Allergy Facts, Symptoms, and Treatment

A starchy cereal grain, rice is a staple food for roughly half of the world's population.1 With more than 8,000 varieties, rice is commonly characterized according to its grain length, with short, medium, and long categories.2 However, rice can be further broken down according to processing types. Brown rice, which has been treated to remove only the husks, contains small amounts of fats and roughly 8 percent protein along with calcium, iron, riboflavin, niacin, and thiamine. Meanwhile, rice milled to remove both the husk and the bran, better known as white rice, has a greatly diminished nutrient value.1 

Typically eaten boiled, steamed, or fried, rice is also ground into flour. And in its various forms, rice is used in a host of foods such as soups, pilafs, pastries, cereals, and alcoholic beverages.1,3 Rice allergy is common in East Asian countries, but its prevalence is much lower in the United States and Europe. In addition, rice related allergic urticaria (aka hives) has been reported in relation to touching rice, and rice allergic individuals can be affected by both cooked and uncooked versions.2

Where is rice found?

Supplying as much as 50 percent of daily calories for half of the world's population, rice is cooked and eaten independently and is ground into flour.1,2,3 In its various forms, it's found in myriad foods such as soups, side dishes, breakfast cereals, noodles, alcoholic beverages, salads, risottos, pilafs, paellas, pastries, cakes, and biscuits. Rice and rice flakes are also eaten as desserts, and rice milling byproducts, such as bran and rice polish, are harvested for use in items such as oil.1,3 Note, however, that individuals with a wheat allergy or celiac disease can usually consume rice and rice flour without issues.3

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Are there other allergens I could be sensitized to?*

Some people with rice allergy may also experience symptoms when eating other seemingly unrelated foods. This is called cross-reactivity and occurs when your body's immune system identifies the proteins, or components, in different substances as being structurally similar or biologically related, thus triggering a response. The most common cross-reactivities with rice include: other cereals, wheat, maize, peaches, citrus fruits, grapes, tomatoes, asparagus, lettuce, hazelnuts, walnuts, peanuts, onions, carrots, and spelt.7

*These products may not be approved for clinical use in your country. Please work with your healthcare provider to understand availability.

How do I manage my allergy?

Because there is no cure for food allergies, your healthcare provider may recommend a plan that includes the following.8-11

  • Read ingredient labels and "may contain" advisory panels on food and nonfood products carefully, and avoid all foods and products containing any form of the allergen. Note that these lists and panels may not appear on the same side of a product's packaging and that manufacturers frequently change ingredients. If you're unable to obtain a list of ingredients, it's safest to avoid that item.
  • Avoid cross-contamination when cooking by using two sets of cooking and eating utensils, with one exclusively for the allergic individual. Wash all dishes and utensils in hot soapy water between uses.
  • Craft an action plan with a list of steps for you and others to take should you accidentally ingest the allergen. Print out a copy of the plan and carry it with you.
  • Talk with restaurant chefs about your allergy and order food that's simply prepared and void of any form of the allergen. Avoid desserts, as they often contain or have come into contact with food allergens.
  • Plan ahead for traveling to ensure your food allergy will be managed and any emergency medication is always available.
  • Wear a medical ID bracelet identifying the allergen to which you're allergic.
  • Carry any recommended or emergency medication with you at all times.
  • Teach children with food allergies which foods to avoid. Work with caregivers and school staff to eliminate or reduce exposure to the allergen and to ensure they understand when and how to use medication to treat symptoms.

Your healthcare provider may direct you to take one of the following medications:

  • Epinephrine auto-injector when there are signs of an acute severe event, aka anaphylaxis (see below). Ensure your family members know how to administer it in case of an emergency.
  • Antihistamines as a supplement may be useful in relieving mild symptoms (e.g., itch); however, they do not halt the progression of an allergic reaction.
  • Bronchodilator (albuterol) as a supplemental therapy for respiratory symptoms, especially in those with a history of bronchospasm or asthma.

If you're with someone who's having an allergic reaction and shows signs of shock, act fast. Look for pale, cool, and clammy skin; a weak, rapid pulse; trouble breathing; confusion; and loss of consciousness. Do the following immediately:

  • Call local emergency services.
  • Ensure the affected individual is lying down with legs elevated.
  • Administer epinephrine immediately for any obvious signs of anaphylaxis.
  • Check the affected individual's pulse and breathing and administer CPR or other first-aid measures if necessary.

