Wheat allergy is an immune reaction to proteins in wheat. It is a food allergy and is different from coeliac disease and non-coeliac gluten sensitivity. A wheat allergy can cause rapid allergic symptoms and, in some people, anaphylaxis.
Wheat contains several proteins that can trigger allergy. Some reactions happen after eating wheat. Others can happen after inhaling wheat flour, especially in occupational settings such as baking. A separate pattern, wheat-dependent exercise-induced anaphylaxis, occurs when wheat exposure is followed by exercise or another co-factor.
Symptoms
Immediate reactions can include hives, itching, swelling of the lips or face, vomiting, abdominal pain, diarrhoea, runny nose, wheeze, cough, throat tightness, dizziness or collapse.
Delayed reactions can occur in some people, especially children, and may involve eczema or digestive symptoms. Severe symptoms such as breathing difficulty, throat swelling, faintness or collapse should be treated as possible anaphylaxis.
Difference from Coeliac Disease and Gluten Sensitivity
Coeliac disease is an autoimmune condition triggered by gluten. Non-coeliac gluten sensitivity is a diagnosis considered after coeliac disease and wheat allergy have been excluded. Wheat allergy is an allergy to wheat proteins and is diagnosed and managed differently.
This distinction matters for labels and diets. Gluten-free is not always the same as wheat-free, so people with wheat allergy still need to check allergen labelling carefully.
Diagnosis
Diagnosis is based on the reaction history and may include skin prick testing, blood tests for wheat-specific IgE and, where safe and appropriate, a supervised food challenge. Testing should be interpreted by a clinician because positive tests can show sensitisation without proving that wheat causes symptoms.
People should not remove major foods from a child's diet long term without advice, because unnecessary restriction can affect nutrition and make diagnosis harder.
Management
Management usually means avoiding wheat and having a written allergy plan. People need to check ingredients, catering information and cross-contamination risk. In the UK, wheat is one of the allergens that must be declared when used as an ingredient.
Mild reactions may be treated with antihistamines if that is in the person's care plan. People at risk of anaphylaxis may be prescribed adrenaline auto-injectors and should know when and how to use them.
Anaphylaxis
Anaphylaxis can develop quickly. Signs include airway swelling, breathing difficulty, wheeze, collapse, severe dizziness, confusion or symptoms affecting more than one body system.
If anaphylaxis is suspected, adrenaline should be used promptly if available and emergency help should be called. The person should usually lie down with legs raised unless breathing makes that difficult.
See Also
References
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