Wheat Allergy

Wheat allergy is an allergic reaction to foods containing wheat. It’s one of the more common food allergies in children. Wheat can be found in many foods, including some you might never suspect, such as breads, cakes, breakfast cereals, pasta, crackers, beer, soy sauce and condiments, such as ketchup.

Avoiding wheat is the primary treatment for wheat allergy. Medications may be necessary to manage allergic reactions when you accidentally eat wheat.

Wheat allergy may sometimes be confused with celiac disease, but these conditions are different. A wheat allergy generates an allergy-causing antibody to proteins found in wheat. But, one particular protein in wheat — gluten — causes an abnormal immune system reaction in the small intestines of people with celiac disease.

Symptoms
If you or your child has wheat allergy, you or your child will likely experience symptoms within a few minutes to a few hours after eating something containing wheat. Wheat allergy symptoms include:

  • Swelling, itching or irritation of the mouth or throat
  • Hives, itchy rash or swelling of the skin
  • Nasal congestion
  • Itchy, watery eyes
  • Difficulty breathing
  • Cramps, nausea or vomiting
  • Diarrhea
  • Anaphylaxis

Anaphylaxis
For some people wheat allergy may cause a life-threatening reaction called anaphylaxis. In addition to other signs and symptoms of wheat allergy, anaphylaxis may cause:

  • Swelling or tightness of the throat
  • Chest pain or tightness
  • Severe difficulty breathing
  • Trouble swallowing
  • Pale, blue skin color
  • Dizziness or fainting
  • Fast heartbeat

Age of onset
A wheat allergy may not be a lifelong disorder. Whether you outgrow it may depend, in part, on when the allergy first appears.

  • Young children. Wheat allergy in children usually develops during infancy or early toddler years. Most children with wheat allergy have other food allergies. Children usually outgrow wheat allergy between ages 3 and 5.
  • Adolescents and adults. Wheat allergy isn’t as common in adolescents and adults.

Tests
Your doctor will likely use a combination of tests, including a physical exam, to make a diagnosis. Tests or diagnostic tools may include:

  • Skin test. In this test, tiny drops of purified allergen extracts — including extracts for wheat proteins — are pricked onto your skin’s surface. This is usually carried out on the forearm, but it may be done on the upper back. The drops are left on your skin for 15 minutes before your doctor or nurse observes your skin for signs of allergic reactions. If you’re allergic to wheat, you’ll develop a red, itchy bump where the wheat protein extract was pricked onto your skin. The most common side effect of these skin tests is itching and redness.
  • Blood test. In some cases a skin test can’t be performed because of the presence of a skin condition or because of interactions with certain medications. As an alternative, your doctor may order a blood test that screens for specific allergy-causing antibodies to various common allergens, including wheat proteins.
  • Food diary. A detailed record of what and when you eat, as well as when you experience symptoms, may help your doctor identify the cause of a food allergy.
  • Elimination diet. Your doctor may recommend a diet with certain foods removed, particularly those foods that are common allergens. Under your doctor’s direction, you will gradually add foods back into your diet and note when symptoms return.
  • Food challenge testing. With this test, you eat capsules containing the food suspected of being the allergy-causing agent. Under careful supervision for a few hours or days, usually at a hospital, you begin with a small amount of the food and gradually increase the amount you consume. During the test, you’re monitored for any allergy symptoms.

Treatments and drugs
The best treatment for wheat allergy is to avoid exposure to wheat proteins. Because wheat proteins appear in so many prepared foods, you’ll need to read product labels carefully.

Drugs

  • Antihistamines may reduce signs and symptoms of wheat allergies. These drugs can be taken after exposure to wheat to control your reaction and help relieve discomfort. Ask your doctor if a prescription or over-the-counter allergy drug is appropriate for you.
  • Epinephrine is an emergency treatment for anaphylaxis. If you’re at risk of having a severe reaction to wheat, you may need to carry two injectable doses of epinephrine (such as EpiPen, EpiPen Jr.) with you at all times. A second pen is recommended for people with high risk for life-threatening anaphylaxis in case anaphylactic symptoms return before emergency care is available.

Emergency care
Emergency medical care is essential for anyone who experiences an anaphylactic reaction to wheat, even after receiving an injection of epinephrine. It’s important to call 911 or your local emergency number as soon as possible.