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Definition
A minor allergic reaction to some raw fruits and vegetables
Causes itching and swelling only to the lips and tongue
Also called Pollen-Food Syndrome
Health Information
Symptoms
Rapid onset of itching (or tingling) and swelling of the mouth.
This includes the lips, tongue, throat, and roof of the mouth.
The uvula (tag of tissue hanging down in back) can become very swollen.
The reaction follows eating a high risk raw fruit or vegetable.
Oral Allergy Syndrome (OAS) can start by age 5.
Severe reactions and serious symptoms rarely happen.
Causes
A contact allergy. It is limited to the parts of the mouth that touch the raw food.
Trigger foods for OAS are always raw and uncooked.
Fresh Fruits. Includes apple, apricot, banana, cherry, melons, orange, peach and pear
Raw Vegetables. Includes carrot, celery, parsley, potato and tomato. Carrots and celery have the highest risk for also causing serious symptoms.
Certain Seeds. Includes sunflower seeds and fennel seeds
Oral Allergy Syndrome and Nose Allergies Can Be Linked
Over 50% of people who are allergic to pollen also have OAS. This means 10% of all people.
Ragweed pollen allergy can cross-react with all melons. Also, sometimes with bananas and tomatoes.
Birch pollen allergy can cross-react with raw potatoes, carrots, celery and apples.
Grass pollen allergy can cross-react with tomato and kiwi.
Care Advice
Overview:
Oral Allergy Syndrome (OAS) is very common. It happens in 10% of people. Most of them also have pollen allergies.
The symptoms are not harmful and can be treated at home.
Required for OAS: Your child has never had any serious symptoms with this food.
OAS symptoms don’t last very long.
Here is some care advice that should help.
Rinse the Mouth:
Rinse the lips and mouth with warm water. Do this a few times.
Reason: To remove any traces of the food.
Cold Pack:
Use ice or a cold pack to the swelling lips or tongue for 10 minutes.
Reason: To lessen the swelling and the itch.
Oral Allergy Medicine
One dose of an oral allergy medicine (such as Cetirizine, Loratadine, or Diphenhydramine) may help the symptoms go away faster.
No prescription is needed.
For oral allergy medicine age restrictions and dose charts, please click here.
Prevention of Future OAS:
Keep a list of the foods that cause your child’s symptoms.
Avoid these foods if they are raw (fresh).
The cooked version of these foods usually won’t cause any symptoms.
What to Expect:
With or without treatment, the itching will go away in 1 to 2 hours.
The mouth swelling will also go away quickly.
Call Your Doctor If
Trouble swallowing or drooling occurs
Trouble breathing occurs
Swelling or rash occurs elsewhere
You think your child needs to be seen
Your child becomes worse
📚 References
This content was adapted from Schmitt Pediatric Guidelines LLC, Author: Barton Schmitt MD, FAAP.
Reviewed by JW MD, Patient Education Committee.