Wheat intolerance, or celiac disease
Celiac disease is a condition in which the immune system recognizes certain proteins in wheat as harmful and attacks them. The small intestine is the first organ affected, which leads to a reduction in its ability to absorb nutrients. It is a widely underdiagnosed health condition that is estimated to affect about 1% of the population. This intolerance requires a lifelong diet that excludes wheat flour and its derivatives.
Wheat Allergy: Two Possible Forms
An allergy to wheat flour, which involves IgE antibodies (antibodies produced by the immune system during an allergic reaction), can affect anyone who consumes wheat-based products. There are two forms: a food allergy and a respiratory allergy.
The food-related form is the most common; it can appear as early as infancy during breastfeeding, which then requires the mother to eliminate wheat from her diet. The respiratory form, on the other hand, primarily affects professionals exposed to flour, such as bakers. Wheat allergy can also trigger reactions to other grains, particularly rye and barley, and to a lesser extent, oats.
Symptoms and Diagnosis
Symptoms of wheat flour allergy most often appear shortly after ingestion, including nausea and vomiting, but there are also delayed symptoms such as hives, eczema, or asthma. Diagnosis is based on observation of symptoms, skin tests, measurement of specific IgE antibodies, and—in the absence of a history of severe reactions—an oral challenge test.
Elimination Diets: How Do They Differ in the Course of the Condition?
As with celiac disease, wheat flour allergy requires a wheat-free diet—a regimen that is difficult to follow on a daily basis, since wheat and its derivatives are present in many foods.
The key difference lies in the course of the condition: unlike celiac disease, wheat flour allergy tends to improve over time thanks to the elimination diet, which in most cases allows for the gradual reintroduction of wheat.
Frequently Asked Questions
What is the difference between wheat intolerance and wheat allergy?
Wheat intolerance (celiac disease) is an immune system reaction to wheat proteins that damages the intestine, whereas a wheat allergy involves IgE antibodies and causes more immediate reactions such as nausea or hives.
How many people are affected by celiac disease?
Celiac disease is estimated to affect about 1% of the population, but it remains largely underdiagnosed.
Does wheat allergy only affect food?
No. There is a food-related form, which is the most common, and a respiratory form observed mainly in people occupationally exposed to flour, such as bakers.
Can a wheat allergy be cured?
In most cases, yes: unlike celiac disease, wheat allergy tends to improve with an elimination diet, which often allows for the reintroduction of wheat later on.
How is a wheat allergy diagnosed?
The diagnosis is based on reported symptoms, skin tests, measurement of specific IgE antibodies, and, if necessary, an oral challenge test.