Wednesday, July 10, 2013

Wheat Allergy or Celiac Disease?

As different as wheat allergy and celiac disease are, people often confuse them.

Wheat allergy is an allergic reaction to foods containing wheat and is a common food allergy in children. It usually develops in infancy or toddlerhood; it is less common in adolescents and adults. As with many allergies, children may outgrow a wheat allergy as they age.

Celiac disease is an autoimmune disease, an abnormal immune response that is triggered by ingesting gluten, and affects the small intestine. Autoimmune diseases mistakenly attack the body’s normal tissues. This is a permanent condition and may present in childhood or adulthood.

A wheat allergy generates an allergy-causing antibody to a wheat protein (there are four, including gluten), which then generates a range of mild to severe symptoms during the allergic reaction. In celiac disease, the gluten protein is the culprit. Any suspicion about you or a family member having either of these conditions should prompt a medical exam and testing to accurately diagnose the problem.

It is possible for a person to have both a wheat allergy and celiac disease. 

Both share the common challenge of how to satisfactorily eliminate certain (and often similar) foods from the diet. They both also call for parents and guardians to adequately train their children to say “no” to certain foods, become comfortable asking about ingredients in what’s being served outside of the home, and read labels or learn to recognize certain words relating to deleterious ingredients.

Wheat Allergy
Since ingesting wheat protein causes the immune system to go into attack mode to try and get rid of the allergen, avoiding wheat is the primary way to avoid wheat allergy.

We can all list the obvious foods where wheat and wheat proteins are found such as baked goods, cereals, and pastas but some foods might surprise you, as wheat protein is also in many prepared foods such as soy sauce, condiments, beer, flavorings, candies, and much more. People with wheat allergies should read every label of every item they purchase in the supermarket, including cosmetics, to ensure they are not inadvertently exposed to the allergen. If in doubt, contact the food manufacturer—better safe than sorry! You can find a list of foods containing wheat here.

When switching to a wheat-free diet, try alternate grains such as amaranth, barley, corn, oat, quinoa, rice, rye, and tapioca. However, people with wheat allergy may also be allergic to barley, rye, and oat due to them containing similar proteins so ask your physician if you can eat these.

Wheat allergy symptoms usually appear within minutes to a few hours of eating something with wheat in it. They are similar to those of many other allergies: swelling, itchy mouth, eyes, or skin, trouble breathing, and intestinal distress. In severe cases there may be anaphylaxis. This is life-threatening, with its own subset of extreme symptoms: swelling of the throat and trouble swallowing, chest pain, rapid heartbeat, dizziness or fainting, change in color, and severe breathing difficulty. Many people with severe allergies carry injectable epinephrine with them to dispense in an emergency. A call to 911 is strongly advisable whenever anyone suffers an anaphylactic reaction, even after administering the injections.

Celiac disease
In celiac disease the body is highly sensitive to gluten; the condition can result in poor absorption of essential nutrients from your food because it attacks the small intestine, where absorption takes place. If left untreated it can cause serious complications including malnutrition and intestinal damage, but a completely gluten-free diet and lifestyle will lead to healing. Permanently removing gluten from the diet, which is found in wheat, rye, barley and sometimes oats, is the only treatment for celiac disease. (Gluten-free oats are available and are found in many gluten-free foods.)  

After omitting gluten, the intestinal villi will heal and absorption of nutrients will improve.

Symptoms of celiac disease are often different in children and adults. In children, parents may notice irritability along with various digestive symptoms such as:
  • Vomiting
  • Poor weight gain or slower growth
  • Abdominal bloating or pain
  • Persistent diarrhea, abnormal stools
  • Tooth discolorations/defects
  • Delayed puberty

In adults the symptoms may be related to other organ systems including:
  • Iron deficiency anemia
  • Arthritis, bone and joint pain, osteoporosis, fractures
  • Fatigue
  • Numbness and tingling in the extremities
  • Seizures
  • Canker sores
  • Irregular menstrual periods, infertility, miscarriage
  • Itchy, blistering skin rash

As with wheat allergy there are foods to avoid—many more in this case—and care should be taken to read labels and ask questions about hidden ingredients.

It’s not hard to put together a healthful, well-rounded diet. There are many gluten-free starches and grains that celiac sufferers can enjoy; fresh fish and meats (no breading or coating!), fruits and vegetables, most dairy products are good to eat, and wines and distilled spirits are allowed (no beer, which contains forbidden grains). For desserts and sweets, there are many choices today but make sure the product is clearly labeled as gluten-free. As with wheat allergy, beware of what could have surprising ingredients in them.

You can see a list of allowed and prohibited foods for those on a gluten-free diet here and the National Foundation for Celia Awareness is a wonderful resource.