Many people experience digestive and health problems caused by eating gluten or wheat. If you or your child is experiencing an intolerance to gluten or wheat, there are three different medical conditions that could explain what’s going on: celiac disease, wheat allergy, or non-celiac gluten sensitivity (NCGS).
Gluten is a protein in wheat, barley, and rye. Wheat is a grain used as an ingredient in breads, pastas, and cereal. Wheat often appears in foods like soups and salad dressings as well. Barley is commonly found in beer and in foods containing malt. Rye is most often found in rye bread, rye beer, and some cereals.
Keep reading to learn the common symptoms and causes of celiac disease, wheat allergy, or NCGS so that you can begin to understand which of these conditions you might have.
Wheat is one of the top eight food allergens in the United States. A wheat allergy is an immune response to any of the proteins present in wheat, including but not limited to gluten. It’s most common in children. Around 65 percent of children with a wheat allergy outgrow it by the age of 12.
Symptoms of wheat allergy include:
- nausea and vomiting
- irritation of your mouth and throat
- hives and rash
- nasal congestion
- eye irritation
- difficulty breathing
Symptoms related to a wheat allergy will usually begin within minutes of consuming the wheat. However, they can begin up to two hours after.
The symptoms of a wheat allergy can range from mild to life-threatening. Severe difficulty breathing, known as anaphylaxis, can sometimes occur. Your doctor will likely prescribe an epinephrine auto-injector (such as an EpiPen) if you’re diagnosed with a wheat allergy. You can use this to prevent anaphylaxis if you accidentally eat wheat.
Someone who is allergic to wheat may or may not be allergic to other grains such as barley or rye.
Symptoms of celiac disease
Celiac disease is an autoimmune disorder in which your immune system responds abnormally to gluten. Gluten is present in wheat, barley, and rye. If you have celiac disease, eating gluten will cause your immune system to destroy your villi. These are the fingerlike parts of your small intestine that are responsible for absorbing nutrients.
Without healthy villi, you won’t be able to get the nutrition that you need. This can lead to malnutrition. Celiac disease can have serious health consequences, including permanent intestinal damage.
Adults and children often experience different symptoms due to celiac disease. Children will most commonly have digestive symptoms. These can include:
- abdominal bloating and gas
- chronic diarrhea
- pale, foul-smelling stool
- stomach pain
- nausea and vomiting
The failure to absorb nutrients during critical years of growth and development can lead to other health problems. These can include:
- failure to thrive in infants
- delayed puberty in adolescents
- short stature
- irritability in mood
- weight loss
- dental enamel defects
Adults may also have digestive symptoms if they have celiac disease. However, adults are more likely to experience symptoms such as:
- depression and anxiety
- joint pain
- canker sores inside the mouth
- infertility or frequent miscarriages
- missed menstrual periods
- tingling in the hands and feet
Recognizing celiac disease in adults can be difficult because its symptoms are often broad. They overlap with many other chronic conditions.
Symptoms of non-celiac gluten sensitivity
There is increasing evidence for a gluten-related condition that causes symptoms in people who don’t have celiac disease and are not allergic to wheat. Researchers are still trying to discover the exact biological cause of this condition, known as NCGS.
There’s no test that can diagnose you with NCGS. It’s diagnosed in people who experience symptoms after eating gluten but test negative for wheat allergy and celiac disease. As more and more people go to their doctor reporting unpleasant symptoms after eating gluten, researchers are trying to characterize these conditions so that NCGS can be better understood.
The most common symptoms of NCGS are:
- mental fatigue, also known as “brain fog”
- gas, bloating, and abdominal pain
Because no laboratory test exists for NCGS, your doctor will want to establish a clear connection between your symptoms and your consumption of gluten to diagnose you with NCGS. They may ask you to keep a food and symptom journal to determine that gluten is the cause of your problems. After this cause is established and your tests come back normal for wheat allergy and celiac disease, your doctor may advise you to begin a gluten-free diet. There is a correlation between autoimmune disorders and gluten sensitivity.
When to see a doctor
If you think you might suffer from a gluten- or wheat-related condition, then it’s important that you talk to your doctor before diagnosing yourself or beginning any treatment on your own. An allergist or gastroenterologist can run tests and discuss your history with you to help reach a diagnosis.
It’s especially important to see a doctor in order to rule out celiac disease. Celiac disease can lead to severe health complications, especially in children.
Because there’s a genetic component to celiac disease, it can run in families. This means that it’s important for you to confirm if you have celiac disease so you can advise your loved ones to get tested as well. More than 83 percent of Americans who have celiac disease are undiagnosed and unaware they have the condition, according to the advocacy group Beyond Celiac.
To diagnose celiac disease or wheat allergy, your doctor will need to conduct a blood or skin prick test. These tests are dependent on the presence of gluten or wheat in your body in order to work. This means that it’s important not to begin a gluten-free or wheat-free diet on your own before seeing a doctor. The tests may come back incorrect with a false negative, and you won’t have a proper understanding of what’s causing your symptoms. Remember, NCGS has no formal diagnosis.
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The treatment for celiac disease is adhering to a strict gluten-free diet. The treatment for a wheat allergy is to adhere to a strict wheat-free diet. If you have NCGS, the extent to which you need to eliminate gluten from your lifestyle depends on the severity of your symptoms and your own tolerance level.
Many gluten-free and wheat-free alternatives to common foods are available such as bread, pasta, cereals, and baked goods. Be aware that wheat and gluten can be found in some surprising places. You might even spot them in ice cream, syrup, vitamins, and food supplements. Be sure to read the ingredient labels of the foods and beverages you consume to make sure they don’t contain wheat or gluten.
Your allergist, gastroenterologist, or primary care doctor can advise you on which grains and products are safe for you to eat.
Wheat allergy, celiac disease, and NCGS have many similarities in their causes and symptoms. Understanding which condition you may have is important so that you can avoid the proper foods and follow appropriate treatment recommendations. You’ll also be able to advise your loved ones about whether they may be at risk for the same condition