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Wheat Allergy

Introduction
Signs and symptoms
Causes
Risk Factors
Screening and diagnosis
Treatment
Prevention

Signs and symptoms of wheat allergy can include:

• Swelling, itching or irritation of the mouth or throat
• Hives or skin irritation
• Nasal congestion
• Airway inflammation
• Gastrointestinal symptoms such as cramps, nausea and vomiting

Allergy symptoms differ from person to person and generally occur a few minutes to a few hours after wheat's been ingested. In some people, allergic reactions occur:

• When exercising after eating wheat
• From inhaled flour in the workplace (sometimes called bakers' asthma)

All food allergies are caused by an immune system malfunction. Your immune system identifies certain wheat proteins as harmful, triggering the production of immunoglobulin E (IgE) antibodies to neutralize the protein (allergen). The next time you come in contact with these proteins, these IgE antibodies recognize them and signal your immune system to release histamine and other chemicals.

Histamine and other body chemicals cause a range of allergy signs and symptoms. Histamine is partly responsible for most allergic responses, including runny nose, itchy eyes, dry throat, rashes, hives, nausea, diarrhea, labored breathing and anaphylactic shock.

There are four different proteins in wheat that can cause allergies: albumin, globulin, gliadin and gluten. If you have a reaction to gluten, which is found in wheat and other grains such as oats, barley and rye, you may have gluten intolerance or celiac disease rather than a wheat allergy

Certain factors may put you at greater risk of developing a wheat allergy:

• Family history. You're at increased risk of allergy to wheat or other foods if allergies, such as hay fever, asthma, hives or eczema, are common in your family.
• Age. Wheat allergy is most common in children. As you grow older, your digestive system matures and your body is less likely to absorb food or food components that trigger allergies.

To evaluate a possible wheat allergy, your doctor may:

• Ask detailed questions about your signs and symptoms
• Perform a physical exam
• Have you keep a detailed food diary
• Have you eliminate wheat from your diet (elimination diet) - and then have you eat the food again to see if it causes a reaction

He or she may also recommend one or both of the following tests:

• Skin test. In this test, your skin is pricked and exposed to small amounts of the proteins found in wheat. If you're allergic, you develop a raised bump (hive) at the test location on your skin. Allergy specialists usually are best equipped to perform and interpret allergy skin tests.
• Blood test. A blood test can measure your immune system's response to wheat by measuring the amount of certain antibodies in your bloodstream, known as immunoglobulin E (IgE) antibodies. A blood sample is sent to a medical laboratory, where it can be tested for evidence of sensitivity to wheat.

If your doctor suspects your symptoms are caused by something other than a food allergy, you may need other tests to identify - or rule out - other medical problems. If you have digestive problems, such as diarrhea, abdominal pain or bloating, or you also have a reaction to grains other than wheat, your doctor may want to do tests to rule out gluten intolerance or celiac disease - an allergic reaction caused by gluten.

The only way to prevent an allergic reaction is to avoid wheat and wheat proteins altogether. This can be difficult, as wheat is a common food ingredient.

Medications, such as antihistamines, may reduce signs and symptoms of wheat allergies. These drugs can be taken after exposure to wheat to control your reaction and help relieve discomfort.

Despite your best efforts, you may still come into contact with wheat. If you have a serious allergic reaction, you may need an emergency injection of epinephrine (adrenaline) and a trip to the emergency room. If you're at risk of having a severe reaction, you may need to carry injectable epinephrine (such as EpiPen) with you at all times.

There is no sure way to prevent a food allergy from occurring in the first place - but you can prevent symptoms by avoiding the food that causes them.

If you know you are allergic to wheat, the only sure way to avoid an allergic reaction is to avoid wheat products. Know what you're eating and drinking. Be sure to read food labels carefully.

Hidden sources of wheat products
Wheat is a very common food ingredient, and it isn't just found in pastas, breads and other baked goods - it's also used in foods ranging from sauces to some beers, so read all food labels carefully. Some brands of hot dogs and ice cream even contain wheat. Wheat is often used in products including:

• Food thickeners
• Hydrolyzed vegetable protein
• Natural flavorings
• Soy sauce
• Meat and crab substitutes

Eating out
Eating in restaurants when you have a wheat allergy can be a challenge - communicating clearly with restaurant staff and choosing your food carefully can help.

• Be cautious about cross-contamination - wheat getting into your food from shared pans, cutting boards or utensils.
• Be sure deep-fried foods, such as french fries, aren't cooked in oil that's been used to cook breaded foods.
• If you aren't positive whether meals contain wheat, order simple dishes without sauces.
• Be wary of meat substitutes that are common in Chinese and vegetarian dishes - these products often contain wheat.

Following a wheat-free diet can be difficult - but it is becoming easier. Food manufacturers in the United States are now required to clearly label foods that contain wheat products. Health food and specialty stores commonly carry breads and other products that are wheat-free, including ingredients to use as wheat substitutes when baking. There are a number of Web sites that offer advice, discussions about wheat allergy, and even wheat-free ingredients, products and cookbooks.

If you're at risk of a serious allergic reaction, talk with your doctor about carrying and using emergency epinephrine (adrenaline). If you've already had a severe reaction, wear a medical alert bracelet or necklace that lets others know that you have a food allergy.

While there is no sure way to prevent an allergic reaction to wheat, reading labels, being cautious when eating out, and using wheat-free products and recipes can help you avoid an unpleasant or dangerous reaction.