Banana Allergy - Anaphylaxis Campaign

General information

This article is written to help people with allergy to bananas to understand and manage their allergy.

Allergic reactions to banana vary widely and can include itching of the mouth and throat, itchy rash (hives, urticaria), skin or mucosal swellings (angioedema), and in rare cases narrowing of the throat, wheezing, and even collapse. In most cases, symptoms begin within seconds or minutes of eating the fruit.

Symptoms

Mild symptoms

Banana allergy most commonly occurs in conjunction with allergy to other foods, presenting as one of two types of oral allergy syndrome (affecting the mouth or throat).

The two types are:

Pollen food syndrome. This occurs in some hay fever sufferers who are allergic to certain tree pollens (silver birch, alder or hazel pollens). In these cases, proteins in the pollen are so similar in structure to those present in certain plant foods that allergy symptoms occur when the food is eaten due to a process known as cross-reactivity. The foods involved are certain fresh fruits, certain vegetables and certain nuts. Banana can be one of those foods.

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

With both of these two conditions, severe symptoms are unlikely because the proteins causing the allergy are unstable and become destroyed when the food (in this case, banana) reaches the stomach. Symptoms are therefore confined to the lips, mouth, tongue, throat or gullet. In most cases, people with either of those types of oral allergy are advised that they do not need to carry adrenaline auto-injectors.

Severe symptoms

Banana allergy is also known to occur in people who are neither sensitized to pollen nor to natural rubber latex. Although this primary form of banana allergy is rare, especially in children, those affected are at much greater risk. The symptoms may affect not only the mouth and skin, but there may also be breathing difficulty and/or drop in blood pressure which may lead to loss of consciousness. These are the symptoms of anaphylaxis, a severe life-threatening allergic reaction. People who are at risk of anaphylaxis are likely to be prescribed one or more adrenaline auto-injector devices, which must always be available and should be used as soon as a serious reaction is suspected.

Therefore we strongly advise that anyone who suspects that they or their child has banana allergy should see their GP and request referral to an NHS allergy clinic.

Diagnosis

Specialised allergy tests have recently become available that are more accurate than the earlier tests. They can often tell the specialist not only whether an allergy is likely to be present but can also identify the culprit protein, and even indicate which protein family it belongs to. Such tests can help the specialist to determine the likelihood of a severe reaction and whether a prescription for an adrenaline auto-injector is advisable.

Managing banana allergy

In all cases of banana allergy, avoiding bananas makes good sense, but it is especially important in the severe form of banana allergy that we have described above.

Be careful of fruit salads and fruit drinks and anywhere else where banana might be an unexpected ingredient. If you are prescribed a medicine by your doctor, check that banana flavouring hasn’t been added. One medical journal reports on an eight-year-old girl who suffered an allergic reaction within one hour of taking an oral dose of penicillin containing banana essence as a flavouring additive. Be careful, too, of care products such as shampoos and body lotions. Always read the ingredient lists.

In milder cases (where banana allergy is related to pollen food syndrome or latex food syndrome) avoiding bananas is still advisable. It is important to know if your allergy is in this category. If a reaction does occur, stop eating the food and wash your mouth out with water. Although a severe reaction is unlikely, you may wish to take an antihistamine tablet. This may help, but symptoms usually disappear quickly on their own (usually in less than two hours) so antihistamine tablets are likely to have little impact.

Our expert medical reviewer tells us that some people with a fruit allergy secondary to pollen food syndrome or latex food syndrome can tolerate their culprit fruits once cooked, because the protein that causes the reaction is likely to be de-activated by heat.

What else could I react to?

If you are allergic to bananas, you may also react to avocado, kiwi or chestnut. People with a banana allergy sometimes also experience oral reactions to fruits such as peach, olive and tomato, and raw vegetables such as bell pepper and carrot. As plantain is from the same botanical family, it is possible those with a banana allergy may react to plantain.

Two key messages

If you know or suspect you have banana allergy, getting expert medical advice is vital. See your GP in the first instance.
If your allergy is diagnosed as being potentially severe and you are prescribed an adrenaline auto-injector, make sure this is readily available at all times.

Further information

More information can be found on “Our Factsheets” webpage. If your banana allergy is diagnosed as being potentially severe, you may wish to read our factsheets on Anaphylaxis and Adrenaline in the Anaphylaxis: General advice and information section.

See the factsheet on pollen-food syndrome in the Food allergens factsheets section.

See the Latex allergy – the facts Factsheet in the Non-food allergens factsheets section.

Reviewer — This article has been peer-reviewed by Dr Michael Radcliffe, Consultant in Allergy Medicine, University College London Hospitals NHS Foundation Trust. We are not aware of any conflicts of interest with regard to his review of this article.

All the information we produce is evidence based or follows expert opinion and is checked by our expert Clinical and research reviewers. If you wish to know the sources we used in producing any of our information products, please let us know, and we will gladly supply details.