Wheat allergy is not the same as celiac disease. While both result in an intolerance to wheat, and both improve by removing wheat from the diet, the processes involved are very different.
With wheat allergy, as with any other food hypersensitivity, the immune system reacts to repeated ingestion of wheat protein by producing IgE antibodies -- a type of immunologic response that leads to sensitization of cells in the gut, skin, and respiratory lining. Once these cells are sensitized, all it takes is a small amount of exposure to wheat in the diet for them to release histamine and other chemicals that lead to a variety of allergy symptoms, ranging from itchy skin, hives, and lip or eyelid swelling to respiratory symptoms like wheezing or cough, to intestinal symptoms like cramping or diarrhea. Wheat-specific IgE can often be lost over time if wheat is eliminated completely from the diet for a year or more.
Celiac disease, on the other hand, is a condition where gluten (a protein found in wheat, oats, and barley) stimulates a different type of nonallergic immune reaction, leading to flattening of the fingerlike projections that normally line the intestines, and malabsorption of nutrients. This can be confirmed with a biopsy of the intestinal lining, and with blood tests for specific IgG antibodies commonly found in celiac disease. Symptoms are strictly gastrointestinal, and dramatically improve on a gluten-free diet -- but unlike wheat allergy, reintroduction of gluten in the diet is not likely to be tolerated.
Take home message: Distinguishing between wheat allergy and celiac disease is important in determining proper management and risk for future reactions.
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ReplyDeleteallergy specialist