How to Manage Wheat Allergy Symptoms

Symptoms of a wheat allergy can start within minutes of eating foods that contain the grain.

The allergy to wheat is among the top eight most common allergies in the US and produces the same symptoms as many other food allergies. Those symptoms include:

  • Rashes
  • Eczema
  • Runny nose
  • Sneezing
  • Headaches

This type of allergy is especially common in children; however, they usually outgrow it by age three. The condition is also hereditary, which means that an individual is more likely to be allergic to wheat if they come from a family with a history of allergies.

 

Wheat Allergy vs. Celiac Disease

Wheat allergy and celiac disease (also known as gluten intolerance) are two conditions that are often confused for each other, although they are different illnesses. A wheat allergy is the immune system’s overreaction to a protein found in wheat. This means that wheat allergy sufferers may not be allergic to other grains. Celiac disease is a reaction to gluten in multiple grains, including barley and rye.

 

Treating Wheat Allergy Symptoms

The recommended treatments for wheat allergy symptoms include:

Avoiding Wheat

Complete abstinence from wheat products is the most effective way to deal with a wheat allergy. Wheat avoidance is effective but difficult because of the large number of food products containing wheat in one form or another. In many cases, the fact that a product contains wheat is not obvious. Products that can contain hidden wheat include soy sauce, marinara sauce, and even hotdogs. To make wheat avoidance even more difficult, there is the problem of accidental contamination. Even if a food product does not include wheat as a listed ingredient, accidental wheat contamination can occur during the production process.

Epinephrine

Anaphylaxis is an allergic reaction that is sometimes fatal and is the most serious symptom of a wheat allergy. The treatment for anaphylaxis is the injection of a steroid called epinephrine.

Because the allergic reaction to wheat can sometimes be severe, doctors recommend that wheat allergy sufferers keep an epinephrine auto-injector on their person at all times.

Antihistamines

Antihistamines keep the body’s immune system from causing allergy symptoms and can therefore lessen the discomfort of wheat exposure. An allergy sufferer’s doctor may be able to prescribe an antihistamine or they may be able to find an effective over-the-counter allergy medicine.

In order to minimize the potential for exposure to wheat, allergy sufferers should inform those around them about their allergy and wear a medical identification bracelet at all times. They should also read the ingredient labels on food items to check for wheat.

 

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Wheat Allergy

Overview

Wheat allergies, like hay fever and other allergies, develop when the body’s immune system becomes sensitized and overreacts to something in the environment — in this case, wheat — that typically causes no problem in most people.

Generally, you are at greater risk for developing an allergy to any food, including wheat, if you come from a family in which allergies or allergic diseases, such as asthma or eczema, are common. If both of your parents have allergies, you’re more likely to develop a food allergy than someone with only one parent who has allergies.

Wheat Allergy Symptoms

  • Hives or skin rash
  • Nausea, stomach cramps, indigestion, vomiting or diarrhea
  • Stuffy or runny nose
  • Sneezing
  • Headaches
  • Asthma
  • Anaphylaxis (less common), a potentially life-threatening reaction that can impair breathing and send the body into shock.

 

Wheat Allergy Triggers

  • Bread, pasta or any other food containing wheat
  • Nonfood items with wheat-based ingredients, such as Play-Doh, cosmetics or bath products

 

Wheat Allergy Management and Treatment

  • Avoid foods and other products that trigger symptoms.
  • Control some symptoms with antihistamines and corticosteroids.
  • Use epinephrine (adrenaline), available by prescription, to reverse anaphylactic symptoms.

 

Symptoms

While the symptoms of a wheat allergy are usually mild, in some cases they may be severe and can be deadly, making a diagnosis and appropriate management of the allergy imperative.

Wheat allergy is most common in children; about two-thirds of them outgrow it at a relatively young age. Though many patients with wheat allergy can eat other grains, that’s not true for everyone. Talk with your allergist about what you can safely eat and what you should avoid.

Generally, you are at greater risk for developing an allergy to any food, including wheat, if you come from a family in which allergies or allergic diseases, such as asthma or eczema, are common. If both of your parents have allergies, you’re more likely to develop a food allergy than someone with only one parent who has allergies.

Wheat allergy is typically outgrown by adulthood — about 65 percent of children with a wheat allergy will outgrow it by the time they are 12.

