Allergic reactions, IBS, fructose malabsorption, and eating on an empty stomach are all possible causes of stomach or chest pain after eating apples.
Health benefits and risks of apples
Apples are considered very healthy, and they are indeed among the healthiest foods one can eat.
Just a few of the numerous health benefits of regular apple consumption:
However, some people do experience symptoms after eating this healthy fruit. This is because people with certain medical conditions might be sensitive to one or more compounds in the apple:
- proteins in apple might trigger allergic reactions
- some people might be sensitive to the sugar (mostly fructose) in apple
- apples are acidic (pH is around 3.3 – 3.9), which might cause symptoms, especially on an empty stomach
- apple is a high FODMAP food, which might be an issue for people with IBS
- some people cannot properly digest the sorbitol (a form of sugar) in apples and might experience gas and bloating
Let’s see the most common symptoms apples can trigger:
Stomach pain after eating apples
Eating apples on an empty stomach and irritable bowel syndrome are probably the two most common causes of stomach pain after eating apples.
Food allergy might also be a possible trigger.
Apples on an empty stomach
Eating apples on an empty stomach is fine for most people, however, those who have existing gastric problems might experience symptoms.
The culprit might be acidity, high sugar content, or allergic reactions.
If you are regularly experiencing stomach or chest pain when eating apples on an empty stomach, peeling or cooking the apples might relieve the symptoms.
Albeit the skin of the apple contains a lot of nutrients and vitamins, it might cause digestive problems for some.
IBS and apples
Even though apples improve gut health, people suffering from IBS might experience adverse effects after eating apples.
In IBS, absorption of food is compromised, and the fructose begins to add up in the colon. When the fermentation of fructose starts, it can induce symptoms like:
- osmotic diarrhea
- bloating
- flatulence, bloating, and gas
- nausea
Apples can worsen IBS symptoms, so it is advised to substitute them with low fructose content fruits, such as berries, kiwi, even oranges might be good for IBS.
Stomach pain after drinking apple juice
Apple juice contains a lot more fructose and sorbitol, and a lot less fiber than raw apples. This might cause symptoms like abdominal pain or bloating, especially when drinking too much.
Stomach pain after drinking apple juice occurs due to:
- apple allergy
- malabsorption of fructose and sorbitol
- fructose intolerance (genetic predisposition)
Some infants can not digest sorbitol and fructose. Due to indigestion they can have stomach pain, bloating, and gas. Malabsorption of sorbitol and fructose triggers stomach pain.
Chest pain after eating apples
Eating-related chest pain after apples is quite rare. However, if it occurs, the most likely causes are:
- acid reflux
- apple allergy
Apples and acid reflux
Apples are safe when taken in small amounts but large quantities can trigger digestive problems.
Acid reflux occurs when acidic stomach contents regurgitate back to the esophagus. When eating too many apples (or anything else), the pressure in the stomach increase, which makes this backflow of digestive juices more likely.
Red apples have a neutralizing effect on the stomach because of some basic salts e.g magnesium.
However, green apples – which are more acidic than red ones -, are more likely to trigger chest or stomach pain. Green apples naturally contain:
- malic acid
- ascorbic acid
- pectin
Because of the higher acid content, green apples are more likely to cause acidity.
Allergic reactions
Apple allergy is not common. Usual symptoms are:
- itching, rashes, hives
- swelling of the mouth, lips, tongue, throat
- swelling of other body parts
- stomach cramps
Chest pain is a possible, but not a typical allergy symptom. However, if it occurs with one or more of the symptoms above, apple allergy is a likely issue.
While most allergic reactions are fairly mild, some can be very serious. Breathing difficulties and anaphylaxis require immediate medical help.
Chest pain after drinking apple juice
Apple juice contains a lot more sugar and a lot less fiber than raw apples. Therefore apple juice is more likely to trigger chest pain, especially for those who are prone to one or more of the following conditions:
- Acid reflux: high-sugar foods might trigger heartburn (center chest pain) for many people.
- Esophageal spasms: drinking very cold drinks can cause painful contractions in the food pipe – called esophageal spasms – which also feel like pain around the center of the chest.
Canned apple juice often contains preservatives and some citric acid, which might also be the culprit.
Itchy mouth and sore throat after eating apples
An itchy mouth or throat pain after eating apples is commonly caused by:
- food allergy or oral allergy syndrome
- acid reflux
Itchy mouth and apple allergy
Some people are genetically predisposed to some allergens, others can develop such a condition during adulthood.
Itching of the mouth or throat usually happens after eating raw apples. Raw apples contain certain allergens which have antigenic effects and activate our immune system. As a result, the immune system gives an inflammatory response by making antigen-antibody complex.
Common symptoms of this condition are:
- bloating and stomach distress
- itching in the mouth and throat
- rashes on the face or body
- swelling of lips due to allergy
- gas
- acid reflux
Sore throat, acid reflux, and apples
Albeit uncommon, apples might trigger the backflow of stomach acids into the esophagus or up into the throat and mouth. Risk factors are:
- eating too many apples
- gas formation in the stomach
When the highly acidic stomach contents flow up to the throat, they cause irritation there. Typical symptoms are a sore throat and a sour taste in the mouth. Coughing and phlegm are also common symptoms.
Does apple juice cause gas?
Apple juice causes gas-like symptoms. It occurs due to the following reasons:
- malabsorption of fructose and sorbitol present in apple juice.
- fructose intolerance
Undigested components of apple juice – like fructose and sorbitol – are fermented by the bacteria in the gut flora.
When drinking too much apple juice, there is an overgrowth of bacteria that causes the breakdown of these undigested contents and produces gas e.g, methane and hydrogen.
Gas can cause the following symptoms:
- diarrhea
- bloating, flatulence
- abdominal cramps
- gastrointestinal upset
- nausea and vomiting
How to relieve symptoms caused by apples?
In terms of symptoms, the amount you eat and the way you eat apples can make a real difference:
- Eating too much of anything can cause digestive problems. This is true in the case of apples.
- Fresh, raw apples and apple juice are more likely to trigger symptoms. Cooked or baked apples are easier to digest, therefore less likely to cause issues.
- Avoid eating apples with sugary foods and drinks. Since apples already contain sugar, this might cause symptoms like gas or bloating.
- Sometimes eating apples on an empty stomach can trigger symptoms like stomach pain. In this case, just make sure you eat something before apples.
Another factor to consider is the underlying health issue (if any) that triggers symptoms:
- Those who are allergic to apples should consult with an allergist and might need to completely avoid eating apples.
- Probiotics can help to relieve IBS symptoms. You can take probiotics in their natural forms – like yogurt or buttermilk – or try probiotic tablets to help your digestion.
- People with fructose malabsorption should reduce their apple intake. Physical activity and dietary supplements that help to digest sugar might relieve symptoms.
Final thoughts
Apple is a healthy fruit and in unlikely to trigger any symptoms. However, people with an underlying health problem might experience issues after eating apples.
Most likely health conditions that can cause symptoms are food allergy, IBS, and fructose malabsorption.
Those who are prone to acid reflux might experience symptoms after eating too many apples.
Frequently asked question
Yes, apples might cause phlegm production.
Phlegm is secreted as a consequence of mucus hypersecretion. Apple-related allergies can be a trigger since allergic reactions induce the production of histamine which is a potent vasodilator and it increases secretion of the mucous gland and overproduction of mucous, which in turn causes phlegm production.
Another possible cause is the backflow of stomach contents into the mouth.