Celiac Disease, Gluten Sensitivity, & Wheat Allergy
What are these conditions, what are the symptoms, and how do I get diagnosed and treated?
Celiac Disease (CD) is a genetic disorder of the immune system affecting the lining of the small intestine. When people with CD consume gluten (the protein portion of grains like wheat, barley, and rye), the body responds by attacking the villi of the small intestine. This leads to poor nutrient absorption.
While there are over 300 symptoms associated with CD, some of the more prevalent symptoms are: Gastrointestinal upset (diarrhea, constipation, bloating, gas), fatigue, headache, joint pain, depression, inability to concentrate, irritability, mouth sores, tingling or numbness in extremities, and skin rash or irritation; however, some people with CD have no symptoms at all.
Diagnosis of CD is often difficult due to the similarity between this condition and other health issues. Common misdiagnoses are: Irritable Bowel Disorder (including Crohn’s Disease and Ulcerative Colitis), chronic fatigue syndrome, fibromyalgia, and depression. According to the National Foundation for Celiac Awareness, blood tests for certain antibodies (produced in someone with CD in response to gluten) are the first step to diagnosis. With positive blood tests, an endoscopy (a test where a thin, flexible tube is inserted into the small intestine via the mouth) is typically performed so that the inside of the small intestine can be seen and a biopsy (tissue sample) may be taken.
If you have CD, the only treatment is a 100% gluten-free diet. Any amount or form of gluten can damage the small intestine.
Gluten Sensitivity (GS) is also referred to as gluten intolerance and leads to many of the same negative symptoms experienced by those with CD; however GS does not lead to damage of the small intestine. Similar diagnostic testing may be used to determine if you have CD or GS. Although these conditions are not the same, GS is serious and the only treatment to alleviate symptoms is to follow a 100% gluten-free diet.
Wheat allergy is an allergic reaction to wheat in which the body creates antibodies to combat the wheat protein. While wheat allergy does elicit an immune response in the body, it is not the same as CD and does not lead to damage of the small intestine.
Some symptoms of wheat allergy are: hives on the skin, nausea, difficulty breathing, and in severe cases, anaphylaxis. Wheat allergy is common in children and can be diagnosed by a skin prick test and/or blood tests.
Treatment of wheat allergy is avoidance of foods and products containing wheat. There are drugs available to reduce symptoms if a reaction occurs – you can read more about these on the Mayo Clinic’s wheat allergy page.