Celiac Disease vs. Wheat Allergy: Key Differences in Dietary Approach

Celiac Disease vs. Wheat Allergy: Key Differences in Dietary Approach

Wheat intolerance is a food problem that affects many people around the world. Two of the most common wheat-related conditions are coeliac disease and wheat allergy. Although they may share some similar symptoms, these two conditions are very different from a dietary perspective and require distinct management approaches. In this article, we will explore the main differences between coeliac disease and wheat allergy, focusing on the dietary aspects.

Coeliac disease:

Celiac Disease (or celiac disease) is a chronic inflammation of the small intestine, triggered by the ingestion of gluten in genetically predisposed individuals. According to data from the Ministry of Health, there are 241,729 people diagnosed in our country, but coeliac disease affects 1% of the Italian population: there are therefore approximately 400,000 patients still waiting for a diagnosis. An autoimmune disease, the immune system reacts negatively to the presence of gluten, a protein found in wheat, barley, rye and other related cereals. When a person with celiac disease consumes gluten, the immune system attacks the intestinal mucosa, causing damage and inflammation. This can lead to a range of gastrointestinal symptoms and long-term health problems if not managed properly.

Here are some of the best dietary practices for those with coeliac disease:

Absolute elimination of gluten: People with celiac disease must completely avoid gluten in all its forms, both overt and covert. This means they must carefully read food labels, avoid wheat, barley, rye and their derivatives, and choose foods and drinks specifically labelled as ‘gluten-free’.
Caution in the kitchen: cross-contamination with gluten is a serious problem for people with coeliac disease. This means that they must be careful when preparing meals, using clean utensils and pots and pans and paying attention to possible cross-contamination.
Regular medical monitoring: People with coeliac disease should have regular medical check-ups to monitor their health status and check for possible nutritional deficiencies due to intestinal malabsorption.

Wheat allergy:

Wheat allergy is an immediate and abnormal immune reaction to proteins present in wheat. Unlike coeliac disease, which is an autoimmune disorder, wheat allergy involves an IgE-type immune response, similar to that of common food allergies. It involves different immune mechanisms, is triggered by a complex of wheat molecules other than gluten, and results in response times and reactions quite different from those of coeliac disease, including rash and the dreaded anaphylactic shock. Furthermore, while in coeliac disease the only gluten exposure pathway capable of activating the disease is the intestinal, the triggering pathways of wheat allergy are different and also include the respiratory system, skin and mucous membranes.

The right dietary behaviour for someone with a wheat allergy can be summarised in three parts:

Selective elimination: People with a wheat allergy should only avoid wheat and not necessarily other cereals containing gluten such as barley and rye. In addition, they may tolerate some forms of wheat, such as buckwheat or spelt, which are not actually wheat.
Labelling: They must pay attention to food labels to identify the presence of wheat or traces of wheat in food products.
Most immediate reactions: Reactions to wheat allergy can be severe and generally occur shortly after wheat intake. This type of allergy requires immediate management of allergic reactions, such as the use of epinephrine in case of severe reactions.

In conclusion, although coeliac disease and wheat allergy involve an adverse reaction to wheat, it is important to understand the key differences in dietary approach to properly manage these conditions.

People with coeliac disease must completely avoid gluten in any form, while those with a wheat allergy must focus on selectively removing wheat from their diet. Both conditions require scrupulous attention to diet and, if suspected, it is important to consult a doctor for a diagnosis and an appropriate management plan.