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Have you ever been sitting with your friends or family, minding your own business, and eating a plate of fresh fruits and vegetables?  All of a sudden you feel your throat and mouth start to itch, and your lips and tongue are swelling to an enormous size. If you are answering yes to this question, you may have oral allergy syndrome

In the movie “Hitch,” Will Smith is out on a date and of course is trying to impress the lady.  He starts eating some shellfish and a few seconds later the symptoms of oral allergy syndrome begin to take over his conversation with the food servers.  Watch the link above to see Hollywood’s version of oral allergy syndrome. Please note:  Do not drink bottles and bottles of benadryl to get rid of the symptoms like the character in the movie does.  Please get medical treatment immediately!

What is Oral Allergy Syndrome

Oral allergy syndrome, also known as pollen-food syndrome,is caused by cross-reacting allergens found in both pollen and raw fruits, vegetables, or some tree nuts. The immune system recognizes the pollen and similar proteins in the food and directs an allergic response to it. People affected by oral allergy syndrome can usually eat the same fruits or vegetables in cooked form because the proteins are distorted during the heating process, so that the immune system no longer recognizes the food. So bring on the banana bread!


Not everyone with pollen allergies will suffer from oral allergy syndrome however, The following are commonly associated pollen allergens and foods- called cross-reactors:

  • Birch pollen: apple, almond, carrot, celery, cherry, hazelnut, kiwi, peach, pear, plum
  • Grass pollen: celery, melons, oranges, peaches, tomato
  • Ragweed pollen: banana, cucumber, melons, sunflower seeds, zucchini


Again, because the proteins in pollen are similar to those in some foods, the antibodies created to the pollen mistake the food for pollen and this causes the reaction to the food.  Symptoms come on immediately and include: Redness, swelling or itching of lips, tongue, inside of mouth, soft palate and ears, as well as itching in the throat. Swelling in the throat is a possibility as is anaphylactic shock, but this is rare

Latex-Related Symptoms

Another type of oral allergy syndrome affects some people who suffer from latex allergy. This is caused by a reaction to proteins found in natural rubber or latex. Because some latex allergens are similar to the allergens in certain foods, people who are allergic to latex might also find they react to foods such as apple, avocado, banana, carrot, celery and chestnut.  The symptoms are the same as described above.

Other Allergic Conditions

Allergic reactions to fruit and vegetables are not always related to pollen or latex. Sometimes there is a true allergy to the food itself. Reactions may be more severe in true food allergies.  Symptoms of the mouth can also be caused by nuts, peanuts, egg and fish. This is NOT oral allergy syndrome and may be more serious. Any reaction to a food should be evaluated by a physician, preferably an Allergist.

Diagnosis and Management

The correct identification and the avoidance of the culprit food must be the main goal.  Having previous experience of what has happened when eating certain foods is the most important evidence.  Skin and blood tests can help to confirm the exact diagnosis. About 2% of patients can develop a systemic reaction (anaphylaxis reaction). For this reason, if you have had a serious reaction in the past, the trigger food MUST be avoided and you may need to carry an epinephrine auto-injector pen (epi-pen).  Only the foods that have caused symptoms need to be avoided. So there is not reason to miss out on that fresh salsa as long as you haven’t reacted to the foods it’s made of.

If you have oral allergy syndrome,  it is important that when trying a fruit or vegetable for the first time, it is best to be cautious.  Here are some steps to follow:

  • Rub the lip with a small amount
  • chew a small portion and spit it out.
  • Wait 15 minutes to see if any symptoms develop

Once you are sure that particular food is causing symptoms then it is important to avoid it.  However, the food cooked may not be a problem (refer to top).

Desensitization treatment to an oral allergy syndrome is not available in very many areas of the world and can still be very risky.  However, it may become available in the future.



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