Gluten Allergy vs. Gluten Sensitivity vs. Wheat Allergy

What is the difference between a gluten allergy and a sensitivity? Is it the same as a wheat allergy?

Recent research has revealed that it is possible to be sensitive to gluten and not have Celiac Disease.  While Celiac Disease (CD) affects 1% of the US population, the Center for Celiac Research estimates that gluten sensitivity (GS) may affect 6% of the population.  Although findings are preliminary, GS appears to be less clinically severe than CD.  Symptoms of GS primarily affect the gastrointestinal system but they are not mediated by the immune system and do not cause damage to the intestinal tissue otherwise seen in CD. Small amounts of gluten may be tolerable in gluten sensitive persons, unlike that of CD, though ultimately both conditions benefit from a gluten-free diet.

GS and CD should not be confused with a wheat allergy, which is intolerance to all foods containing wheat. Wheat is only one source of gluten so it does not mean an intolerance to all gluten sources.

  Gluten Allergy(Celiac Disease) Gluten Sensitivity Wheat Allergy
Prevalence 1% of US population 6% of US population Less than 1% of children; some adults after exercise
Type of condition Autoimmune Non-autoimmune Autoimmune
Symptoms Vary, but can include: gastrointestinal distress (bloating, diarrhea, nausea, etc.) malnutrition, anemia, weight loss, bone and joint pain, migraines, irritability, infertility, menstrual irregularities, depression, seizures, neuropathy, dermatitis. Abdominal pain, bloating, gas, diarrhea, headaches, brain fog, fatigue, balance problems, bone or joint pain, leg numbness Swelling, hives, nausea, vomiting, diarrhea, anaphylaxis
Triggers Even small amounts of gluten (found in wheat, barley, rye) Gluten, amount unknown All proteins in wheat
Testing & Diagnosis Serological testing: IgA tissue transglutaminase and IgA endomysial antibodiesIntestinal biopsy (definitive testing) No specific tests currently available.Need to check response to a gluten-free diet and a gluten challenge Skin test, blood test for all wheat proteins
Treatment Strict gluten-free diet Gluten-free diet; although small amounts may be tolerated Avoid wheat products
 

 

References:

  1. Case S. Celiac disease, gluten sensitivity and the gluten-free diet. 2011.  http://www.nutrition411.com
  2. Sapone et al. BMC Medicine 2011, 9:23. Available at: http://www.biomedcentral.com/1741-7015/9/23
  3. Wheat allergy. Mayo Clinic. 2011. Available at: http://www.mayoclinic.com/health/wheat-allergy/DS01002
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