Mouth Bleeding After Eating Kiwi
Stop eating kiwi immediately and avoid it completely—you are experiencing an allergic reaction to kiwi fruit, which is a significant food allergen capable of causing symptoms ranging from oral irritation to severe systemic reactions. 1
Understanding Your Reaction
Kiwi allergy commonly causes oral symptoms including mouth irritation, tingling, and bleeding of the oral mucosa, a presentation known as oral allergy syndrome (OAS). 2
Actinidin, a proteolytic enzyme, is the major allergen in kiwi fruit (identified as Act c 1), and this thiol-protease can directly damage oral tissues in sensitized individuals. 3
The bleeding you experience is likely due to IgE-mediated inflammation and direct enzymatic irritation of your oral mucosa from the kiwi proteins, particularly actinidin and Act d 11. 4, 3
Immediate Management
Rinse your mouth thoroughly with a bland oral rinse composed of 0.5% sodium bicarbonate and 0.9% saline solution (1 teaspoon salt, 1 teaspoon baking soda in 4 cups of water) to cleanse the area and raise oral pH. 5
Apply gentle manual compression with clean gauze if bleeding persists for more than 2 minutes. 5
Monitor for progression of symptoms including lip swelling, tongue swelling, throat tightness, difficulty breathing, wheeze, rash, or gastrointestinal symptoms, as kiwi can cause severe reactions including anaphylaxis. 1
When to Seek Emergency Care
Seek immediate emergency medical attention if you develop any of the following: difficulty breathing, wheezing, throat tightness, tongue or lip swelling, widespread rash, dizziness, or collapse. 1
Young children and first-time reactors are at higher risk for severe systemic reactions, though adults can also experience anaphylaxis. 1
Diagnostic Evaluation
Consult an allergist for formal evaluation with prick-to-prick skin testing using fresh kiwi pulp, which has 93% sensitivity for confirmed kiwi allergy. 1
Specific IgE testing (CAP sIgE) can be performed but has lower sensitivity (54%) compared to fresh fruit skin testing, though it provides better specificity. 1
Double-blind placebo-controlled food challenge (DBPCFC) is the gold standard for diagnosis but should only be performed in a supervised medical setting due to risk of severe reactions. 1
Cross-Reactivity Considerations
Kiwi allergy frequently cross-reacts with birch pollen allergens (Bet v 1), particularly through Act d 11, which shows IgE co-recognition with PR-10 family allergens. 4
Latex-fruit syndrome is common—if you have latex allergy, you are at increased risk for kiwi allergy and should be evaluated for both. 2
Other fruits may trigger similar reactions due to cross-reactive proteins, including banana, avocado, and other tropical fruits. 2
Long-Term Management
Complete avoidance of kiwi fruit in all forms (fresh, dried, juices, smoothies, desserts) is the only effective treatment for kiwi allergy. 1, 2
Carry an epinephrine auto-injector if you have a history of severe reactions or if your allergist determines you are at risk for anaphylaxis based on testing and clinical history. 1
Read food labels carefully as kiwi may be present in fruit salads, smoothies, baked goods, and other processed foods. 2
Common Pitfalls to Avoid
Do not assume mild oral symptoms will remain mild—18% of kiwi-allergic patients report severe symptoms including wheeze, cyanosis, or collapse. 1
Do not continue eating kiwi thinking you will "build tolerance"—repeated exposure in allergic individuals can lead to more severe reactions. 1
Do not rely solely on commercial skin test extracts, as they have significantly lower sensitivity (75%) compared to fresh fruit testing (93%). 1