Oral Allergy Syndrome

 

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Oral Allergy Syndrome

October 15, 2014

 

 

My mouth itches when I eat certain foods. Does this mean that I’m allergic to that food?

Many people who have these symptoms actually have a condition known as Oral Allergy Syndrome (OAS). OAS is a situation in which you are reacting to certain proteins in foods and it is causing itching and burning of the lips, mouth and throat.

 

What other symptoms do people get when they have OAS?

There is some disagreement on how to label someone with OAS. Some experts feel that it should be used to describe people who only have oral symptoms; others will use it to describe a wide variety of symptoms. More severe skin reactions such as rash, hives or angioedema and Gastrointestinal symptoms such as vomiting, diarrhea and cramping have been labeled as OAS.

 

What causes OAS?

In patients with OAS, the protein that they are reacting to is identical or similar to certain proteins in pollens. The patient is allergic to the pollen and when the patient eats the food (or otherwise comes in contact with it, their body reacts to the protein as if it is coming in contact with the pollen.

 

What are some of the foods and pollens that are linked in OAS?

There are many food/pollen links which are too numerous to list. Some of the most commonly listed ones include Alder pollen and almonds, apples, celery, peaches; Birch pollen with apples, pear, plums, peach, celery, carrot, and wheat; Grass pollen with melons, tomatoes and oranges; Mugwort pollen with carrots and celery; Ragweed pollen and banana, watermelon, cantaloupe, and honeydew.

 

Does it matter what time of year it is?

Though OAS symptoms can occur year-round, it is often worse during the relevant pollen seasons. In this part of Florida, trees pollinate in the spring, grasses in the late Spring/early summer, and weeds pollinate in the autumn.

 

I’ve noticed that if the food is cooked, it’s not a problem. What does this mean?

Exposing food to heat can sometimes change the structure of the protein sufficiently and therefore the immune system does not recognize it as an allergen.

 

Should I be concerned that this is going to get worse?

Often, patients do not worsen over time. However, there have been many patients, whose symptoms have continued to worsen gradually over time, even progressing to anaphylactic reactions.

 

Is there a test that can help me?

Knowing your pollen allergies can often help you clarify which foods to “watch out for”.  Allergy testing for foods, oral challenge procedures and performing elimination diets is also helpful.

 

What can I do to treat this problem?

Avoidance is the first step in treating allergies, particularly during the relevant pollen season. Some patients find they can tolerate the food if it has been heat treated or otherwise manipulated. Of course this can be dangerous and should be performed in consultation with a qualified allergist. For life-threatening reactions, injectable epinephrine is the treatment of choice.  There is some data to suggest that allergen immunotherapy (allergy shots) to the relevant pollen reduces the sensitivity to the offending food.

 

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