Is Coeliac Disease and Wheat Allergy the same thing?
The importance of identifying gluten-related disorders
It can be quite fashionable to follow a gluten-free (GF) diet these days to either lose weight or in the quest for healthier eating. There are individuals who avoid gluten altogether because they suffer severe consequences from ingesting it. Quite often, it is hard to tell the difference between the symptoms of coeliac disease (CD) and those of wheat allergy. It is primordial to correctly diagnose and treat these conditions to avoid long-term serious consequences.
Individuals affected by CD suffer from a lifelong auto-immune disorder triggered by the ingestion of gluten. Although there is a clear genetic predisposition to develop CD, several environmental factors have been associated to it and one of the most important is a high gluten load.
The name gluten does not refer to a specific substance, but it is the collective name for a group of proteins present in these cereals: wheat (including spelt and Khorasan/KAMUT®), barley, rye and triticale (a hybrid between wheat and rye). Oat contains a protein called avenin, which is related to the gluten contained in the above cereals but it is better tolerated. However, because oat is often contaminated with the aforementioned cereals, it is advisable for people suffering from CD to consume only certified GF oat. A minority of people with CD (around 1%) still reacts to avenin so they must also avoid GF oat.
It is very important to understand that CD is not an allergy to gluten but an auto-immune reaction, meaning that your body produces antibodies against itself, not against gluten! There is no cure yet for CD and the only treatment is a strict adherence to a GF diet. The most common symptoms of CD are: abdominal pain, diarrhoea, weight loss and fatigue. If not properly diagnosed and addressed with a GF diet, CD can cause severe consequences such as failure to thrive in children, osteoporosis, fertility problems and even neurological and psychiatric disorders. All these problems are caused by both gluten itself that acts as a sort of “toxin” on the intestine of people with CD and the exaggerated response of the immune system.
Non-coeliac sensitivity is still quite a controversial diagnosis as there is no standard test that can diagnose this condition. Affected people experience similar but far less intense CD symptoms after ingestion of gluten or sometimes just after eating wheat leading to some suggestions to name it wheat intolerance syndrome). We do not really know the reason for this particular sensitivity but several mechanisms could trigger it such as intestinal disturbances (i.e. dysbiosis, infections, slow digestion, presence of yeast etc.) or even stressful events. Non-coeliac sensitivity does not cause damage to the intestine unlike CD and can improve over time. Individuals with this condition are able to tolerate small amount of gluten and do not usually require a strict adherence to a GF diet.
Wheat allergy is a proper food allergy, meaning that people affected experience severe symptoms after the ingestion or inhalation of small amount of wheat. Like other food allergies, the adverse reaction is almost immediate and can be life-threatening (anaphylaxis). The hypersensitivity reaction (allergy) to wheat occurs not just against the group of proteins that we call gluten (like gliadins and glutenins) but also to others that are present in wheat such as alpha-amylase/trypsin inhibitor, non-specific lipid transfer protein (nsLTP). It is, therefore, essential to know the difference between CD and wheat allergy as the causes and the actions needed are really different. If you have been diagnosed with wheat allergy you need to completely avoid this allergen, which means that you may not be completely safe if you choose GF products as they can still contain proteins different from gluten that can trigger an allergic reaction. The good news is that if you have wheat allergy you do not need to avoid all cereals but just wheat!
If you are suffering from any of the aforementioned symptoms, you should get a proper medical diagnosis to confirm if you are suffering from CD or just wheat allergy or a simple sensitivity. Do not exclude any foods from your diet just because you “perceive” them as the cause of your symptoms. Remember to read food labels carefully if you suffer from any food allergy or intolerance/sensitivity. IVIS Group’s rimaRetail© service offers retailers the opportunity to highlight allergens and other food sensitivities as part of the regular shopping journey.
State of the Art Review: Celiac disease and non-celiac gluten sensitivity (nih.gov)
Do oats contain gluten? | University of Chicago Celiac Disease Center (cureceliacdisease.org)
Properties of Gluten Intolerance: Gluten Structure, Evolution, Pathogenicity and Detoxification Capabilities (nih.gov)
Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity (nih.gov)
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About the author
Elena Panzeri has a MSc in Nutrition and Genetics from Twickenham University (UK) and a BSc in Nutritional Therapy from the University of Westminster (UK). In addition, she also obtained a diploma in Naturopathy in Italy and has been working in the field of natural medicine and nutrition for more than 20 years.
Her main areas of expertise are the application of Functional Medicine testing, Nutrigenetics, Nutrigenomics and Microbiome analysis. Her passion is the implementation and translation of all omics technologies into clinical practise to offer cutting-edge testing to patients alongside the most traditional methods of healing.
Elena is a senior member of IVIS Group’s Nutrition Experts