Wheat Allergy: Symptoms, diagnosis and management?

Wheat allergy is a common allergy seen in children and figures amongst the top eight food allergies seen worldwide. Allergic reactions to wheat can be caused by eating wheat containing products, inhaling wheat flour or skin contact with wheat flour.

What are the symptoms of wheat allergy?
A child, adolescent or adult with wheat allergy usually develops symptoms within minutes to hours after consuming any wheat containing food. The symptoms of wheat allergy include itchy rash, hives, swelling of lips and tongue (angioedema). Children with wheat allergy also get gastrointestinal symptoms like vomiting, loose motions and tummy cramps. Children get nasal congestion, itchy eyes, wheezing and breathing difficulty. Some children can get a severe and life threatening reaction called as anaphylaxis.

Is wheat allergy the same as celiac disease?
Wheat allergy sometimes is confused with celiac disease or gluten sensitivity. Wheat allergy is an IgE mediated allergy which occurs when a child's body produces antibodies to proteins in wheat. Celiac disease is another type of problem where the body's immune system responds to a protein in wheat known as gluten. As celiac disease progresses over time, the lining of the small intestine gets damaged and this leads to poor absorption of nutrients. Other symptoms of celiac disease include diarrhea, poor weight, short height and anemia. People with celiac disease do not get the immediate symptoms which are seen with wheat allergy. Although in both wheat allergy and celiac disease the body reacts to proteins in wheat the body's immune response in celiac disease is quite different from wheat allergy.

How do we confirm a wheat allergy?
Allergy to wheat needs to be confirmed with a Skin Prick Test. Skin Prick is the standard test which is a quick, reliable and inexpensive method to confirm food allergy. Alternatively, we can do a blood allergy test by ImmunoCap method to confirm wheat allergy.

Does wheat allergy go away with age?
Wheat allergy can go away with age in many children by the age they reach 5-6 years of age. The chances of wheat allergy going away is approximately 60-70 percent. In the rest of the individuals wheat allergy can continue into adult life.

What food does a person with wheat allergy need to avoid?
Avoiding wheat and wheat containing foods is the obvious treatment for anyone with wheat allergy. It isn't always as easy as it sounds as wheat is a staple diet in most parts of India especially in the north. In addition wheat is found in many foods, including in some foods where it is a hidden content such as soy sauce, ice cream etc. Careful label reading is very important. It is also important to care when eating out and at school or daycare.

All families of children with wheat allergy should have a written allergy action plan and should have necessary skills/training to administer adrenaline or epinephrine which may be necessary to manage allergic reactions if you accidentally eat wheat.

If your child is having allergy symptoms to wheat containing products you need to consult a pediatric allergist for a proper diagnosis, advise on food avoidance and training on emergency use of epinephrine.

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