Have you ever had a sudden tingling, numbness, or tingling sensation in your mouth, lips, or tongue after eating a fruit, vegetable, or nut? Or did it feel a little swollen? Often when something like this happens, we think, "Oh, this must be an allergy." Yes, it's true. This is actually a type of food allergy. In medicine, we call this ``Oral Allergy Syndrome'' or ``OAS''. Sometimes it's also called ``Pollen-Food Allergy Syndrome'' or ``PFAS''. So today, let's talk about this in a little more detail .
What is this oral allergy syndrome?
Simply put, Oral Allergy Syndrome is an allergic reaction to certain vegetables, fruits, and nuts. However, in this case, the allergic reaction is mostly limited to your lips, mouth, and throat.
This is a bit special. Because the main reason for this allergy is a cross-reaction with plant pollen (like tree pollen, grass pollen, and weed pollen). Imagine, if you are allergic to certain types of pollen, certain foods also contain proteins similar to the proteins in that pollen. So when you eat that food, your immune system thinks that that pollen has entered your body. That is why this reaction occurs.
Who is most likely to develop this? How common is it?
This condition called ``Oral Allergy Syndrome'' mostly affects people who are allergic to tree, grass, and weed pollens. We also call this ``Seasonal Allergies'' or ``Allergic Rhinitis'', which means people who have symptoms like a runny nose and sneezing all the time.
But there is a small thing. This ``(OAS)`` is rare in babies under 3 years old. The reason for this is that it takes several years of life for an allergy to pollen to develop.
Although there are no exact statistics on how common this ``Oral Allergy Syndrome'' is, it is considered to be the most common food allergy seen among adults. Some studies suggest that between 47% and 70% of people with pollen allergies may have this ``(OAS)''. So it's more common than you think, right?
Is this a dangerous situation?
The question that many people have is whether this is dangerous. Most of the time, ``Oral Allergy Syndrome'' is not a serious condition. Most people just experience itching or a slight swelling of the mouth and lips.
However, very rarely, less than 2% of people with OAS can develop a serious allergic reaction called anaphylaxis. Anaphylaxis is a life-threatening condition that can cause difficulty breathing. Therefore, it is important to be aware of the symptoms.
How does this affect our bodies?
An allergy, or allergic reaction, is a reaction that our body has to something it thinks is harmful. This is what happens in Oral Allergy Syndrome. When you eat trigger foods, your immune system thinks something harmful has entered your body. Your lips and mouth swell in response.
But the good thing here is that normally the stomach acid in your stomach destroys the proteins in those foods, so this allergic reaction doesn't spread to other parts of your body.
What are the symptoms of this?
Symptoms of Oral Allergy Syndrome usually begin within minutes of eating the food that causes the allergy.
The most commonly seen symptoms are:
- Your lips, mouth, tongue, or throat are itchy, numb, or slightly swollen.
- Small blisters on the lips or in the mouth.
These are the most common symptoms. They usually subside on their own within about 30 minutes.
Other symptoms that are less common but may occur include:
Sometimes, symptoms can also affect other parts of the body, but these are less common.
- Nausea.
- Some raw foods can cause skin to itch, redden, or swell when touched.
- Hives or a rash.
- Difficulty breathing (Anaphylaxis) and other severe reactions are very rare. This is an important thing to remember.
What foods cause this?
Fruits, vegetables, and nuts are the main causes of Oral Allergy Syndrome. As we discussed earlier, the proteins in these foods are very similar to the proteins in some pollens. Therefore, your body reacts to these foods in the same way it would to pollen from trees, grass, or weeds.
Think of it like a piece of a puzzle. It doesn't fit exactly in the right place, but it's so similar that you think it's in the right place. That's what happens here. Which foods you react to in this way depends on your other allergies (especially pollen allergies).
Let's see which pollen types are associated with which foods:
If you are allergic to certain pollens, you are more likely to be allergic to foods related to those pollens. However, this does not mean that you will be allergic to every food related to a particular pollen. Sometimes, even if you are not allergic to pollens, you can still have an allergic reaction to certain foods.
Below are some examples. Although these are not unique to Sri Lanka, it is important to understand this pattern. Your doctor can explain this more in a way that is appropriate for you.
If you are allergic to birch tree pollen:
- Spices: Aniseed, Caraway, Coriander, Fennel, Parsley.
- Legumes: Peanuts, Soybeans.
- Fruits with seeds: Avocados, Apples, Kiwis, Pears.
- Stone fruits: Apricots, Cherries, Peaches, Plums.
- Nuts: Almonds, Hazelnuts.
- Vegetables: Carrots, Celery.
If you are allergic to grass pollen:
- Melons like watermelon and cucumber.
- Oranges.
- Potatoes.
- Swiss chard (a type of leafy green).
- Tomatoes.
If you are allergic to ragweed pollen:
- Artichokes (a type of vegetable).
- Bananas.
- Cucumbers.
- Melons such as watermelons and cucumbers.
- Zucchini.
If you are allergic to mugwort pollen:
- Garlic.
- Spices: Aniseed, Caraway, Coriander, Fennel, Parsley.
- Mustard.
- Peppers like fish chilies and bell peppers.
- Vegetables: Cabbage, Carrot, Cauliflower, Celery, Broccoli, Parsnip (a type of potato), Onion.
Other foods to be careful of:
In addition, berries, citrus fruits, figs, grapes, mangoes, pineapples, and pomegranates can also cause OAS in some people.
