Oral Allergy Syndrome is somewhat paradoxical in that it is
primarily diagnosed in people who have certain kinds of pollen allergy. Certain
fruits, vegetables, and nuts cause localized allergic reactions in the mouth
and throat. It's mainly because of cross-reactive allergic reactions due to
similarities in some structures that exist among some proteins in those foods
and in pollen.
Understanding the Mechanism of OAS
Cross-Reactivity at the Heart of OAS
Cross-reactivity is at the center of the entire idea of OAS.
IgE antibodies had been produced in a patient allergic to pollen as a response
the body put together to that allergen. Those IgE antibodies would then look at
some proteins in certain food products as foes and act accordingly even where
such foods are innocuous. For example, a person with a birch pollen allergy can
test positive for apples or cherries because the proteins present in apples
and cherries are very related to those present in birch pollen.
Oral Allergy Syndrome Symptoms
Whereas many OAS symptoms can be felt within minutes from ingesting the caused food, the symptoms remain as follows:
- Itching/burning feeling in mouth, throat, or lips
- Lip, tongue, or throat swelling usually combined with
tenderness
- Rash or hives around the mouth
- Gastrointestinal symptoms like nausea, vomiting, or
diarrhoea, although this seldom happens
These are usually mild and may subside within an hour. The
discomfort may be annoying and most of them avoid those trigger foods
Some Common OAS Triggers
OAS has been connected to some established foods and a certain pollen allergy. Examples of common ones include the following
- Birch Pollen Allergy
- Those with a birch pollen allergy react to: Apples
- Pears
- Cherries
- Carrots
- Almonds
These foods have proteins that are structurally identical to
that present in the birch pollen, thus causing cross-reactivity.
Ragweed Pollen Allergy
The individuals suffering from ragweed pollen allergies may react to:
- Bananas
- Cucumbers
- Melons, such as cantaloupe and watermelon
- Zucchini
People whose body's immune systems are not hardened to
specific protein similarities may face OAS reaction.
Grass Pollen Allergy
The people allergic to grass pollen may react to the following foods:
- Peaches
- Tomatoes
- Oranges
This may result in oral allergy symptoms. Again, it is
because of cross-reactivity due to structural similarity between the involved
proteins.
Not Everyone Is Affected
It is important to note, however, that not everyone who is
pollen-sensitive eventually develops OAS. The severity can vary substantially
between individuals, and most people eat these foods without any problems at
all. A number of factors affect a person's predisposition to develop OAS,
including a person's level of pollen allergy, personal immune reactions, and
the types of proteins involved.
Oral Allergy Syndrome: Diagnosis
The OAS diagnosis is quite a multi-step process:
1. History of Illness
A proper medical history is required. Providers will
question:
- Known allergies, notably pollen
- Symptoms developed after some foods
- The time of symptom onset in relation to the food
consumption
2. Testing for Allergy
To confirm the diagnosis, allergists may conduct the following specific tests:
- Skin Prick Tests: The doctor injects minor quantities of
allergens, like pollen and food into the skin and monitors for reactions.
- Blood Tests: Specific IgE test measures the antibodies that
the person has against specific allergens; it may determine both pollen and
food sensitivity.
3. Oral Food Challenge
Occasionally, the oral food challenge is conducted under
medical supervision. This typically occurs when small amounts of suspected
allergens in the diet are ingested within a clinical setup and clinical
attention for manifestations of allergic reaction are sought. This therefore
confirms the diagnosis of OAS and at the same time dismisses other food
allergies.
Management of OAS
Avoidance of Triggers
The cornerstone of management for OAS is avoidance of
trigger foods. Patients should be educated about their pollen allergies and
that which might correlate to specific foods. A food diary may assist in
identifying possible triggers.
Cooking and Food Preparation
Cooking most food alters the configuration of their proteins, and the proteins are often less likely to cause OAS symptoms. For example:
- Steaming, roasting, or boiling may denature proteins
responsible for the allergy. Cooked apples or carrots may not trigger symptoms
of OAS in many people sensitive to the raw fruits and vegetables
- Peeling: The skin of many fruits and vegetables contains
most of the allergenic proteins. Peeling these vegetables and fruits may reduce
the risk of a person developing allergies
If symptoms of OAS are mild when they occur,
over-the-counter antihistamines may be effective. Anyone exposed to more
serious reactions will require a prescription for an epinephrine auto-injector;
however, anaphylaxis is rare with OAS.
Health Care Provider Follow-up
People with OAS should see an allergist on a regular basis
for follow-up care. The allergist can continue to advise them on the management of
their symptoms and how to avoid triggers, besides new treatment or management
strategies that may come up.
Living with Oral Allergy Syndrome
Living with OAS requires vigilant awareness and
self-management. For some tips on how to live with oral allergy syndrome, read
on.
Understanding Allergies and Symptoms
You need to know what you are allergic to and the specific
food that will activate your OAS. Knowledge may help avoid accidental exposure
and reduce anxiety when eating.
Balance Your Diet
Planning the diet will be stressful because of having to avoid foods that trigger a symptom, but ensuring nutritional adequacy is important. Here are some tips:
- Safe Substitutions: Identify other fruits and vegetables
that would be relatively safer for substitution, such as those less likely to
trigger symptoms. For example, if an allergen were apples, the alternative
would be pears or cooked fruits.
- Variety is the Best Option: One will get various necessary
nutrients through diversity in diet, but one should not include all the known
allergens. A person requires a number of fruits and vegetables that probably
cannot cause such symptoms.
- Consult with a Registered Dietitian: A dietitian can help
you develop a balanced meal plan fitting around your allergies at the same time
helping to ensure you will get enough nutrition.
Research
Besides knowing which fruits are related to your allergies,
knowing seasonal pollen can also help predict reactions. Many weather services
provide a pollen forecast, which enables people to make informed dietary
choices during peak allergy seasons.
Conclusion
Oral Allergy Syndrome is not a problem since it can be
handled by proper alertness and the adoption of avoidance measures.
By understanding the relationship between pollen allergies and food sensitivities,
one can efficiently navigate choices in diet and maintain healthy and balanced
lifestyles. Suspecting OAS or upon the manifestation of symptoms, an
appointment with an allergist will be of great benefit to guide and support
competent management. The proper approach ensures that people shall have
much diversity in their diets, whilst causing less discomfort and well health.
Please book an appointment with the Best ENT Specialist in Lahore, Karachi, Islamabad, and all major cities of Pakistan through InstaCare, or call our helpline at 03171777509 to find a verified doctor for your disease.
