Thursday, August 27, 2015

What is the difference between a 'gluten' allergy and celiac disease?

Learn more about "gulten" allergies, celiac disease and wheat allergies. What's the difference between these conditions?

What is the difference between a 'gluten' allergy and celiac disease?


Lately, it seems like everyone is talking about gluten free products. What is gluten exactly and does it need to be avoided by all?

Gluten refers to a family of proteins found in the grains of wheat, barley, and rye. Celiac disease is a form of gluten intolerance, but strictly speaking, it is not an allergy. It is a rather a complex immune phenomenon involving antibodies that the body produces when someone eats gluten. These antibodies lead to damage of the lining of the small intestine, which can affect absorption of foods and can lead to malnutrition.  

Most kids with celiac disease will have abdominal symptoms when they ingest gluten. Some will also have a rash similar in appearance to eczema. There is a genetic component to celiac disease, it tends to run in families, and is more common among Caucasians than among other racial and ethnic groups. The best way to diagnose celiac disease is by blood test to measure IgA levels against gluten components.  The only real treatment is to remove gluten – primarily wheat – from the diet. People with celiac disease who avoid gluten usually do quite well, but approximately 15 percent of patients will have non-responsive celiac disease.

A wheat allergy is different from celiac disease. A wheat allergy occurs when IgE antibodies to wheat are present, and can cause symptoms that are different from celiac disease. The proteins to which these antibodies are directly may be different from those in celiac disease. This type of allergy can be diagnosed with a skin test or a blood test for IgE levels to wheat. In severe cases, a true wheat allergy can result in anaphylaxis. The signs are usually a rash, vomiting, abdominal pain, wheezing and/or circulatory collapse. The treatment is strict avoidance of wheat, careful reading of labels, and to have an epinephrine autoinjector with the patient at all times.

Recently, some celebrities and athletes have touted the benefits of a gluten-free diet. World champion tennis player Novak Djokovic describes in his book how maintaining a gluten free diet propelled his rise to the top of the tennis world. Many other people have perceived an improvement in their health even though they have tested negative for celiac disease. This has resulted in a new condition, called non-celiac gluten hypersensitivity, for which there is no conclusive diagnostic test. As with any nutritional regimen, you should avoid wheat if you don’t seem to tolerate wheat. However, if you can tolerate and enjoy it, there’s no reason to avoid it. “Gluten-free” does not necessarily equal “healthy.”


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The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

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Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Magee DeFelice, M.D. Division Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Emiliano Tatar, M.D. Pediatrician at Einstein Healthcare Network Roxborough Plaza
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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