Tips For Managing Oral Allergy Syndrome and Hay Fever
Oral allergy syndrome is a disorder in which the ingestion of a particular food causes an allergic response in the mouth. Symptoms sometimes occur in the digestive tract and respiratory system as well. The most common symptoms of the disorder are a burning, itching or tingling sensation in the lips, tongue, lining of the mouth and throat.
Oral allergy syndrome, or OAS, is generally less serious than a tradItional food allergy, which can cause a major and widespread allergic response. This isn't always the case, however.
Most people who experience OAS also suffer from hay fever. In fact, an allergy to pollen is believed to be responsible for most cases of oral allergy syndrome. Hay fever is caused by proteins in inhaled pollen grains that trigger an attack by the body's immune system. Some foods contain similar proteins to those in pollen grains and also trigger an immune system attack. The immune system is unable to tell the difference between the proteins in the pollen grains and the proteins in the food, a phenomenon known as cross-reactivity. Oral allergy syndrome is sometimes known as pollen-food syndrome or pollen-food allergy syndrome.
Oral allergy syndrome can occur all year found, but it's often worse in the pollen season. Therefore strategies to reduce or prevent both OAS and hay fever can be useful for a person who has both of the disorders. I have oral allergy syndrome and hay fever and find some of the techniques described below very helpful.
Oral Allergy Syndrome Symptoms
In many people, symptoms of oral allergy syndrome are restricted to the mouth. The first symptom listed below is the most common and may be the only one that appears. OAS symptoms usually develop immediately after eating a food, but they may not develop until up to thirty minutes later, or very occasionally up to an hour after eating the allergenic food.
- A burning, itching or tingling sensation in the lips, mouth and throat
- Swelling of the lips, tongue or throat
- Nausea, vomiting or diarrhea
- Runny nose
- Itchy eyes
- Anaphylaxis (a very rare symptom)
Oral allergy syndrome is uncomfortable but is generally not dangerous. Very occasionally, OAS can be a serious condition. The tissues in the mouth and throat may swell so much that they block the airways, which is a medical emergency. A severe asthma attack or anaphylaxis are also emergencies. Anaphylaxis is a very serious, rapidly developing and systemic (whole body) allergic response. Fortunately, the more serious symptoms of oral allergy syndrome are rare. It's estimated that only 1.7% of people with oral allergy syndrome experience anaphylaxis due to the disorder.
Stamens, Anthers and Pollen
Pollen is produced by the male part of a flower, which is called the stamen. The stamen consists of a stalk called a filament bearing a sac called an anther. The anther contains the pollen grains.
Is the Problem Really Oral Allergy Syndrome?
Someone who suspects that they have oral allergy syndrome should visit their doctor to discuss the situation with them. Some traditional food allergies can produce similar symptoms to OAS. For example, a soybean allergy can result in tingling and swelling in the mouth, nausea and a runny nose when the bean is eaten.
It's important to discover whether an allergic response is a case of oral allergy syndrome, which usually affects a limited area in the body and causes relatively minor problems, or is actually a more serious allergy, which may have far-reaching and dangerous effects.
Doctors can order allergy tests to determine which type of pollen or food someone is allergic to. They can also suggest and prescribe treatments for hay fever, oral allergy syndrome and traditional food allergies.
What is Oral Allergy Syndrome?
Oral Allergy Syndrome Information from the National Health Service
According to the National Health Service in the UK, 75% of people with an allergy to silver birch pollen also experience oral allergy syndrome.
Cross-Reactivity and Oral Allergy Syndrome
Oral allergy syndrome is an unusual type of food allergy because the body is really responding to pollen proteins rather than food molecules. People generally develop OAS after being exposed to pollen grains and suffering from hay fever for years. Not all people with hay fever develop oral allergy syndrome, but many do. Some people with OAS don't experience hay fever.
The condition develops in older children, teenagers and adults, but usually not in young children. It's a frustrating disorder because the sufferer finds that a food that they used to eat with no problem now causes unpleasant symptoms. It's especially annoying when this food is a favorite one or when several foods cause problems.
The table below shows the most common foods that can trigger OAS in people when they are allergic to a particular type of pollen. Other foods not mentioned in the table may have the same effect. If a person responds to one food in a category, they don't necessarily respond to other foods in that category.
