Dr. Mohsin Rashid
Professor – Pediatrics, Gastroenterology & Nutrition, Dalhousie University
While symptoms can overlap, celiac disease and wheat allergy are two distinct disorders. Celiac disease is an autoimmune disorder wherein ingestion of gluten (proteins found in wheat, rye, and barley) causes damage to the lining of the small intestine. Individuals may have typical symptoms, like diarrhea, or atypical ones, like fatigue, anemia, short stature, etc. The tissue transglutaminase antibody is a blood test used for screening, and diagnosis is confirmed with a small intestinal biopsy.
Wheat allergy is an Immunoglobulin E (IgE)-mediated disorder. It can affect one or more organs and causes hives, runny nose or cough, and wheezing “baker’s asthma”. It can also cause abdominal pain, vomiting, and diarrhea — symptoms that mimic celiac disease. The diagnosis is confirmed by skin prick testing and blood tests.
To summarize, the following are the major differences between celiac disease and wheat allergy:
- Celiac disease is an autoimmune disorder, wheat allergy is not autoimmune.
- Celiac disease is a permanent disorder, while wheat allergy may be temporary in
- some cases.
- In celiac disease, one has to avoid all gluten-containing grains (wheat, rye, and barley), whereas in wheat allergy only wheat needs to be avoided.
- Celiac disease causes damage to the lining of the small intestine, while wheat allergy does not.
- Celiac disease increases the risk of developing other autoimmune disorders, while wheat allergy carries no such risk.
If individuals get symptoms after consuming wheat, they should consult their family physician for assessment and to have screening done for celiac disease. A wheat-free or gluten-free diet should not be started based on symptoms alone as it makes confirmation of celiac disease difficult.
