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The Basics of Wheat Allergy and Celiac Disease

Living Wheat-Free and Gluten-Free For the Newly Diagnosed


Updated March 21, 2009

Managing without wheat is two-sided. On one hand, wheat is in more foods than you might guess -- not just baked goods and pasta, but also sauces and a vast number of processed foods. On the other, the wide range of people who adopt wheat-free diets (due to allergies, autoimmune disorders, other health conditions) means that wheat-free alternatives to most common foods are available at well-stocked grocery stores.

A gluten-free diet is the treatment for celiac disease. Celiac disease isn't a wheat allergy, but since the first steps for these conditions are similar, I'll be treating them together in these articles.

1. Educate Yourself About Your Condition

Wheat allergy and celiac disease are different conditions. Both require strict avoidance of wheat (and, in the case of celiac disease, other gluten-containing grains) to maintain good health. But wheat allergy, like other allergies, is an IgE-bound histamine reaction of the immune system, while celiac disease is an autoimmune disorder that affects the small intestines. Knowing how to (and whether you can) treat an inadvertent exposure, which medical practitioner is best suited to oversee your care, and whether your condition may someday be outgrown are among the early questions you may have.

2. What You Can Eat and What You Can't

Wheat allergies and celiac disease both mean a wheat-free diet. Celiac patients (or "celiacs") must avoid gluten-containing grains rye and barley as well, and some react to a related protein called avenin in oats. While rye and barley aren't staples of the North American diet in and of themselves (though rye is the basis for pumpernickel bread and barley is prevalent in some Eastern European cuisines), barley malt is a common ingredient in processed foods, and both rye and barley are present in some alcoholic beverages.

3. Reading Labels for Wheat Allergy and Celiac Disease

FALCPA, a labeling law that went into effect in the United States in 2004, made reading labels far easier for those with wheat allergies and moderately easier for celiacs. As a "top eight" most common food allergen, the presence of wheat must be listed on food labels in "plain language," either in the ingredient list or just below. The FDA does not yet have a set rule for the use of the term "gluten-free," so celiacs need to learn which ingredients may indicate the presence of gluten-containing ingredients.

4. Eating Out With Allergies and Intolerances

Public awareness of celiac disease has led to a rise in gluten-free menus at chain restaurants large and small -- a boon for those with wheat-free diets as well. But it's important to take basic precautions before eating out with any food allergy. Some cuisines are naturally low in wheat or can be adapted relatively easily for safer restaurant dining.

5. Coping With The Diagnosis

Getting used to an allergy diagnosis -- whether you're an adult learning about a condition for the first time or the parent of an allergic child -- is a major adjustment. Expect a period of stress as you get used to the demands of a new diet and learn to negotiate social situations. Keep reminding yourself that many people have been coping with food allergies and severe food intolerances and are living rich, full lives (and even eating well) -- you can too!

6. Managing Severe Allergic Reactions

Different people have different symptoms when exposed to allergens. In the case of wheat, a couple of the more common symptoms are severe: asthma attacks and anaphylactic shock. If your doctor considers you at risk for either of these reactions, you'll be given rescue medication and shown how to use it. At any rate, you should be aware of what a severe allergic reaction looks like if you have a food allergy.

7. Special Health Concerns for Celiacs

Celiac disease isn't an allergy and doesn't come with anaphylaxis risks. But that doesn't mean that it's not serious: Celiacs who don't comply with their diets are at increased risk of osteoporosis, miscarriage, and intestinal lymphoma. Other autoimmune disorders are also comorbid with celiac disease, meaning that having a celiac diagnosis increases your risk of having one. Care of celiac disease is overseen by gastroenterologists, who can monitor the condition of the small intestine by endoscopy to ensure that no damage due to inadvertent gluten exposure is occurring.

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