Unless it's obvious that a particular food produces oral allergy syndrome or another allergic response, a nutritious food shouldn't be dropped from the diet. There are a lot of very nutritious foods listed in the table of suspect foods below, especially in the case of a birch pollen allergy. It would be a great shame to eliminate any of them unnecessarily.
Cross-Reactivity Between Pollen and Food
Pollen That Triggers Hay Fever
Possibly Allergenic Fruits
Possibly Allergenic Vegetables
Possibly Allergenic Nuts or Seeds
bananas, cantaloupes, honeydew melons, watermelons
cucumber, zucchini, chamomile, Echinacea
oranges, kiwi fruits, melons
tomatoes (which are technically a fruit)
apples, pears, kiwi fruits, peaches, apricots, nectarines, plums, prunes (dried plums), cherries
carrots, parsnips, celery, potatoes, fennel, parsley, beans, peas, lentils, peanuts, tomatoes, green peppers, coriander, anise
hazelnuts, almonds, walnuts
apples, pears, peaches, cherries
carrots, parsnips, celery, green peppers, parsley
Ways to Prevent Oral Allergy Syndrome Symptoms
The only way to be certain of avoiding oral allergy syndrome is to completely avoid any allergens in the diet. This is not as easy as it sounds, however. Sometimes allergenic foods are mixed with non-allergenic foods in items like salads, soups, stews, spice mixtures and supplements. It may not be advisable to buy these items in stores or restaurants unless the ingredients are known.
Avoidance of some problematic foods may not be necessary. There are certain food preparation techniques which may enable a person to eat a food that otherwise produces OAS. One advantage of oral allergy syndrome proteins compared to the allergenic proteins in a traditional food allergy is that the OAS ones change their shape or break down when heated. This may prevent the immune system from recognizing them.
Food Preparation For Oral Allergy Syndrome
Many people with oral allergy syndrome can eat allergenic foods if they prepare them in a certain way. Please note that if you have experienced a serious case of oral allergy syndrome or if you have a traditional food allergy, none of the food preparation techniques described below must be tried. The food that you are allergic to must be completely avoided. For people who experience mild to moderate oral allergy syndrome, though, the following strategies may enable some problematic foods to be eaten.
Eat Cooked Food
Cooking breaks down some of the allergenic proteins in food, so an allergy sufferer may tolerate the cooked food but not the raw food. This is the case for my reaction to hazelnuts. When I eat the raw nuts I experience oral allergy syndrome symptoms. Generally, when I eat hazelnut butter made from roasted hazelnuts I don't experience any symptoms. I say "generally" because I have occasionally eaten hazelnut butter that has made my throat sore.
Some allergists recommend that if a person has a reaction to raw nuts they should eliminate them from the diet instead of cooking them or preparing them in a different way, since nuts are so allergenic.
Cooking food is often very helpful for oral allergy syndrome. Many OAS sufferers can eat apple pie, apple sauce and pasteurized apple juice, but not fresh apples, for example.
Eat Canned Food
During the canning process food is heated. This may be helpful for OAS sufferers. Fresh peaches or pears may trigger OAS symptoms, for example, while canned ones may not.
Eat Peeled Food
Sometimes the allergenic proteins causing OAS are located in the peel or skin of a fruit, vegetable or nut. Peeling the food may prevent symptoms. Peeled or cooked apples are fine for me, but if they are raw and are still covered with their skin they trigger OAS symptoms.
Medical Treatments For Oral Allergy Syndrome
If none of the above techniques work for you or if your allergic response is becoming worse, visit your doctor. The doctor may prescribe an antihistamine. Histamine is a chemical produced by the immune system to help it fight invaders. Unfortunately, it also produces the unpleasant symptoms of allergies. Antihistamines prevent histamine from binding to cells and doing its job.
If a person has a serious case of OAS which causes potentially dangerous swelling in the air passages, the doctor may prescribe an epinephrine auto-injector. Epinephrine is a chemical that expands the airways when they constrict. It's rarely needed in oral allergy syndrome, however.
Another possible treatment is immunotherapy, or allergy shots. The therapy starts with the patient being given a tiny dose of the allergen. As time passes, the dose gradually increases until a maintenance dose is reached. This treatment can cause the body to develop a tolerance to the allergen.
