Have you ever felt strange or uncomfortable after eating a food made with wheat flour, perhaps a piece of bread, a piece of cake, or a loaf of bread? Maybe you got a skin rash, a stomach ache, or even a little difficulty breathing. These things are not just something that happens to you, but it could be due to a wheat allergy . Let's talk about this in detail today, okay?
What is Wheat Allergy?
Simply put, a wheat allergy is an overreaction of our immune system to wheat in the foods we eat and drink, and sometimes even in the things we breathe. Think about it, wheat is usually harmless and nutritious for most people. But if you have a wheat allergy, your body's defense system, the immune system, treats wheat as if it were an "invader," like a bacteria or a virus. That's when these symptoms appear.
This can sometimes be life-threatening . Especially severe allergic symptoms like swelling of the throat and difficulty breathing, we call it `(Anaphylaxis)`, if something like that happens, you should immediately go to the nearest hospital or call an emergency ambulance service like 1990. It is not good to put it off.
Who does this condition affect? How common is it?
Actually, anyone can develop a wheat allergy. But if someone in your family has allergies, you are more likely to develop one . That means if your mother, father, siblings, or other family members have allergies to dust, food, or other things, you are more likely to develop an allergy to things like wheat.
In terms of how common this is, studies suggest that between 0.2% and 1.3% of the world's population has a wheat allergy. In the United States, about 0.4% of children have it. Although there are no exact statistics on how common it is in our country, this condition can be seen among us as well. It is seen a little more often, especially among young children.
How does a wheat allergy affect the body?
There are two main ways our immune system responds to a wheat allergy.
1. Immunoglobulin E (IgE)-related reaction
This is the most common reaction. When you eat or breathe in something that contains wheat, your body makes a type of antibody called `(Immunoglobulin E)` or `(IgE)`. These `(IgE)` antibodies are what start the allergic reaction.
These `(IgE)` reactions usually begin within a few minutes of consuming wheat . Sometimes they can be delayed for up to four hours. The most dangerous part of this is that it can lead to a severe, life-threatening allergic reaction called `(Anaphylaxis).`
2. Non-IgE mediated reaction
This also involves the immune system, but the `(IgE)` antibodies are not involved. This reaction occurs more slowly than the `(IgE)` reaction mentioned earlier. It may take up to 48 hours for symptoms to appear.
Examples of such reactions are `(Eosinophilic esophagitis - EoE)` (in which the tube that goes from our mouth to our stomach, the esophagus, becomes inflamed) and `(Eosinophilic gastritis - EG)` (in which the walls of the stomach become inflamed). These are slightly more complicated conditions.
What are the symptoms of wheat allergy?
Okay, now let's see what the symptoms are. These symptoms can vary from person to person , and they can also vary in severity . Some may have them only a little while others may have them all at once.
The main visible features are:
- Skin symptoms:
- Hives or urticaria (itchy rash)
- Swelling, especially of the lips, tongue, and face
- Getting a skin rash
- Digestive system symptoms:
- Stomach cramps
- Indigestion, bloating
- Nausea and vomiting
- Diarrhea
- Respiratory system symptoms:
- Stuffy nose
- Runny nose
- Sneezing
- Wheezing
- Other features:
- Headache
- Inflammation
- And, the most dangerous condition we've ever talked about is ``Anaphylaxis``
What are the severe symptoms of anaphylaxis?
This is something to be very careful about . If you have any of these symptoms, it is essential to seek medical advice immediately .
- Difficulty breathing (dyspnea)
- Difficulty swallowing (dysphagia)
- Chest tightness
- Feeling of doom or dread
- Sudden drop in blood pressure (hypotension), accompanied by a weak pulse and anxiety
- Increased heart rate
- Shock
- Feeling suddenly faint
- Dizziness , loss of consciousness (syncope)
- Swelling of the face, tongue, and throat
- Wheezing, coughing
- Severe stomach pain
- Nausea, vomiting, diarrhea
Important: These symptoms of `(Anaphylaxis)` are a condition that requires emergency medical treatment. Therefore, it is very important to be aware of this.
How long after eating wheat do symptoms appear?
It varies depending on the severity of your allergy.
Some people may experience symptoms within minutes of eating wheat . Others may not experience symptoms for up to 48 hours . So it is difficult to say exactly when symptoms will appear.
