Wheat Allergy

What Is a Wheat Allergy?

When someone is allergic to wheat, the body's immune system, which normally fights infections, overreacts to proteins in the wheat. If the person eats something made with wheat, the body thinks these proteins are harmful invaders and responds by working very hard to fight off the invader. This causes an allergic reaction.

Wheat allergy is more common in kids than adults, and many children seem to "outgrow" their wheat allergy over time.

What Are the Signs & Symptoms of a Wheat Allergy?

When someone with a wheat allergy has something with wheat in it, the body releases chemicals like histamine . This can cause symptoms such as:

• wheezing
• trouble breathing
• coughing
• hoarseness
• throat tightness
• belly pain
• vomiting
• diarrhea
• itchy, watery, or swollen eyes
• hives
• red spots
• swelling
• a drop in blood pressure, causing lightheadedness or loss of consciousness (passing out)

Allergic reactions to wheat can differ. Sometimes the same person can react differently at different times. Some reactions can be very mild and involve only one system of the body, like hives on the skin. Other reactions can be more severe and involve more than one part of the body.

Wheat allergy can cause a severe allergic reaction called anaphylaxis. Anaphylaxis might start with some of the same symptoms as a less severe reaction, but can quickly get worse. The person may have trouble breathing or pass out. More than one part of the body might be involved. If it isn't treated, anaphylaxis can be life-threatening.

What's the Difference Between Wheat Allergy and Celiac Disease?

An allergy to wheat involves an allergic response to a protein in wheat. Gluten is not one of the wheat proteins that typically causes an allergic reaction. Gluten is involved in a condition called celiac disease.

It's easy to confuse celiac disease with wheat allergy, but they are very different. Celiac disease does not cause an allergic reaction. With celiac disease, there is a different type of immune system response in the intestines, causing a problem with the absorption of food.

While people with wheat allergy can usually eat other grains, people with celiac disease cannot eat any food containing gluten, which is also found in other grains such as barley, rye, and sometimes oats.

How Is an Allergic Reaction to Wheat Treated?

If your child has a wheat allergy (or any kind of serious food allergy), the doctor will want him or her to carry an epinephrine auto-injector in case of an emergency.

An epinephrine auto-injector is a prescription medicine that comes in a small, easy-to-carry container. It's easy to use. Your doctor will show you how. Kids who are old enough can be taught how to give themselves the injection. If they carry the epinephrine, it should be nearby, not left in a locker or in the nurse's office.

Wherever your child is, adult caregivers should always know where the epinephrine is, have easy access to it, and know how to give the shot. Staff at your child's school should know about the allergy and have an action plan in place. Your child's rescue medications (such as epinephrine) should be accessible at all times.

Every second counts in an allergic reaction. If your child starts having serious allergic symptoms, like swelling of the mouth or throat or difficulty breathing, give the epinephrine auto-injector right away. Also give it right away if the symptoms involve two different parts of the body, like hives with vomiting. Then call 911 and take your child to the emergency room. Your child needs to be under medical supervision because even if the worst seems to have passed, a second wave of serious symptoms can happen.

It's also a good idea to carry an over-the-counter (OTC) antihistamine for your child as this can help treat mild allergy symptoms. Use antihistamines   after — not as a replacement for — the epinephrine shot during life-threatening reactions.

What Else Should I Know?

If allergy testing shows that your child has a wheat allergy, the doctor will give you guidelines on keeping your child safe. Your child must completely avoid products made with wheat. Although most allergic reactions to wheat happen after eating a wheat product, sometimes people can react to raw wheat that they breathe in (such as a baker who inhales flour in the workplace).

Natural food stores and the health food section in grocery stores usually have safe alternatives, including wheat-free breads, crackers, and breakfast cereals. Also, look for substitute flours made from potato, rice, wheat, barley, oats, and corn. For information on foods to avoid, check sites such as the Food Allergy Research and Education network (FARE).

Always read food labels to see if a food contains wheat. Manufacturers of foods sold in the United States must state whether foods contain any of the top eight most common allergens, including wheat. The label should list "wheat" in the ingredient list or say "Contains wheat" after the list.

Some foods look OK from the ingredient list, but while being made they can come in contact with wheat. This is called cross-contamination. Look for advisory statements such as "May contain wheat," "Processed in a facility that also processes wheat," or "Manufactured on equipment also used for wheat." Not all companies label for cross-contamination, so if in doubt, call or email the company to be sure.

Cross-contamination can happen if wheat gets into a food product because it is made or served in a place that uses wheat in other foods. This can happen on kitchen surfaces and utensils — everything from knives and cutting boards to a toaster or grill. Fried foods often have the potential to be cross-contaminated, because they can be fried in the same oil as foods that contain wheat.

When eating away from home, make sure you have an epinephrine auto-injector with you and that it hasn't expired. Also, tell the people preparing or serving your child's food about the wheat allergy. Sometimes, you may want to bring food with you that you know is safe. Don't eat at the restaurant if the chef, manager, or owner seems uncomfortable with your request for a safe meal.

Also talk to the staff at school about cross-contamination risks for foods in the cafeteria. It may be best to pack lunches at home so you can control what's in them.

Other things to keep in mind:

• Make sure the epinephrine auto-injector is always on hand and that it is not expired.
• Don't feed your child cooked foods you didn't make yourself or anything with unknown ingredients.
• Tell everyone who handles the food — from relatives to restaurant staff — that your child has a wheat allergy.