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Wheat allergy and gluten intolerance- Are they the same thing?

The short answer is no.

When someone is allergic to wheat, they may develop symptoms of an itchy mouth immediately after eating. The itchy mouth may be followed by lip swelling, tongue swelling, and hives. This allergic reaction could also be associated with nausea and vomiting. These symptoms will occur within seconds to minutes after consuming wheat. Symptoms generally occur every time wheat is consumed. In reality, wheat allergy is relatively uncommon in adults. Children with wheat allergy usually outgrow this allergy by the age of 5 years.

Gluten intolerance manifests itself in a completely different way. Symptoms of gluten intolerance are often nonspecific. People may develop bloating and loose stools after consuming foods that contain gluten. However, symptoms may not occur immediately after eating gluten. The intolerance may be present for months or years before one realizes there is something wrong. The more specific name for gluten intolerance is Celiac disease. When people with Celiac disease consume gluten, an immune response occurs in the small intestine. This response results in the loss of absorptive capacity of the intestine. People with gluten intolerance may have weight loss and nutrition deficiencies due to the loss of intestinal absorptive capacity. A chronic itchy, bumpy rash may also occur on the extensor surface of the elbows, knees, and buttocks. The most noticeable symptoms are often flatulence and loose, fatty stools.

How are these disorders diagnosed?

Wheat allergy is diagnosed by an allergist after a careful history is taken. An allergist may perform skin or blood tests to confirm a suspected diagnosis.

Gluten intolerance is best diagnosed by a gastrointestinal specialist. This specialist looks for characteristic loss of absorptive properties in the small intestine. Blood tests and genetic studies may also be performed to support the diagnosis.

What happens when the diagnosis is confirmed?

Patients with wheat allergy must avoid consumption of wheat. However, other grains are often tolerated. Patients should carry an epinephrine pen in the event that a severe allergic reaction occurs. Wheat allergy is often outgrown, so regular follow-up visits with the allergist can assess for resolution of this allergy.

Patients with gluten intolerance must avoid gluten indefinitely. These foods include wheat, rye and barley. A gluten-free diet must be strictly followed to allow the return of normal intestinal functioning. The prognosis is good as long as a life-long gluten-free diet is followed.