As with reactions to other foods, the symptoms of a wheat allergy may include:

  • Hives or skin rash
  • Nausea, stomach cramps, indigestion, vomiting or diarrhea
  • Stuffy or runny nose
  • Sneezing
  • Headaches
  • Asthma
  • Anaphylaxis (less common), a potentially life-threatening reaction that can impair breathing and send the body into shock

Symptoms may range from mild to severe. If you experience any of these reactions after exposure to something containing wheat, see an allergist.

 

Diagnosis

Some indications of an allergy to wheat — stomach cramps, diarrhea and other gastrointestinal symptoms — overlap with those produced by a sensitivity to gluten or by celiac disease, an autoimmune disorder, so it’s crucial to get an accurate diagnosis. An allergist can determine whether an allergy is present.

Your allergist will first take a medical history, asking particularly about other family members with allergies or allergic diseases, such as asthma or eczema. If both of your parents have food allergies, you’re more likely to have them as well.

Diagnosis of an allergy can be made through a skin-prick test or a blood test.

In the skin-prick test, a small amount of a liquid containing wheat protein is placed on the back or forearm, which is then pricked with a small, sterile probe to allow the liquid to seep into the skin. If a raised, reddish spot forms within 15 to 20 minutes, that can indicate an allergy.

In the blood test, a blood sample is sent to a laboratory to test for the presence of immunoglobulin E antibodies to wheat protein. The results are reported as a numerical value. A blood test that looks for different antibodies can be used to screen for celiac disease.

If these tests aren’t definitive, your allergist may order an oral food challenge. Under medical supervision, you’ll eat small amounts of wheat to see if a reaction develops. Because of the possibility that a reaction could be severe, this test is conducted in your allergist’s office or at a food challenge center with emergency equipment and medication on hand.

Management and Treatment

Managing a wheat allergy — your own or someone else’s — includes strict avoidance of wheat ingredients in both food and nonfood products.

Wheat is one of eight allergens with specific labeling requirements under the Food Allergen Labeling and Consumer Protection Act (FALCPA) of 2004. Under that law, manufacturers of packaged food products sold in the U.S. and containing wheat as an ingredient must include the presence of wheat, in clear language, on the ingredient label.

The grain is found in a myriad of foods — cereals, pastas, crackers and even some hot dogs, sauces and ice cream. It is also found in nonfood items such as Play-Doh, as well as in cosmetic and bath products. Note that the FALCPA labeling rules do not apply to nonfood items; if you have questions about ingredients in those products, check the manufacturer’s website or contact the company.

Foods that don’t contain wheat as an ingredient can be contaminated by wheat in the manufacturing process or during food preparation. As a result, people with a wheat allergy should also avoid products that bear precautionary statements on the label, such as “made on shared equipment with wheat,” “packaged in a plant that also processes wheat” or similar language. The use of those advisory labels is voluntary, and not all manufacturers do so.

A challenging aspect of managing a wheat allergy is baking. While there’s no simple substitution for wheat as an ingredient, baked goods such as breads, muffins and cakes may be made using a combination of non-wheat flours, such as those made from rice, corn, sorghum, soy, tapioca or potato starch. Your allergist can provide you with guidance on which grains are safe for you.

Options for wheat-free grocery shopping include foods made from other grains such as corn, rice, quinoa, oats, rye and barley.

The recent growth in gluten-free products is making it easier to manage a wheat allergy. Gluten is a protein found in wheat, barley and rye.

A gluten-free product may be safe for those who are allergic to wheat because the product should not contain wheat ingredients. However, because a product marketed as “gluten-free” must also be free of rye and barley in addition to wheat, those who must avoid only wheat may be limiting themselves. Anyone managing a food allergy shouldn’t rely on a “free from” label as a substitute for thoroughly reading the complete ingredient label.

People with any kind of food allergy must make some changes in the foods they eat. Your allergist can direct you to helpful resources, such as special cookbooks, patient support groups and registered dietitians, who can help you plan your meals.

Managing a severe food reaction with epinephrine

A wheat allergy reaction can cause symptoms that range from mild to life-threatening; the severity of each reaction is unpredictable. People who have previously experienced only mild symptoms may suddenly experience a life-threatening reaction known as anaphylaxis. In the U.S., food allergy is the leading cause of anaphylaxis outside the hospital setting.

Epinephrine (adrenaline) is the first-line treatment for anaphylaxis, which can occur within seconds or minutes, can worsen quickly and can be deadly. In this type of allergic reaction, exposure to the allergen causes the whole-body release of a flood of chemicals that can lead to lowered blood pressure and narrowed airways, among other serious symptoms.

