Understanding Oral Airway Syndrome


Those of you who follow my blog regularly, know that I often talk about topics that are discussed in educational handouts available to patients in my practice. Today, I would like to discuss Oral Airway Syndrome.

Oral Airway Syndrome is caused by a cross-reactivity between proteins derived from pollen in fruits or vegetables. Not surprisingly, it is often confused with a food allergy and thus can be difficult to diagnose. Symptoms of Oral Airway Syndrome include: itching or swelling of the lips, mouth, and throat, and/or itching of the gums, nose and eyes. Oral Airway Syndrome occurs more often in patients with underlying allergic rhinitis and asthma, and generally adults appear to be more affected than children. Symptoms are often worse during the spring and fall pollen season because of the cross-reactivity with the fruit or vegetable pollen.

The best strategy to avoid symptoms of Oral Airway Syndrome is to avoid the offending food or change how it’s prepared.  Patients often notice that they do not react to the food the same way when it is cooked, versus consuming it raw. By cooking the food, the proteinaceous coat that causes the allergic reaction becomes denatured and patients are able to tolerate the food. In severe cases, immunotherapy to the pollen or allergen involved can also be helpful. Oral antihistamines can be helpful as well.

Below is a list of pollen sources and the foods that can potentially cause a cross-reaction:


Potentially Cross-Reactive Foods: bananas, melon, zucchini, cucumber, dandelions, chamomile tea

Pollen: Birch

Potentially Cross-Reactive Foods: apples, pears, peaches, apricots, cherries, plums, nectarines, prunes, kiwi fruit, carrots, celery, potatoes, peppers, parsley, coriander, parsnips, hazelnuts, almonds, walnuts

Pollen: Grass

Potentially Cross-Reactive Foods: peaches, celery, melon, tomatoes, oranges

Pollen: Mugwort

Potentially Cross-Reactive Foods: celery, apple, kiwi, peanuts, fennel, carrots, parsley, coriander, sunflower, peppers

Pollen: Alder

Potentially Cross-Reactive Foods: celery, pears, apples, almonds, cherries, hazelnut, peaches, parsley

Additionally, people who are allergic to latex may find these foods potentially cross-reactive: bananas, avocado, kiwi, chestnuts, papaya

To obtain a copy of this and other helpful handouts, please visit our practice, Annapolis Allergy & Health Enhancement Center. 


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