A true food allergy causes an immune system reaction, usually to a protein found in food, that affects numerous organs in the body. It can cause a range of symptoms, and, in some cases, an allergic food reaction can be severe or life-threatening.
In contrast, food intolerance symptoms are generally less dramatic and often limited to gut symptoms. If you have a food intolerance, you may be able to eat small amounts of the problematic foods without trouble.
Coeliac disease is an autoimmune condition related to gluten, a protein found in the cereals wheat, barley and rye. It is not an allergy. When a person has coeliac disease, the immune system mistakenly identifies substances found inside gluten as a threat to the body and attacks them. This damages the lining of the small intestine and disrupts the body’s capacity to absorb nutrients from food.
A person who has coeliac disease may experience symptoms including abdominal pain, bloating, indigestion, diarrhoea or constipation and unintentional weight loss, among others. The only known treatment for coeliac disease is a lifelong gluten-free diet.
Wheat allergy is an allergic reaction to foods containing wheat. The allergic reaction can be caused by eating wheat and also, in some cases, by inhaling wheat flour. In contrast to a grass allergy, it is not the wheat pollen that triggers the allergic reaction, but rather the proteins in the wheat.
All three conditions involve reactions to proteins in cereals, and that the treatment is to avoid eating food containing those proteins.
For people with coeliac disease this will mean adopting a strict lifelong gluten-free diet. People with non-coeliac gluten sensitivity must adopt a low gluten diet to tolerance. Anyone with a wheat allergy must strictly avoid wheat.
Most gluten free foods will be suitable for someone with a wheat allergy, but be careful for the presence of gluten free wheat starch. On the other hand, wheat-free foods could contain rye or barley, the two other cereals that contain gluten and which must be avoided by people with coeliac disease.
Coeliac disease is quite different to wheat allergy and gluten intolerance in that it is an autoimmune disorder, in which the immune system directs antibodies to attack gluten.
If you have wheat allergy, exposure to a wheat protein primes your immune system for an allergic reaction. A person can develop an allergy to any of the different types of wheat proteins.
Some people with wheat allergy develop symptoms only if they exercise within a few hours of eating wheat. Exercise-induced changes in your body either trigger an allergic reaction or worsen an immune system response to a wheat protein. This condition, called wheat-dependent exercise-induced anaphylaxis (WDEIA), usually results in life-threatening anaphylaxis.
Gluten intolerance or non-coeliac gluten sensitivity are terms used to describe the condition of people who cannot tolerate gluten in their food and experience symptoms similar to those who have coeliac disease – but without the same kind of intestinal damage as occurs in coeliac disease.
Some people may be surprised when they are not diagnosed as having coeliac disease, given that they appear to have the symptoms associated with that condition, prompted by eating gluten. However, whilst somebody with coeliac disease must strictly follow a gluten-free diet, those with non-coeliac sensitivity may simply need to reduce their gluten intake to a level they can tolerate with no symptoms.
Irritable bowel syndrome (IBS) is a common condition that affects the digestive system and leads the sufferer to endure a variety of symptoms such as cramps, bloating, diarrhoea and constipation.
The exact causes of IBS are not clear and there is no specific cure for the condition. But in many cases sufferers identify certain foods that trigger the problem or worsen it. Among the most common trigger foods are those containing wheat and gluten, with dairy products, onions, nuts and caffeine-containing drinks also known to cause abdominal upset in IBS patients.
If you consult with your doctor about a possible case of IBS, they should check whether you actually have coeliac disease as a first step.
Coeliac disease, gluten intolerance and wheat allergy can have very similar symptoms, although the latter tends to cause swelling, irritation and hives, as well as possible abdominal pain. Whatever you think may be causing symptoms such as chronic diarrhoea, cramping, fatigue and the others connected with these conditions, you should go to a doctor before attempting to reach your own conclusions.
In the case of suspected coeliac disease, the diagnostic process begins with a blood test. It is important that you do not remove gluten from your diet before this as the test depends on spotting antibodies resulting from the autoimmune reaction that causes coeliac disease.
If the result is negative, but you feel your symptoms are related to gluten, it may be that you are gluten intolerant and it is worth trying a gluten-free diet to see if your symptoms are alleviated.
Wheat allergy can be diagnosed through a skin-prick test or a blood test.
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