen. It has been estimated that as many as 3 in every 4 people with allergy to birch experience a sensation in the lips or tongue after eating raw apples, which is a mild form of OAS.

Many people with OAS have had hay fever symptoms between February and July for a number of years before developing OAS.

People who have hay fever from February to May are usually allergic only to tree pollen and are more likely to react only to fruits and some nuts such as hazelnuts.

People who have hay fever from March to the end of July are probably allergic to both grass and tree pollen and are not only more likely to develop OAS, but will be potentially allergic as well to a much wider range of foods, including fruits, vegetables, tree nuts and peanuts.

Allergy to grass and mugwort pollens can also cause OAS and a similar condition occurs in some patients with rubber latex allergy.

There is, at present, no way to predict who will develop a problem with any particular food.

What Should I Do If I Have An Allergic Reaction

The majority of cases of food pollen syndrome reactions are mild such as mouth or lip itching or swelling, and stopping eating the food and drinking some water may be all you need to do reduce or eliminate the symptoms. The tingling, itching and swelling should settle within 30 minutes to an hour without treatment, but if you are concerned or are having severe or unpleasant symptoms then take a non-sedating antihistamine.

If you have taken an antihistamine and feel your symptoms are not improving then you may need additional treatment and you should seek medical advice. Do not rely on antihistamines or an asthma inhaler if you have a food allergic reaction which affects your breathing or circulation .

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When To See A Doctor

If you think you have an apple allergy or you have OAS that seems to be getting worse, consult your medical provider.

They can help you figure out next steps and if it’s necessary to carry medication for any time you accidentally eat apple or other trigger foods.

If you ever experience any symptoms of anaphylaxis, seek urgent medical care.

Delayed Hypersensitivity To Mango

Mango is also known to rarely cause delayed hypersensitivity reaction in the form of contact dermatitis and periorbital edema, and has been documented in twelve patients till date . The first patient with allergic reaction to mango documented in the literature had presented with manifestations of delayed hypersensitivity .

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What Are The Tests For Oral Allergy Syndrome

If it is essential to accurately identify exactly which fresh fruits or raw vegetables are causing OAS.

The symptoms and association with foods are much more important than tests in the diagnosis of OAS.

The standard skin prick and specific IgE blood tests that are used for food allergy are unreliable. Food allergens causing OAS are usually damaged or destroyed by heat and processing, and so are likely to be destroyed during the process of making the extracts used in these tests.

Allergy skin prick, testing using the juices from the fresh fruits and raw vegetables themselves, can be tried. This is a more sensitive test and can be effective. A skin prick test for birch pollen is the most useful of the standard allergy tests.

Standard allergy tests covering peanuts and all the tree nuts are also often helpful. Almond, hazelnut and walnut are the nuts often involved in OAS.

If you are worried about eating other foods then you can safely test them yourself:

• Rub the food on the outside and then the inside of your lip.
• If you feel no tingling or itchiness or swelling then take a bite, chew well and spit it out.
• Then wait for 15 minutes to see whether you develop any symptoms that suggest OAS.

NB: You must only perform this test if your usual symptoms are mild and only involve your mouth. If your symptoms usually include swelling, wheezing or tummy pain then you must not test any food except under medical supervision.