Important: Don't be alarmed by this list. You won't be allergic to all of these foods. It's best to seek medical advice to know exactly which foods are causing you problems.
How do you accurately diagnose this condition?
How does a doctor recognize this?
An allergist usually diagnoses Oral Allergy Syndrome by listening carefully to your symptoms. He or she will ask you questions about what foods you eat, when they occur, how long they last, and what is causing them.
Then, he or she may do some allergy testing to confirm the diagnosis.
What tests are being done for this?
There are two main types of tests:
1. Allergy skin test: This involves gently scratching a small area of your skin and placing a small amount of various allergens (such as tree pollen or the sap from foods that you have reacted to). If you are allergic to that substance, the area will turn red and develop a small bump called a hive.
2. Food challenge test: Under the supervision of a doctor, you are given a small amount of the suspected food to eat. This is done to see if you have an allergic reaction. This should only be done in the presence of a doctor.
What are the treatments for this?
What usually happens?
Actually, there is no specific treatment for ``(Oral Allergy Syndrome)``. If you have an allergic reaction, it usually gets better on its own within about 30 minutes after you stop eating the food that caused it.
Sometimes taking an antihistamine can help stop the reaction or prevent it from getting worse. However, most of the time, these mild symptoms go away faster than the medication starts to work.
Types of medicines used:
Your doctor may prescribe medications like these for Oral Allergy Syndrome:
- Antihistamines: These work by blocking chemicals in your body that cause mild allergic reactions. There are over-the-counter medications available at the pharmacy. Examples include diphenhydramine (Benadryl®), fexofenadine (Allegra®), and loratadine (Claritin®). You'll need to find one that works best for you.
- Epinephrine: This is used only in the event of a severe allergic reaction. It is given as an injection. It works by reducing swelling, opening the airways, and making it easier to breathe. If you have had a severe reaction before, your allergist may prescribe an epinephrine pen (e.g., Auvi-Q®, EpiPen®) for emergency use.
What can you eat if you have OAS? How can you avoid it? (Prevention & Management)
Don't think that having Oral Allergy Syndrome means you can't eat a lot of food. Most people only experience OAS to a few fruits, vegetables, and nuts, not all of them.
There is no real way to "cure" Oral Allergy Syndrome. However, some treatments can help prevent future reactions. Some people's OAS gets better over time, or their reactions to certain foods become tolerable.
So, how do you avoid this, or reduce the reaction?
- Cooking and eating foods you are allergic to: When fruits and vegetables are heated, that is, cooked, the nature of the allergenic proteins in them changes. Then you do not get an allergy. Many people with OAS can consume cooked foods, sauces, and pasteurized fruit juices without problems.
- Avoiding foods you are allergic to at certain times of the year: Many people's pollen allergies are worse during the spring, summer, or fall (in Sri Lanka, when the weather is dry and windy). So, the longer you have pollen allergies, the more severe your reaction to those foods may be.
- Treating your allergies proactively: Taking daily allergy medication can help some people prevent reactions to those foods.
- Allergy shots / Immunotherapy: This involves giving you gradually increasing doses of the allergens as injections. This helps your body get used to the allergens. You may not have any reactions, or they may be very mild. Some people may also get relief from Oral Allergy Syndrome (OAS).
What can we expect while living with this condition? Will this go away?
Remember that serious allergic reactions to ``Oral Allergy Syndrome'' are rare. If you are bothered by symptoms from a particular food, you should avoid that food.
Although there is no permanent cure for this, Oral Allergy Syndrome can go away over time for some people. Over time, your body may become accustomed to foods that previously caused a reaction.
Do I need to see a doctor? When do I need to go to the emergency room?
If you have allergic reactions to foods, talk to your doctor about any problems you're having. He or she can help you determine whether it's just a nuisance or something more serious that needs treatment.
You should go to a hospital for emergency treatment (ETU) if you have symptoms of a severe allergic reaction such as:
- Facial swelling.
- Swollen tongue.
- Difficulty breathing or swallowing.
If you have any of these symptoms, do n't delay, go to a hospital immediately.
Questions to ask your doctor:
When you go to see a doctor, you can ask questions like these:
- How serious is my allergy?
- What foods can I eat without any problems?
- Are there any treatments or therapies that can help with this?
- What are the symptoms of a severe reaction that I should watch out for?
Although Oral Allergy Syndrome is often just a nuisance, some people can have severe reactions. So if you have any concerns about a food allergy, talk to your doctor or an allergist. You may be able to continue eating your favorite foods, or you may be able to find alternatives that provide relief without the itch.
Shall we briefly recall what we talked about? (Take-Home Message)
Okay, so let's recap the most important points from what we've talked about.
- Oral Allergy Syndrome (OAS) is a condition in which symptoms such as itching and swelling occur in the mouth, lips, and throat after eating certain fruits, vegetables, and nuts.
- This is due to a cross-reaction with pollen allergies.
- This is usually not serious, but rarely, severe conditions such as ``Anaphylaxis'' can occur.
- You can help control this by cooking and eating the foods you are allergic to, avoiding those foods at certain times, and taking medications as prescribed by your doctor.
- If you experience severe symptoms such as difficulty breathing, swelling of the face or tongue, you should seek medical attention immediately.
- If you have any doubts about this, definitely see a doctor and get advice. There is nothing to be afraid of, the most important thing is to be aware of this.
I hope you found this information useful! Stay healthy!
` Oral Allergy Syndrome, OAS, Pollen Food Allergy Syndrome, PFAS, Oral Allergy, Food Allergy, Pollen Allergy, Food Allergy
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