What You Need to Know About Oral Allergy Syndrome

Have you experienced uncomfortable itching and perhaps some swelling of the mouth, lips, tongue or throat when eating fresh fruits or vegetables? These bothersome symptoms correspond with oral allergy syndrome (OAS), an often-undiagnosed condition believed to affect roughly one-third of all people with environmental (seasonal) allergies.

The local farmer’s markets have been bursting with beautiful, fresh produce throughout the summer. If you’ve been tempted to taste some seasonal nectarines, peaches, plums, or cherries and noticed inflammation and tingling in your mouth or throat a few minutes later, it might be a sign of oral allergy syndrome (OAS).

What causes oral allergy syndrome?

OAS, sometimes called pollen-food syndrome or a pollen-food allergy, is a condition where people have allergic reactions to certain types of food due to cross-reactivity with pollen allergens.

Having a negative reaction to nectarines, peaches, or stone fruits generally corresponds with a birch pollen allergy. If you sneeze, wheeze, and sniffle when birch pollen counts are high, there is a strong likelihood you could also have an allergic response to certain foods that have similar protein structures to birch pollen.

However, OAS affects people with other types of pollen allergies, too.

Which foods trigger oral allergy syndrome?

The following  pollen allergies can prompt OAS symptoms:

Alder Tree Pollen Allergy

• Fruits: Apples, cherries, peaches, pears
• Herbs: Parsley
• Nuts: Almonds, hazelnuts
• Vegetables: Celery

Birch Pollen Allergy

• Fruits: Apples, apricots, avocados, bananas, cherries, figs, kiwi, nectarines, peaches, pears, plums, prunes, strawberries,
• Herbs: Cilantro, coriander, parsley
• Nuts: Almonds, hazelnuts, walnuts
• Vegetables: Carrots, celery, chicory, parsnips, peppers, potatoes, soy, wheat

Grass Pollen Allergy

• Fruits: Figs, melons, oranges, tomatoes

Mugwort Weed Pollen Allergy

• Herbs: Coriander, parsley
• Vegetables: Carrots, celery, peppers, fennel

Ragweed Pollen Allergy

• Fruits: Bananas, melons
• Herbs: Dandelions, Echinacea, chamomile, hibiscus
• Vegetables: Artichokes, cucumber, zucchini

While OAS symptoms are generally lessened or eliminated when cooked or processed foods are consumed, there are certain fruits and vegetables, such as celery and nuts, that still have the potential to cause a reaction even after cooking.

It has been reported that some people develop symptoms only when eating certain varieties of fruit – specific cultivars of apples, for example. So, a person who has symptoms after eating a Golden Delicious apple might not have any symptoms after eating a Red Delicious apple.

What are oral allergy syndrome symptoms?

The symptoms of OAS can vary from person to person, but the most frequent symptoms include the following:

• Itchiness in or around the mouth
• Mild inflammation of the mouth, face, lips, tongue, and throat
• Hives in or around the mouth
• Bumps on the lips and around the mouth

These reactions are typically mild and confined to the mouth and throat area. However, in a small percentage of cases, OAS may cause more severe symptoms.

Is oral allergy syndrome dangerous?

Generally, OAS is not life-threatening. However, in approximately 2% of people with OAS, more serious reactions can occur. These reactions may include nausea, difficulty breathing, difficulty swallowing, and even anaphylaxis, a severe and potentially fatal allergic reaction.

How long does oral allergy syndrome last?

OAS symptoms last a few minutes to one hour. The process of digestion typically destroys the proteins that cause the immune system to over-respond, so longer symptom manifestations are relatively rare.

Is oral allergy syndrome common?

It is estimated that approximately one-third of people with allergic rhinitis caused by tree,  weed, and grass pollens will also have OAS, with some studies putting the number as high as 70%.

How do I know if I have oral allergy syndrome?

If you suffer from hay fever and notice slight inflammation in and around your mouth after eating certain raw fruits or vegetables, you should consider being screened for OAS.

However, not everyone with seasonal pollen allergies will have adverse reactions to all or even any of the corresponding foods with similar protein structures. Reactions to certain foods may initiate with one type of food, with symptoms occurring with other types of food over time.

Diagnosis of OAS involves taking an accurate history of symptoms and allergy testing to identify the cross-reactive pollen. This then allows for a thoughtful approach to eliminating food triggers from the diet.

Can I get rid of oral allergy syndrome?

OAS cannot be cured, but it can be managed effectively through various measures, including avoiding symptom-causing foods and immunotherapy. It is not uncommon for symptoms to lessen naturally over time.

While managing OAS can be complex, it is essential for anyone with this condition to consult with a healthcare professional, such as an allergist, for personalized guidance and treatment recommendations.

What are the oral allergy syndrome treatments?

With proper management, people with OAS can lead active lifestyles and enjoy their favorite foods without the fear of uncomfortable symptoms.

Clinical Diagnosis

A clinical diagnosis by a qualified allergist is the first step towards managing OAS. The allergist will perform a thorough physical examination and medical history evaluation to determine the cause of the allergic reactions. Your doctor might perform allergy tests, such as skin prick tests or blood tests, to identify the causal pollen allergens.

Avoiding Triggering Foods

One of the key strategies in managing OAS is to avoid fruits, vegetables, or nuts that may be cross-reactive with pollen allergens.

Antihistamines

If the wrong foods are consumed despite best efforts to avoid them, taking antihistamines can provide temporary relief. Antihistamines work by blocking the effects of histamine, which is released during an allergic reaction. They can help reduce symptoms such as itching, swelling, and hives.

Immunotherapy

For people with pollen allergies, immunotherapy (allergy shots) may be recommended to reduce the effects of OAS.

Immunotherapy involves exposing the body to small, increasing doses of the specific pollen allergen to desensitize the immune system over time. This therapy is typically administered through allergy shots, which aim to increase the number of antibodies generated by the immune system.

Allergy Partners: Offering Effective Treatments and Management Techniques for Oral Allergy Syndrome

Allergy Partners is committed to helping people with oral allergy syndrome manage their symptoms and improve their quality of life. With a comprehensive treatment plan and symptom management strategies, Allergy Partners empowers patients to lead fuller and healthier lives, free from the burden of allergic reactions and discomfort.