While people with celiac disease and wheat allergy both need to avoid wheat, there are differences between the 2 diagnoses. Both trigger an immune response, but they present in very different ways. It is estimated that around 1% of the population has celiac disease (1).
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Celiac Disease
With celiac disease, the body response to a protein called gluten that is found in wheat, barley and rye (2). Gluten can also contaminate oats, so people with celiac disease must also avoid oats that are not certified gluten-free. There does seem to be a genetic component to celiac disease. Currently, it is still recommended to expose children to gluten, even if parents do have celiac disease.
When someone with celiac disease eats gluten, their body releases antibodies that result in inflammation and can cause damage to the lining of the intestine. This damage can lead to the body not properly absorbing nutrients.
Risk Factors
There does seem to be a genetic component to celiac disease, so if you have a family member with it, you are at increased risk for developing it. Other risk factors include type 1 diabetes, down syndrome, turner syndrome, autoimmune thyroid disease, microscopic colitis, and addison’s disease (3).
Diagnosis
You have test for antibodies in the blood that show an immune reaction to gluten. It is important that you eat gluten prior to these tests. If you have been following a gluten-free diet, the test will return negative, because your body won’t have an antibodies.
You can also look for specific human leukocyte antigens that can rule out celiac disease.
If these tests show that you have celiac disease, your doctor will likely want to take a look at your intestine via an endoscopy to see if there is any damage.
Symptoms
Most symptoms include the gastrointestinal tract, such as diarrhea, constipation, abdominal pain, bloating, and weight loss. Sometimes people will also experience skin rashes or issues from nutrient deficiencies.
Dermatitis herpetiformis is an itchy, blistering skin disease that is caused by gluten intolerance. It’s most often found on the elbows, knees, torso, scalp, and buttocks. This can occur without any gastrointestinal symptoms, even if there have been changes to the intestinal lining.
Wheat Allergy
In contrast, wheat allergy tends to present similarly to a traditional IgE mediated allergy. The body responds to a protein in wheat, not to gluten itself.
Risk Factors
Risk factors include eczema and a family history of food allergies.
Diagnosis
The gold standard for a diagnosis is to eat the food and have a reaction. There are skin prick tests and blood tests that can confirm a diagnosis.
Symptoms
Although reactions can range from mild to severe, it is usually recommended for all kids with wheat allergies to have an epi-pen with them at all times. Epinephrine is used to treat anaphylaxis, a severe reaction to allergies.
This is not intended as medical advice. If you have any concerns about your child, reach out to your physician. If your child is having multiple symptoms or severe symptoms, call 911.
| Mild | Severe | |
|---|---|---|
| Skin | mild rash, some hives | widespread rash, hives all over the body |
| Face | itchy mouth, runny nose, sneezing | lip swelling, tongue swelling |
| Gastrointestinal | nausea | vomiting, diarrhea |
| Airway | none | coughing, wheezing, trouble breathing |
Krystyn Parks is a Registered Dietitian and Lactation Consultant who specializes in feeding children. She has a Master’s Degree in Nutritional Science from California State University Long Beach. She is an International Board Certified Lactation Consultant and has been registered with the Commission on Dietetic Registration since 2013.