Wheat allergy is less common than egg and cow’s milk allergy and is mostly outgrown during childhood. Some adults may have a wheat allergy. This is seen more frequently in those in the baking industry. Many people who think they have a wheat allergy actually have an intolerance to wheat. Intolerances are very different to true allergies. Intolerances do not involve the immune system, usually cause digestive issues at higher doses of the food and do not cause dangerous symptoms such as anaphylaxis. Another type of reaction to wheat is coeliac disease, which is an immune issue rather than a true allergy. Coeliac disease is a condition in which gluten proteins found in wheat and some other cereals damage the small bowel lining and the gut.
Wheat consists of several proteins, of which gluten and gliadin are perhaps the more well known.
Wheat allergy is mostly associated with immediate type IgE mediated allergies. However, it can also cause a delayed-type of allergy presenting with gut symptoms or eczema several hours after ingestion.
Wheat is a universal allergen which is very difficult to avoid. The help of a dietician should be enlisted when going on a wheat free diet. Wheat is a main ingredient of many foods such as:
Breads, chapattis and naan breads, breakfast cereals, biscuits, crackers, crumpets, scones, pancakes, wafers, cakes, pizza, pasta, pastries and yorkshire puddings.
It is also found in many convenience foods such as soups, sauces, spices, malted drinks, processed meats and ready- made meals.
People with wheat allergy should make sure they eat “wheat free” foods and not just gluten-free foods as gluten is only one of the proteins in wheat. If in turn they are allergic to the gluten component of wheat, then other sources of gluten such as rye, barley and some oats need avoidance too.
Wheat is very difficult to avoid completely and most wheat allergic people will have an accidental reaction at some stage. Caregivers in schools, family members and friends should know about the allergy and what to do in an emergency. This includes an action plan and accessible emergency medications.
As wheat allergy is most commonly outgrown during childhood, the patient should be followed up every 6-12 months to check for signs of tolerance developing.