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ACAAI > Patients & Public > Resources > Ask the Allergist

Wheat allergy or celiac disease?

Q. Is celiac disease the same as a wheat allergy?

A. Celiac disease (also called celiac sprue) is caused by an abnormal immune reaction to gluten in the small intestine. Gluten is a protein found in various grains. When individuals with celiac disease eat gluten-containing products such as barley, rye, and wheat, damage occurs in the lining of the small intestine. People typically experience symptoms such as abdominal pain, bloating, or diarrhea as a result, and may be at risk of malnutrition and complications such as osteoporosis and anemia.

Blood tests are frequently used to identify patients with high likelihood of having celiac disease. To confirm a diagnosis of celiac disease, a biopsy of the small intestine is obtained by a GI specialist.

If a patient with celiac disease eliminates gluten from the diet, the small intestine will start to heal and overall health improves. Medication is not normally required.

In contrast, a wheat allergy is an overreaction of the immune system specifically to wheat protein. When a person with wheat allergy ingests wheat protein, it can trigger an allergic reaction that may result in a range of symptoms such as skin rash, itching, swelling, trouble breathing, wheezing, and loss of consciousness. Wheat allergy can be potentially fatal. Patients with wheat allergy must strictly avoid wheat, and must have quick access to epinephrine in event of an allergic emergency.

Wheat allergy is most common in children. Many children outgrow wheat allergy in early childhood. Many patients with wheat allergy can consume other grains. However, some patients with wheat allergy are also allergic to other grains. You should discuss foods that can be safely consumed and foods to avoid with your allergist.