If you feel sick or uncomfortable after eating foods like bread or pasta, you're not alone. Millions of people struggle with gluten, a protein found in wheat, barley and rye. But does that mean you have a "gluten allergy"? Not exactly. The truth is that many people with these symptoms have gluten sensitivity, or they may be living with celiac disease, a condition that requires strict gluten avoidance.
The true food allergy related to gluten is a wheat allergy, according to the American College of Allergy, Asthma and Immunology (ACAAI). Unlike food sensitivities, which can cause discomfort but are not life-threatening, a wheat allergy can trigger serious allergic reactions. For this reason, it's important to understand the differences between these conditions and to consult with an allergist if you suspect you have a gluten-related issue.
What gluten sensitivity really means
If you have symptoms like abdominal pain, bloating, gas or brain fog for hours or days after eating gluten-containing foods, you may have non-celiac gluten sensitivity (NCGS). This condition, sometimes referred to as “gluten intolerance,” doesn’t involve the immune system in the same way a true food allergy does. In other words, the symptoms can be uncomfortable, but they are not life-threatening.
At-home test kits are currently marketed as being able to “diagnose” gluten sensitivity; however, they have not been tested or approved by the U.S. Food and Drug Administration (FDA), and they could cause you to remove gluten from your diet unnecessarily.
If your symptoms improve when you eliminate gluten from your diet and your allergist has already ruled out other conditions like celiac disease and wheat allergy, you may be diagnosed with gluten sensitivity.
Celiac disease is an autoimmune disorder — not an allergy
Celiac disease is often mistaken for a “gluten allergy," but it's actually an autoimmune disorder. In this condition, the immune system mistakenly attacks healthy tissue, damaging the lining of the small intestine.
Unlike food allergies, which cause quick reactions like hives or swelling, celiac disease causes symptoms such as:
Celiac disease requires strict, lifelong avoidance of gluten. It's important to be tested for celiac disease before trying a gluten-free diet. Eliminating gluten from your diet might make the results of blood tests appear in the standard range. You can discuss this with your health care provider if you are suspicious. Proper treatment is crucial, as continued gluten exposure can lead to permanent intestinal damage.
Wheat allergy explained
Wheat allergy is the only allergy linked to gluten-containing foods. It occurs when the immune system reacts to certain proteins in wheat, including gluten. Symptoms can range from mild to severe and may include:
Hives or skin rashes
Swelling of the lips, tongue or face
Nasal congestion or breathing difficulties
Nausea, vomiting or diarrhea
In severe cases, wheat allergy can cause anaphylaxis, which is life-threatening and requires immediate treatment with epinephrine. About two-thirds of children with wheat allergies outgrow them by age 12, but some may continue to have symptoms into adulthood.
Preventing severe allergic reactions
Managing a wheat allergy can be easier with the growing number of available gluten-free products. Here are important steps to help prevent severe allergic reactions:
Always carry epinephrine: If you have a severe wheat allergy, you need to have self-administered epinephrine with you, either an epinephrine auto injector or epinephrine nasal spray. These are the only self-administered treatments for anaphylaxis.
Educate others: Make sure friends and family know how to use your auto-injector in case you can’t do it yourself.
Wear a medical ID: A medical identification bracelet can inform others about your allergy in emergencies when you can’t communicate.
Communicate at school: Parents should inform teachers, principals, school nurses and school staff about their child’s wheat allergy and what to watch for.
Read labels carefully: Always check food labels for “wheat” in the ingredients or any allergen warnings.
In addition to your allergist, nutritionists can also help manage your allergy and make dietary changes.
See an allergist for a proper diagnosis
If you think you might have a wheat allergy, gluten sensitivity or celiac disease, it’s important to see an allergist. They can run tests to determine what is causing your symptoms. A proper diagnosis will help you understand your body's reaction to gluten and guide you on how to manage it. Depending on what they find out, they may refer you to other specialists for further testing.
Your allergist can develop a treatment plan that may include avoiding certain foods, carrying an epinephrine auto-injector or epinephrine nasal spray, and working with a nutritionist for dietary advice. Knowing exactly what you're dealing with is the first step toward feeling better and staying healthy.
