Oral allergy to food

We have seen a rapid rise in the incidence of food allergy in recent years – mainly nut allergy due to the increased consumption of tropical nuts in the UK. Peanuts and Cashew nuts seem to be leading the pack. Oral allergy syndrome is now the commonest food allergic manifestation in adult and parallels the rising incidence of pollen allergic Hayfever. This may be due to increased planting of Birch trees in suburban Britain and a particular enthusiasm to grow trees, as they look attractive and are less messy and do not drop fruit. However, their prolific pollen producing catkins are a distinct social and health disadvantage. Some recent studies on Birch pollen immunotherapy in Hayfever sufferers have shown very good desensitising results and symptom control. An unexpected but valuable spin-off has been that up to 80% of their Oral Allergies also resolved.

Allergies to meats, such as beef, chicken, mutton or pork, are also rare. A person who is allergic to one type of meat may not need to avoid other types of meat. Heating and cooking meat can make the product less likely to cause a reaction.

If you have a cow’s milk allergy, you may wonder: Should I also avoid beef? This is usually not necessary, as the majority of those allergic to milk can safely eat beef products. However, one study showed that almost 8 percent of the 62 children with milk allergy studied also reacted to beef. The study also suggests that well-cooked beef is less likely to be a problem for those allergic to milk.

Similarly, people with egg allergy generally don’t need to also avoid poultry, and vice versa.

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Unfortunately, the only way to completely prevent an allergic reaction is to not eat the food at all. But if you love carrots and can’t imagine giving them up, Dr. Bassett says there are ways to lessen the severity of the reaction. “In some cases, you may peel or cook (even microwave) the food, and that appears to reduce the likelihood of experiencing symptoms,” he adds. “There is also some data to indicate that many patients can see a lessening of symptoms after receiving allergy injections to those same seasonal pollens.” Some lucky people are able to cure their food allergies through allergy desensitization .

Shreffler said apples, peaches, plums, cherries, nectarines, hazelnuts, almonds and carrots are the most common food culprits of oral allergy symptoms that he sees in his Boston allergy clinic. He noted that apples are a common offender for people who are allergic to birch pollen, as well as foods such as celery, pears and other raw fruits containing pits, because these fruits and vegetables are botanically close to birch. Often, it's just one or two foods on the list that might cause oral symptoms in some individuals with birch pollen allergies.

A certain amount of cross-reactivity occurs between foods of similar classes and this should be borne in mind if symptoms recur on specific food avoidance. For example if allergic to peanuts, then there is a high risk of being allergic to beans, peas, lentils, carob, senna and liquorice (all members of the legume family). But foods from divergent food families may cross react such as “celery-spice-carrot-mugwort syndrome”. This may be due to the presence of similar pan-allergens called Profilin and Lipid Transfer Protein (LTP) common to fruit, grass and vegetables and which accounts for the cross-reactivity we see between unrelated foods.  It would appear that allergic reactions to fruit and vegetables, which often coexist with pollen allergy, are on the increase. These pan-allergens seem to play a protective role in plants and are induced by environmental stress such as plant infections, soil conditions, changes in weather and storage conditions.   Birch pollen allergic people can have cross-reactions to apples and other fruit, grass pollen allergic people may react to melon, cereals and tomatoes, while those allergic to latex, react to avocado, chestnut, banana and kiwi-fruit. Profilin generally causes milder reactions and is destroyed by heat and cooking. Northern Europeans are more prone to mild oral allergic symptoms with their Silver Birch tree pollen allergies. However, Lipid transfer Protein (LTP) is heat and digestion resistant and can cause more severe systemic allergic reactions. Certain Peach allergic people sensitised to the LTP allergen Pru p3 are likely to have more severe allergic reactions.  People of southern European decent seem to be prone to more severe LTP fruit allergic reactions with anaphylaxis and no associated hay fever. There is now a blood test to measure Pru p3 specific IgE to help identify those at risk for fruit anaphylaxis.

Oral allergy to food

oral allergy to food

Unfortunately, the only way to completely prevent an allergic reaction is to not eat the food at all. But if you love carrots and can’t imagine giving them up, Dr. Bassett says there are ways to lessen the severity of the reaction. “In some cases, you may peel or cook (even microwave) the food, and that appears to reduce the likelihood of experiencing symptoms,” he adds. “There is also some data to indicate that many patients can see a lessening of symptoms after receiving allergy injections to those same seasonal pollens.” Some lucky people are able to cure their food allergies through allergy desensitization .

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