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Common Symptoms

Rice allergy can range from mild to severe and may vary over time, resulting in mild symptoms during one episode and severe symptoms in another. Although food allergy symptoms can start a few minutes to several hours after ingestion, most begin within two hours.4 Symptoms may involve the skin, gastrointestinal tract, cardiovascular system, and respiratory tract, and may include one or more of the following:4,5

  • Abdominal pain, diarrhea, nausea, vomiting, stomach cramps
  • Hives (allergic urticaria), itching, eczema
  • Wheezing, nasal congestion, shortness of breath, repetitive cough
  • Shock, circulatory collapse
  • Tight, hoarse throat, trouble swallowing
  • Pale or blue skin coloring
  • Dizziness, lightheadedness, fainting, weak pulse
  • Anaphylaxis

Since rice is a member of the grass family, the plant may cause pollen related allergic rhinitis (aka hay fever) in areas where it's grown commercially, and among allergic individuals, allergic urticaria (aka hives) has been reported after touching rice. In addition to traditional food allergy symptoms, rice allergy reactions can include the following: asthma, atopic dermatitis and exercise-induced anaphylaxis (a rare reaction that occurs when the allergen is eaten before exercise).2,6

How do I know if I'm allergic?*

Together with your symptom history, skin-prick testing or specific IgE blood testing can help determine if you are allergic to a particular allergen. If you are diagnosed with an allergy, your healthcare provider will work with you to create a management plan.

*These products may not be approved for clinical use in your country. Please work with your healthcare provider to understand availability.

Is there a risk for a severe event?

Because food allergic reactions are unpredictable and symptoms range from local to systemic, it is recommended that an epinephrine prescription be considered for any patient with an IgE-mediated food allergy.8

  1. Encyclopedia Britannica [Internet]. Chicago: Encyclopedia Britannica Inc.; 2020 May 29. Available from: https://www.britannica.com/plant/rice.
  2. Survarna BS. Rice, the allergen. Nepal J Sci Tech. 2008 9:195 199.
  3. The University of Manchester [Internet]. Manchester, UK: The University of Manchester; 2006 Oct 18. Available from: http://research.bmh.manchester.ac.uk/informall/allergenic-food/index.aspx?FoodId=47.
  4. American College of Allergy, Asthma & Immunology [Internet]. Arlington Heights, IL: American College of Allergy, Asthma & Immunology; 2014. Available from: https://acaai.org/allergies/types/food-allergy.
  5. Mayo Clinic [Internet]. Rochester, MN: Mayo Foundation for Medical Education and Research; 2019 Nov 2. Available from: https://www.mayoclinic.org/diseases-conditions/food-allergy/symptoms-causes/syc-20355095.
  6. The Anaphylaxis Campaign [Internet]. Farnborough, UK: The Anaphylaxis Campaign; 2019. Available from: https://www.anaphylaxis.org.uk/wp-content/uploads/2019/09/Exercise-Factsheet-Sept-2019.pdf.
  7. EAACI, et al. Molecular allergology user's guide. Pediatr Allergy Immunol. 2016 May;27 Suppl 23:1-250. doi: 10.1111/pai.12563. PMID: 27288833. Available from: http://www.eaaci.org/documents/Molecular_Allergology-web.pdf.
  8. Wright BL, Walkner M, Vickery BP, Gupta RS. Clinical Management of Food Allergy. Pediatr Clin North Am. 2015 Dec;62(6):1409-24. doi: 10.1016/j.pcl.2015.07.012. Epub 2015 Sep 7. PMID: 26456440; PMCID: PMC4960977
  9. American College of Allergy, Asthma & Immunology [Internet]. Arlington Heights, IL: American College of Allergy, Asthma & Immunology; 2014. Available from: https://acaai.org/allergies/types-allergies/food-allergy/food-allergy-avoidance.
  10. Harvard Health Publishing [Internet]. Boston, MA: Harvard Medical School; 2020. Available from: https://www.health.harvard.edu/healthbeat/6-tips-for-managing-food-allergies.
  11. Mayo Clinic [Internet]. Rochester, MN: Mayo Foundation for Medical Education and Research; 2019 Sep 14. Available from: https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468.