What causes wheat allergy?
The main cause of this allergy is specific proteins found in wheat. Our immune system overreacts to these proteins. There are four types of these proteins:
- Albumin
- Gliadin
- Globulin
- Gluten (yes, that's what you've heard of called gluten)
Is it possible to suddenly become allergic to wheat?
Yes, it can happen. In particular, `(IgE)`-related reactions can appear suddenly, even at a young age. On the other hand, `(Non-IgE)`-related reactions can seem to appear gradually over time, especially until a definitive diagnosis is made.
Is wheat allergy contagious?
No, not at all . A wheat allergy is not contagious. You cannot spread it to someone else just because you have it.
How do you know if you have a wheat allergy? (Diagnosis)
If you suspect you have a wheat allergy, you should see an allergist . He or she can perform various tests to confirm this.
The doctor may ask you questions like:
- Does anyone in your family have a wheat allergy or other allergies?
- Have you ever had allergies to other foods before?
- What are your symptoms?
- Do you use any over-the-counter medications for these symptoms?
- When did these symptoms start to appear?
- Do you keep a food journal?
After that, the doctor may do tests like these:
1. Skin prick test
What happens is that a very small amount of wheat protein is injected into your skin.
Typically, you clean the skin on your arm or back, apply a drop of liquid wheat protein to the skin, and gently scrape the skin with a small needle. This doesn't hurt much, it feels like a slight tickle. There's no bleeding.
If you have a wheat allergy, within about 15 minutes the area will become red and slightly swollen, like a mosquito bite. The doctor will measure the size of the swelling.
2. Blood test (Blood IgE test)
This involves taking a blood sample from you and sending it to a lab. The lab measures the amount of ``IgE'' antibodies against wheat proteins in your blood.
It may take about a week for the results to come.
3. Graded oral challenge
If the two tests mentioned above fail to reach a clear conclusion, the doctor may perform this test.
This involves starting with a very small amount of food containing wheat under the supervision of a doctor . Gradually increasing the amount, they will see how your body reacts.
But this test is only done if you have a low risk of having a severe allergic reaction. This can take about four hours.
Can wheat allergy be completely cured?
Honestly, most of the time it's not . But there's good news. About 66% of children outgrow this condition as they grow older .
The best way to manage this is to avoid eating foods that contain wheat . In countries like the United States, there is a law that states that if food packages contain wheat, it must be listed on the label. In our country, this is often the case.
But there are other things to consider:
- Non-food items: Sometimes, children's playthings like Play-Doh®, some makeup products, and even toiletries like soap and toothpaste may contain wheat. These non-food items may not be labeled as 'contains wheat' on their labels. So if you're in doubt, it's best to check the manufacturer's website or call their customer service.
- Using the same equipment: In some factories, wheat-free foods may also be made on the same machine that makes wheat-based foods. If that happens, a little bit of wheat can get into the other foods. So check the label for something like "Made on equipment shared with wheat."
If you have a wheat allergy, what foods should you avoid?
There are many foods and drinks that contain wheat or wheat protein. Here are a few examples:
- Bakery products like bread, buns, cakes, cookies, muffins
- Some breakfast cereals
- Couscous
- Some types of sausages (Hot dogs)
- Some malted drinks
- Types of pasta and noodles
- Pizza dough
- Seitan (a meat substitute made from wheat gluten)
- Wheat beer
- All types of wheat flour (All-purpose, enriched, pastry, steel ground, stone ground etc.)
Remember, this list is not complete. Always check the label before eating any food that you are unsure about.
What are the medications for wheat allergy?
If you have a mild or moderate allergy, your doctor may prescribe antihistamines or corticosteroids to help control your symptoms.
But if you have a severe wheat allergy , which means you could have a severe anaphylaxis, your doctor may tell you to always carry an epinephrine injection , such as an EpiPen®, with you. This can help control the symptoms of anaphylaxis quickly. This injection is about the size of a large marker pen. If you accidentally eat something that contains wheat, it is usually injected into the back of your thigh. It is a good idea to keep two of these injections with you at all times.
Are there any side effects of adrenaline injections?
