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What is a food allergy?

A banana allergy is a type of food allergy. Food allergy occurs when the body’s immune system wrongly identifies a food as a threat. When this happens, the body releases chemicals, such as histamine, in response. It is the release of these chemicals that causes symptoms.

What is banana allergy?

Usually, people who are allergic to bananas are allergic to other foods as well. The banana allergy exists as part of pollen food syndrome or latex food syndrome, which mainly affect the mouth and throat.

Pollen food syndrome
Pollen food syndrome occurs in some people with hay fever who are allergic to certain pollens from grass or weeds. Proteins in certain foods are so similar to the proteins in pollen that they cause symptoms when you eat the food. This is due to a process known as cross-reactivity. The foods include certain fresh fruits and vegetables, and bananas can be one of them.

Latex food syndrome
This occurs in some people who are allergic to natural rubber latex. In these cases, there is a similarity between the proteins in latex and the proteins in banana.

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Symptoms of banana allergy

Symptoms usually begin within minutes. If you have pollen food syndrome or latex food syndrome, symptoms are usually confined to the lips, mouth, tongue and throat. They can include:

  • itching of the mouth and throat
  • an itchy rash known as hives (urticaria)
  • swelling of the skin (angioedema)

 

With both conditions, serious symptoms are unlikely because the proteins that cause the allergy are unstable and are destroyed once they reach the stomach.

Most of the allergen (the protein that causes the allergy) is in the skin or pips, so peeling the banana and removing the black seeds in the middle may reduce the symptoms or prevent them altogether.

Most people with either of these types of allergy don’t need to carry adrenaline auto-injectors.

Serious banana allergy symptoms

Rarely, people can be allergic to bananas even if they are not allergic to pollen or natural rubber latex. People with this type are more likely to have serious allergic reactions.

More serious symptoms are often referred to as the ABC symptoms and can include:

  • AIRWAY – swelling in the throat, tongue or upper airways (tightening of the throat, hoarse voice, difficulty swallowing)
  • BREATHING – sudden onset wheezing, breathing difficulty, noisy breathing
  • CIRCULATION – dizziness, feeling faint, sudden sleepiness, tiredness, confusion, pale clammy skin, loss of consciousness

 

The term for this more serious reaction is anaphylaxis.

Most healthcare professionals consider an allergic reaction to be anaphylaxis when it involves difficulty breathing or affects the heart rhythm or blood pressure. Any one or more of the ABC symptoms above may be present.

In extreme cases there could be a dramatic fall in blood pressure. The person may become weak and floppy and may have a sense of something terrible happening. Any of the ABC symptoms  may lead to collapse and unconsciousness and, on rare occasions, can be fatal.

Read more about anaphylaxis

Getting a diagnosis

If you think you or your child might have a banana allergy, see your GP who can refer you to a specialist allergy clinic if needed. They can find a clinic in your area from the British Society for Allergy and Clinical Immunology (BSACI).

Banana allergies can be diagnosed with specialised allergy tests. They can often tell the specialist not only whether you have an allergy, but also identify the culprit protein and even which protein family it belongs to.

Such tests can help the specialist see whether you’re likely to have a serious reaction and whether you need a prescription for adrenaline auto-injectors.

Managing banana allergy

In all cases of banana allergy, it’s important to avoid bananas, but it is essential if you have a serious allergy.

If you have a serious allergy

  • Be careful of fruit salads, fruit drinks and anything else which might contain banana as an ingredient.
  • If you are prescribed a medicine by your doctor, check if banana flavouring has been added. There has been at least one report of a child having an allergic reaction within an hour of taking penicillin containing banana essence as a flavouring.
  • Be careful of personal care products and toiletries, such as shampoos and body lotions. Always read the ingredient lists.

 

If you have a pollen food or latex food allergy

If you do have a reaction to bananas, stop eating the food and wash your mouth with water. Although a serious reaction is unlikely, you may wish to take an antihistamine tablet. This may help, but as symptoms usually disappear quickly on their own, often within two hours, they might not have much impact.

Most people with a fruit allergy related to pollen food syndrome or latex food syndrome can tolerate their culprit fruits once cooked, as the protein that causes the reaction is likely to be deactivated by heat.

Treating more serious symptoms

If you are at higher risk of anaphylaxis, you may be prescribed adrenaline to use in an emergency.

Adrenaline comes in pre-loaded adrenaline auto-injectors (AAIs) that are designed to be easy to use. Make sure you know how and when to use them. Ask your healthcare professional to show you and find help on the manufacturer’s website and get a free trainer device to practice with.

The adrenaline auto-injectors prescribed in the UK are:

 

You must carry two AAIs with you at all times, as you may need to use a second one if your symptoms don’t improve after five minutes or get worse.

If you have asthma, and it is not well controlled, this could make an allergic reaction worse. Make sure you discuss this with your GP or allergy specialist and take any prescribed medicines.

Read more about what to do in an emergency

What else could I react to?

If you are allergic to bananas, cross-reactivity with latex may mean you also react to avocado, kiwi or chestnut. You might also experience oral reactions to other fruits such as peach, olive and tomato, and raw vegetables such as bell pepper and carrot.

Key messages

  • If you know or suspect you have a banana allergy, getting expert medical advice is vital. Start by seeing your GP.
  • If your allergy is diagnosed as potentially serious and you are prescribed adrenaline auto-injectors, make sure you carry them with you at all times and know how to use them.

Further information

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