Once you’re diagnosed with a food allergy, your allergist will likely prescribe an epinephrine auto-injector and teach you how to use it. Check the expiration date of your auto-injector, note the expiration date on your calendar and ask your pharmacy about reminder services for prescription renewals.

Be sure to have two doses available, as the severe reaction may recur. If you have had a history of severe reactions, take epinephrine as soon as you suspect you have eaten an allergy-causing food or if you feel a reaction starting. Epinephrine should be used immediately if you experience severe symptoms such as shortness of breath, repetitive coughing, weak pulse, generalized hives, tightness in the throat, trouble breathing or swallowing, or a combination of symptoms from different body areas such as hives, rashes or swelling coupled with vomiting, diarrhea or abdominal pain. Repeated doses of epinephrine may be necessary.

If you are uncertain whether a reaction warrants epinephrine, use it right away, because the benefits of epinephrine far outweigh the risk that a dose may not have been necessary.

Common side effects of epinephrine may include anxiety, restlessness, dizziness and shakiness. Rarely, the medication can lead to abnormal heart rate or rhythm, heart attack, a sharp increase in blood pressure, and fluid buildup in the lungs. Patients with certain pre-existing conditions, such as diabetes or heart disease, may be at higher risk for adverse effects and should speak to their allergist about using epinephrine.

Your allergist will provide you with a written emergency treatment plan that outlines which medications should be administered and when (note that between 10 and 20 percent of life-threatening severe allergic reactions have no skin symptoms). Be sure that you understand how to properly and promptly use an epinephrine auto-injector.

Once epinephrine has been administered, immediately call 911 and inform the dispatcher that epinephrine was given and that more may be needed from the emergency responders.

Other medications, such as antihistamine and corticosteroids, may be prescribed to treat symptoms of a food allergy, but it is important to note that there is no substitute for epinephrine — this is the only medication that can reverse the life-threatening symptoms of anaphylaxis.

Managing food allergies in children

Because fatal and near-fatal wheat allergy reactions, like other food allergy symptoms, can develop when a child is not with his or her family, parents need to make sure that their child’s school, day care or other program has a written emergency action plan with instructions on preventing, recognizing and managing these episodes in class and during activities such as sporting events and field trips. A nonprofit group, Food Allergy Research & Education, has a list of resources for schools, parents and students in managing food allergies.

If your child has been prescribed an auto-injector, be sure that you and those responsible for supervising your child understand how to use it.

Wheat Allergy or Celiac Disease?

Wheat allergy and celiac disease are similar in some respects, but they aren’t the same thing.

Wheat allergy is an overreaction of the immune system to wheat protein. In someone who is sensitive to wheat protein, exposure to it can trigger an allergic reaction that may result in a skin rash, itching, swelling, trouble breathing, wheezing and other symptoms. It can also cause anaphylaxis, a life-threatening reaction that can include such symptoms as swelling of the throat and mouth, nausea and vomiting, changes in heart rate and loss of consciousness.

By contrast, celiac disease (also called celiac sprue) is caused by an abnormal reaction to gluten in the small intestine. Gluten is a protein found in wheat, barley and rye. When someone with celiac disease consumes products made from these grains, his or her body reacts in a way that damages the lining of the small intestine. Symptoms include abdominal pain, bloating and diarrhea. Because celiac disease hinders the absorption of nutrients, these individuals may be at risk for malnutrition and other complications, such as osteoporosis and anemia. Celiac disease is both a food intolerance and an autoimmune disorder. Researchers estimate that about 1 percent of the U.S. population has celiac disease.

Another big difference: Wheat allergies, unlike celiac disease, can potentially cause reactions that are an immediate threat to life.

Gluten “Allergy”

There is technically no such thing as an allergy to gluten, but some people who test negative for both celiac disease and a wheat allergy may be sensitive to gluten and experience symptoms such as diarrhea, constipation, abdominal pain or fatigue. These symptoms often dissipate when gluten is eliminated from the diet.

 

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Wheat Allergy

Wheat allergy is most common in children, and is usually outgrown before reaching adulthood, often by age three. Symptoms of a wheat allergy reaction can range from mild, such as hives, to severe, such as anaphylaxis. Therefore it is advised that people with wheat allergy have quick access to an epinephrine auto-injector (such as an EpiPen® or Adrenaclick®) at all times. To prevent a reaction, strict avoidance of wheat and wheat products is essential. Always read ingredient labels to identify wheat ingredients.