The following things can happen when you get an adrenaline injection:
- Anxiety
- Dizziness
- Dry mouth
- Headache
- Increased sweating
- Nausea
- Racing heart rate
However, when you take this when you are having an allergic reaction, you will often start to feel relief quickly.
How soon will I feel better after taking the medicine?
- Antihistamines start working within about 30 minutes, and are most effective within the first few hours.
- Corticosteroids usually start working within about an hour.
- An adrenaline injection starts working immediately after it is injected.
Can a wheat allergy be prevented?
The best way to prevent an allergic reaction is to completely avoid eating and using things that contain wheat .
Always read the ingredients label on food packages carefully . If you are in doubt about something, it is wise to not use it until you have confirmed it with the manufacturer.
How to live with a wheat allergy?
Living with a wheat allergy can be challenging. Symptoms can come and go, sometimes they can be severe. And you can't predict how your body will react.
But, if you are careful, you can live a normal, happy life . Your doctor can tell you about helpful information, support groups, and dietitians. They can help you adjust your daily eating habits.
Children are more likely to develop wheat allergies than adults. However, about 80% of children outgrow the condition by the age of 16. That's good news, right?
When should I see a doctor?
If you experience frequent wheat allergy symptoms, or if you notice that these symptoms occur after eating something that contains wheat, see a doctor .
When should I go to an Emergency Treatment Unit (ETU) ?
If you start to experience symptoms of `(Anaphylaxis)` (the severe symptoms we discussed earlier), go to the nearest hospital emergency room immediately or call 911.
What should I ask the doctor?
When you see your doctor, you can ask questions like these:
- How exactly do you tell if I have a wheat allergy?
- Do I have a mild, moderate, or severe allergy?
- What kind of medicine do you recommend?
- What is the full list of side effects of those medications?
- Are there support groups for people with wheat allergies or for parents of children with such allergies?
- Can you recommend a good dietitian?
Are wheat allergy and gluten allergy the same thing?
No, the two are not the same. In fact, there is no such thing as ``Gluten allergy'' in medical terms.
Many people refer to a condition called celiac disease as "gluten allergy." Celiac disease is a condition in which your immune system damages your own small intestine when you eat gluten (a protein found in grains like wheat, barley, and rye).
What is the difference between a wheat allergy and gluten intolerance?
What happens with a wheat allergy is that your immune system overreacts when you eat wheat.
Gluten intolerance is a digestive problem. It occurs when your body can't properly digest gluten. This can cause symptoms like fatigue, nausea, and bloating. It's not an allergy.
What is the difference between a wheat allergy and Celiac disease?
These two are often confused with each other. But these two are different.
In a wheat allergy , the immune system responds to wheat either through ``IgE'' or ``Non-IgE'' pathways.
In celiac disease , the immune system specifically reacts to gluten . Gluten is found in wheat and other grains. In this condition, the immune system attacks the lining of your small intestine . This causes inflammation and damage to the fine, fiber-like structures (villi) in the small intestine. These villi help absorb nutrients from food. When these are damaged, no matter how much food you eat, your body doesn't get enough nutrition, and over time, conditions like malnutrition can develop.
So, you get the idea? Wheat allergy, celiac disease, and gluten intolerance are three different conditions. So it's best to seek medical advice to find out exactly what you have.
Finally, things to remember (Take-Home Message)
Okay, so we've talked a lot about wheat allergy, haven't we?
- A wheat allergy is an unwanted reaction by your immune system to wheat.
- Symptoms can range from skin rashes, stomach upset, and difficulty breathing to life-threatening anaphylaxis.
- See an allergist for an accurate diagnosis . This can be confirmed through skin tests and blood tests.
- The main management for this is to avoid things that contain wheat . Read food labels carefully. Be careful not only with food, but also with other products.
- For those with severe allergies , keeping an adrenaline injection nearby can be life-saving.
- Many children grow out of this condition as they grow older , which is also a relief.
- If you have any questions or doubts, don't be afraid to ask your doctor . They are there to help you.
Don't panic if you find out you have a wheat allergy. Yes, it can be a bit challenging, especially when it comes to choosing foods. But, with awareness and care, you can live successfully with this condition.
` Wheat Allergy, Allergy Symptoms, Anaphylaxis, IgE, Food Allergy, Gluten
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