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 may be less severe and are 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 caused by eating gluten – a protein found in the cereals wheat, barley and rye. It is not an allergy. In people with coeliac disease, the immune system mistakenly identifies gluten as a threat. This triggers the immune system to attack and damage the lining of the small intestine.
A person who has coeliac disease may experience symptoms including abdominal pain, bloating, indigestion, diarrhoea or constipation, among others. The only known treatment for coeliac disease is a lifelong gluten-free diet.
Wheat allergy is an allergic reaction to wheat proteins. Symptoms often come on quickly and can be mild or severe, affecting the skin, gut or in more severe cases – the airways. Most people with an immediate wheat allergy react when they eat wheat-containing foods, but a small number may also react after touching wheat or inhaling it, for example when flour is dispersed into the air during baking.
Gluten sensitivity, also known as non-coeliac gluten sensitivity (NCGS), is a condition in which people experience symptoms after eating foods containing gluten, despite not having coeliac disease or a wheat allergy. Symptoms are often similar to coeliac disease and can include bloating, abdominal pain, diarrhoea, constipation, headaches, fatigue and "brain fog". Unlike coeliac disease, gluten sensitivity does not appear to cause damage to the lining of the gut, and there is currently no specific test to diagnose it. If you think gluten is triggering your symptoms, it is important to be tested for coeliac disease first, as starting a gluten-free diet before testing can affect the accuracy of the results. Researchers are still working to understand exactly what causes gluten sensitivity and whether gluten itself, or other components of wheat, are responsible for symptoms.
Irritable bowel syndrome (IBS) is a common condition that affects the digestive system and leads to 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, with garlic, onions, certain fruits and vegetables and dairy foods.
As the symptoms of IBS are often similar to coeliac disease, your GP should test you for coeliac disease, before diagnosing you with IBS.
Coeliac disease, gluten intolerance/ sensitivity and wheat allergy can have similar symptoms, so ensuring that you receive an accurate diagnosis is very important. It’s essential that you discuss your symptoms with your GP before attempting to make any dietary changes.
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 testing, otherwise the results may not be accurate. Wheat allergy can be diagnosed through a skin-prick test or a blood test that looks for antibodies with wheat.
If the results of these tests are negative, but you feel your symptoms are related to eat gluten-containing foods, it may be that you are suffering from gluten intolerance/ sensitivity, or that you have IBS symptoms that are worsened by eating wheat-containing foods. To ensure that your diet is still providing all of the nutrients that your body needs to stay healthy, it’s important to seek advice from a registered dietitian or nutritionist before attempting to remove foods from your diet.
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