Understanding Wheat Allergy vs Celiac Disease

Wheat is the most common of the grain allergies (oats, barley, corn, etc) and affects about 0.4% of children. That is high enough to make it a top 8 food allergy. Wheat allergy is almost always an immune reaction to the gluten protein in wheat. 

Wheat allergy, like cow’s milk allergy, can involve IgE antibodies and/or other immune cells. Celiac disease, on the other hand, is a non-IgE immune reaction that leads to severe inflammation of the small intestine. 

Most people with celiac will react to wheat, barley, and rye. An IgE allergy to wheat is just to wheat, though people can also have IgE allergies to other grains. 

Non-IgE allergy to wheat can also cause allergic eczema, EoE, FPIES, or other conditions just like milk allergy can. 

What Does Wheat Allergy Look Like

If a wheat allergy involves IgE antibodies, the reaction will begin within minutes of exposure, usually within 2 hours. The symptoms will look like a typical food allergy reaction with hives and vomiting / diarrhea in babies, and wheezing, runny nose and coughs in older children. 

Breathing in wheat flour can cause breathing reactions, and skin contact will usually cause redness and hives. 

If a wheat allergy involves other antibodies, parents are more likely to see persistent eczema, belly pain, and weight loss. Non-IgE reactions often happen hours later, and the symptoms may last for multiple days.

Wheat allergy is a major cause of eosinophilic esophagitis (EoE), an inflammation of the esophagus. EoE usually looks like reflux that doesn’t get better with reflux medicines. Children with EoE have a lot of stomach pain, nausea, vomiting, diarrhea, and weight loss.

Non-IgE allergies to wheat can also cause food protein-induced enterocolitis syndrome (FPIES). If your baby is vomiting a lot or has daily runny poops, they should be evaluated for FPIES. Bloody or mucousy poops need immediate attention and may be food protein-induced proctocolitis. 

What Does Celiac Disease Look Like

People with celiac disease may have symptoms for days after eating wheat. Many get really foul-smelling diarrhea, intense stomach pain, and experience weight loss because their small intestines are too inflamed to absorb nutrients. Other common symptoms are chronic eczema headaches, and learning disorders or delays.

Unfortunately, celiac disease is more common in people with family history, Type 1 diabetes, down syndrome, and juvenile arthritis. The only treatment for celiac disease is a strict gluten-free diet. 

Testing for Wheat Allergy

In babies who are showing symptoms of a wheat allergy, blood, or specific IgE testing for wheat can help identify if the allergy is real and if it is IgE-mediated. Many doctors will also test for other grain allergies at the same time. 

Wheat allergy testing is less reliable than other foods because wheat proteins are similar to grass pollens. The only true test is an oral food challenge. 

Outgrowing a Wheat Allergy 

Many children will outgrow a wheat allergy naturally, but celiac disease is usually for life. As with all allergies, kids with fewer IgE antibodies and fewer other allergic diseases are more likely to outgrow wheat allergy.

Preventing a Wheat Allergy 

The EAT study, done in the UK, recently showed that most wheat allergy was preventable if kids ate wheat regularly. The babies in the study all used wheat baby cereals.

Learn more about preventing all food allergies with our guide to food allergy prevention