Gluten Allergies

A gluten allergy—not to be confused with gluten sensitivity or celiac disease—is caused by gliadin, a glycoprotein that, along with glutenin (another protein), helps to form the gluten protein. Gluten is found in wheat and other related grains such as barley, oats, and rye. Gliadin is also one of the major allergens associated with wheat allergies and a trigger for celiac disease, a serious autoimmune disorder of the small intestine.

Unlike a gluten allergy, in which small amounts of gluten may be tolerated, a patient with celiac disease cannot tolerate any gluten at all. When a person with celiac disease eats gluten, the immune system begins unnecessary inflammation, and eventually damages the lining of the small intestine. Celiac disease restricts absorption of nutrients and may lead to weight loss and malnutrition. Because celiac disease shares symptoms with a number of other disorders, including a gluten allergy, it is important that a person be tested if she suspects she has the condition.

A person with gluten sensitivity (also known as gluten intolerance) may have symptoms such as bloating, abdominal pain, or diarrhea, but, because the immune or autoimmune symptoms are not involved, it is not considered as serious a condition as celiac disease or gluten allergy. As many as 6 percent of Americans have gluten sensitivity.

Gluten allergies and celiac disease are a major public health concern. It is estimated that 0.6 percent of children and 0.9 percent of adults in the U.S. have a gluten allergy while another one percent suffer from celiac disease.

Signs and Symptoms

In Adults

Symptoms of a gluten allergy are often similar to those in celiac disease and may include abdominal pain, diarrhea, constipation, fatigue, bloating, heartburn, bloating, anxiety and anemia.

Additional symptoms of a gluten allergy may include:

  • trouble breathing
  • ulcers in the mouth
  • asthma
  • depression
  • osteoporosis
  • weight loss
  • rash
  • swelling of the lips
  • irritability
  • anaphylaxis (in extreme cases)

In Children

A gluten allergy may look very different in children as opposed to adults, therefore it is important for parents to monitor their child's behavior, as well as his or her diet, if they suspect a gluten allergy.  This allergy may go into remission only to return in later years.

In addition to the above symptoms, children with a gluten allergy may experience eczema.

Tests

Gluten allergies are notoriously difficult to ascertain. Any number of conditions may cause symptoms similar to a gluten allergy, including gluten intolerance and celiac disease.  In addition, symptoms may vary greatly within a single individual, from constipation to diarrhea.

The only way for a person to find out if she has a gluten allergy for sure is to be tested. One of the most common tests to determine whether a person has a gluten allergy is an elimination diet. In an elimination diet, a person removes gluten-containing foods, such as wheat or pasta, from his or her diet for a period of time to see if symptoms resolve.  However, an elimination diet will not rule out either celiac disease or gluten sensitivity.

Other ways to test for a gluten allergy include an IgE or cell-mediated test, which times reactions to various allergens or skin tests. A blood test, along with a stool test for gluten intolerance, is generally recommended because it is possible to have a positive food allergy reading but a negative gluten sensitivity test reading for all of the grains containing gluten and vice versa with these types of tests.

Blood Tests

A food allergy/intolerance blood test such as skin prick tests (SPT), prick-in-prick tests, and lymphocyte activation tests can positively identify whether or not a person has a gluten allergy.

Diagnosis

If a positive diagnosis for a gluten allergy is made and celiac disease is eliminated as a cause of the symptoms, a person can determine how much, if any, gluten he can tolerate in his diet. If a person has a gluten allergy, avoiding gluten may resolve symptoms, give ?him more energy, and generally improve his quality of life. 

Diet

Wheat is the predominant grain product in the US, so removing it from the diet can be very difficult for many people. Because barley, oats, and rye also contain gluten, the list of replacement grains becomes even smaller. Alternatives include amaranth, corn, quinoa, rice, and tapioca. However, as the breadth of the health concerns associated with gluten are becoming more widely known, many food processing companies and restaurants are offering an ever-larger selection of gluten-free options every day.