Immunotherapy is generally prescribed only for people with severe hay fever symptoms. It has helped hay fever sufferers. The results of immunotherapy for OAS treatment have been variable, however. Some OAS sufferers have benefitted from the treatment while others have experienced no benefit.
Fall Hay Fever
Hay Fever Symptoms
Hay fever results from the overactive response of the immune system to pollen grains. It often develops in spring, since allergenic plants such as birch and alder produce their catkins then. These catkins release pollen. In this case hay fever is often referred to as a spring allergy or as "spring allergies". Some plants, such as ragweed, release their pollen later in the year, so hay fever isn't restricted to spring.
Hay fever is also known as seasonal allergic rhinitis. Rhinitis is a condition in which the airways are inflamed due to an allergic response.
Hay fever can be very unpleasant, but it isn't a type of fever, despite its name. The most common symptoms are listed below.
- Frequent sneezing
- Nasal congestion
- Runny nose
- Itchy, watery and red eyes
- Itchy nose, throat and/or ears
The sneezes can be so frequent that they interfere with life and stop a person from doing from what they need to do.
The Pollen Season
In people who suffer from both oral allergy syndrome and hay fever, when the immune system goes into overdrive to attack pollen proteins it's also being primed to attack similar proteins in food. The immune system makes new antibodies to attack pollen grains during hay fever season. These antibodies may attack food proteins, too.
Reducing the overactivity of the immune system during the pollen season may help to reduce the strength of oral allergy syndrome. It also has the benefit of reducing the misery of hay fever!
Hay Fever Advice From an Allergy Specialist
How to Reduce Hay Fever Symptoms
The following strategies will decrease a person's exposure to pollen and help to reduce hay fever symptoms.
- Stay indoors with the windows and doors shut during times of high pollen counts. An air conditioned building is useful in summer.
- Check the pollen forecast daily. Websites such as The Weather Network and The Weather Channel let visitors enter the name of a city to see the local pollen forecast. The sites also tell the visitor whether the pollen count is considered to be high, moderate or low.
- Set air conditioners to recirculate air so that they don't bring in fresh pollen.
- Try to limit outdoor exposure during the time of day when the pollen that you are allergic to is released.
- Pollen counts are high during warm, dry and windy weather but fall during rainy weather. Exercising during rain or right after rain has stopped is best for a hay fever sufferer who wants to exercise outdoors.
- Consider wearing a mask to filter out pollen grains and wrap-around sunglasses to protect your eyes if your hay fever is bad. A scarf over the nose and mouth will also help to prevent the inhalation of pollen.
- Keep car windows closed.
- Attach a filter that traps pollen grains to the air vents of your car.
- Avoid mowing the lawn or gardening during the pollen season. Don't bring flowers into the home.
- Try placing vaseline in the lower part of your nostrils to trap pollen grains.
- Wash nostrils and eyes with saline solution to remove pollen grains.
- Wash your skin, hair and clothing after exposure to pollen grains.
- In your home, use an air filter that traps pollen grains.
- Also use a vacuum with a filter that traps pollen grains.
- Wet-dust to avoid sending pollen particles into the air.
- Don't dry clothes outdoors.
Dealing With Hay Fever
Other Strategies That May Help Hay Fever
Some allergy experts suggest avoiding exposure to pets whose coat has collected pollen grains. Some even suggest keeping the pets outside. That's never going to happen in my home! I wouldn't dream of leaving my pets outside or of paying them less attention. If you feel the same way, it might be helpful to ask someone else in the family to brush the pet before he or she comes inside if they have been outside for a long time.
Antihistamines can be bought in drug stores and can be very effective for preventing hay fever symptoms. Doctors can prescribe more powerful ones if necessary. It's important that non-drowsy antihistamines are used. Sedating ones can be dangerous for drivers and can interfere with school or work. Even when antihistamines are used, though, pollen avoidance techniques are a good idea in someone with OAS in order to prevent the stimulation of the immune system and the production of antibodies.
Depending on food choice, it's possible to eliminate oral allergy syndrome symptoms. Eliminating all hay fever symptoms depends on how sensitive a person is to pollen. There are always some pollen grains in the air. Pollen avoidance techniques and medical treatments can be a big help, though. They can greatly reduce symptoms and in some people eliminate them altogether.
© 2014 Linda Crampton
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