A wheat allergy can present a challenge for the diet as well as for baking, because wheat is the nation’s predominant grain product. Someone on a wheat-restricted diet can eat a wide variety of foods, but the grain source must be something other than wheat. In planning a wheat-free diet, look for alternate grains such as amaranth, barley, corn, oat, quinoa, rice, rye, and tapioca. When baking with wheat-free flours, a combination of flours usually works best. Experiment with different blends to find one that will give you the texture you are trying to achieve.

 

Differences between Wheat Allergy and Celiac Disease or Gluten Intolerance

A wheat allergy should not be confused with “gluten intolerance” or celiac disease. A food allergy is an overreaction of the immune system to a specific food protein. When the food protein is ingested, in can trigger an allergic reaction that may include a range of symptoms from mild symptoms (rashes, hives, itching, swelling, etc.) to severe symptoms (trouble breathing, wheezing, loss of consciousness, etc.). A food allergy can be potentially fatal.

Celiac disease (also known as celiac sprue), which affects the small intestine, is caused by an abnormal immune reaction to gluten. Usually diagnosed by a gastroenterologist, it is a digestive disease that can cause serious complications, including malnutrition and intestinal damage, if left untreated. Individuals with celiac disease must avoid gluten, found in wheat, rye, barley and sometimes oats.

People who are allergic to wheat often may tolerate other grains. However, about 20 percent of children with wheat allergy also are allergic to other grains. Be sure to ask your doctor whether foods containing barley, rye, or oats are safe for you or your child to eat.

 

Avoiding Wheat

The federal Food Allergen Labeling and Consumer Protection Act (FALCPA) requires that all packaged food products sold in the U.S. that contains wheat as an ingredient must list the word “Wheat” on the label.

Read all product labels carefully before purchasing and consuming any item. Ingredients in packaged food products may change without warning, so check ingredient statements carefully every time you shop. If you have questions, call the manufacturer.

As of this time, the use of advisory labels (such as “May Contain”) on packaged foods is voluntary, and there are no guidelines for their use. However, the FDA has begun to develop a long-term strategy to help manufacturers use these statements in a clear and consistent manner, so that consumers with food allergies and their caregivers can be informed as to the potential presence of the eight major allergens.

 

Avoid foods that contain wheat or any of these ingredients:

  • Bread crumbs
  • Bulgur
  • Cereal extract
  • Club wheat
  • Couscous
  • Cracker meal
  • Durum
  • Einkorn
  • Emmer
  • Farina
  • Flour (all purpose, bread, cake, durum, enriched, graham, high gluten, high protein, instant, pastry, self-rising, soft wheat, steel ground, stone ground, whole wheat)
  • Hydrolyzed wheat protein
  • Kamut®
  • Matzoh, matzoh meal (also spelled as matzo, matzah, or matza)
  • Pasta
  • Seitan
  • Semolina
  • Spelt
  • Sprouted wheat
  • Triticale
  • Vital wheat gluten
  • Wheat (bran, durum, germ, gluten, grass, malt, sprouts, starch)
  • Wheat bran hydrolysate
  • Wheat germ oil
  • Wheat grass
  • Wheat protein isolate
  • Whole wheat berries

 

Wheat is sometimes found in the following:

  • Glucose syrup
  • Surimi
  • Soy sauce
  • Starch (gelatinized starch, modified starch, modified food starch, vegetable starch)

 

Some Unexpected Sources of Wheat*

  • Read ingredient labels carefully, even if you would not expect the product to contain wheat. Wheat has been found in some brands of ice cream, marinara sauce, play dough, potato chips, rice cakes, turkey patties and hot dogs.
  • Wheat also may be found in ale, baking mixes, baked products, batter-fried foods, beer, breaded foods, breakfast cereals, candy, crackers, processed meats, salad dressings, sauces, soups, soy sauce, and surimi.
  • Some types of imitation crabmeat contain wheat.

*Note: This list highlights examples of where wheat has been unexpectedly found (e.g., on a food label for a specific product, in a restaurant meal, in creative cookery). This list does not imply that wheat is always present in these foods; it is intended to serve as a reminder to always read the label and ask questions about ingredients before eating a food that you have not prepared yourself.

 

Keep the following in mind:

  • Many country-style wreaths are decorated with wheat products.
  • Wheat flour is sometimes flavored and shaped to look like beef, pork, and shrimp, especially in Asian dishes.
  • Buckwheat is not related to wheat.

 

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