In the past few years, there has been a lot of talk about celiac disease, gluten sensitivity, and wheat allergies. What some people don’t realize is that these conditions are all different from each other. We will discuss the differences and implications between these three conditions.

Celiac disease is an autoimmune digestive disorder that occurs when a genetically susceptible person consumes gluten, which is a protein found in the grains wheat, barley, and rye. Gluten is the compound that gives elasticity to the dough and makes it chewy. When these proteins are ingested, the gluten triggers the immune system to attack the lining of the small intestine. These repeated attacks and accompanying inflammation will eventually erode the lining of the small intestine in a process called villous atrophy.

Symptoms a person with celiac may experience includes abdominal bloating, diarrhea and constipation. Along with the gastrointestinal symptoms it can also cause fatigue, iron deficiency anemia, osteoporosis, weight loss and malnutrition.

Unfortunately, the only treatment for celiac disease is strictly following a gluten-free diet.

Gluten sensitivity or Non-celiac gluten sensitivity (NCGS) is a poorly understood condition. This condition has more recently been receiving a lot of attention from patients, researchers and the media. Though it can cause similar symptoms to celiac disease, it is not an autoimmune disorders and does not have a genetic component. This means that even though a person may have the same type of symptoms, a person with NCGS will not experience damage to their small intestines like a person with celiac disease does.

Some commons symptoms of NCGS are lack of energy, gas, bloating, abdominal pain and/or cramping, diarrhea and constipation. Researchers are still unclear as to what the exact cause of NCGS is. There is no diagnostic test for NCGS like there is for celiac disease. It is more of a diagnosis of exclusion, which means a doctor would need to rule out celiac disease and a wheat allergy before reaching the diagnosis of NCGS.

Some people may say they have a gluten allergy, but celiac disease and gluten sensitivities are not true allergic reactions. Wheat allergy is an actual allergic response to wheat. Wheat allergy is caused by a reproducible immune response to a particular structural aspect of wheat. Wheat allergies are commonly caused by allergic antibodies (IgE) in the body.

Wheat has many different components, including starches, proteins and even a little bit of fat. Not everyone with a true wheat allergy reacts to the same part of the wheat. The notorious protein gluten is one potential allergen, but there are more than two dozen others.

Some of the symptoms of a wheat allergy includes:
• Hives or skin rash.
• Nausea, stomach cramps, indigestion, vomiting or diarrhea.
• Stuffy or runny nose.
• Sneezing.
• Headaches.

More seriously and less commonly, a wheat allergy could result in a condition called Anaphylaxis which is a potentially life-threatening reaction that can impair breathing and send the body into shock. All of the above symptoms tend to appear quickly after eating wheat. The reactions could start within minutes or a couple of hours after ingesting the wheat product.

To be accurately diagnosed with a wheat allergy, a person should have a skin prick test where their physician pricks the very top layer of skin with a small amount of the wheat protein. If a red bump and redness develops where the prick was performed, then there is likely some kind of wheat allergy present. Wheat allergies can also be tested with a blood test, but the skin prick method tends to be the most accurate method.

Similar to celiac and gluten sensitivity, avoidance of wheat and wheat containing products is the best way to manage symptoms. The physician can also prescribe an epinephrine pen for those who have severe allergic reactions.

If you are questioning whether you have celiac disease, a gluten sensitivity or wheat allergy, contact your doctor so you can be tested.