Anishka Ram
(NZRD, MSc. Nutrition and Dietetics)
Note — The article was checked and updated April 2023.
We suggest reading our updated and latest article on coeliac disease — Coeliac Disease: Symptoms and Effects on our health and body.
You might understand your condition, but to make sure that we are making correct decisions with our diet and food, we need to have definitive proof.
Coeliac disease, gluten intolerance or non-coeliac gluten sensitivity and wheat allergy are different conditions with similar symptoms that occur after ingestion of food containing gluten and food items that have been cross-contaminated with gluten.
Symptoms can range from stomach pain, diarrhea, brain fog to having issues with breathing and respiratory problems.
Blood test, skin prick test and gluten challenge are tests used to determine these conditions.
Coeliac Disease Symptoms and Testing
If you suspect that you might have Coeliac disease, here is the symptoms checklist:
- On-going stomach/gut discomfort
- Chronic fatigue
- Irritable bowel syndrome
- Unexplained iron, vitamin B12 (cobalamin) or vitamin B9 (folate) deficiency
- Mouth ulcers
- Unexplained weight loss[1,2]
The GP will ask you to do a serology test. This blood test checks for antibodies that show if there is an immune response occurring in your body.[1]
To have an accurate reading as possible, you will need to consume gluten before taking this blood test.[2] This is called a gluten challenge which consists of eating about 2 slices of wheat bread for 2 weeks.[1,2]
If your test results return positive then it is a strong indication that you have Coeliac disease.[2] If the results return as a weak positive, then you may be asked to do more testing.
This, however, does not mean that you are out of the woods yet. Even if the test results are negative, you still may have non-coeliac gluten sensitivity.[3] In some cases you may be tested for other food intolerance like lactose.[2]
Symptoms of Gluten Intolerance
Gluten intolerance (non-coeliac gluten sensitivity) occurs when symptoms appear after eating foods with gluten in individuals who have tested negative for Coeliac disease and wheat allergy.[3]
Non-coeliac gluten sensitivity can be present in many people, however, the numbers are unknown, whereas Coeliac disease only affects a small percentage of the population.[4]
The only way to find out if you have a sensitivity towards gluten is if you have had Coeliac disease and wheat allergy ruled out but are experiencing the symptoms mentioned above.[5]
Wheat Allergy - Dangers and Testing
A wheat allergy is a food allergy to wheat proteins compared to Coeliac disease which is an autoimmune disease.[6] Wheat allergy affects the skin, gastrointestinal tract and in some individuals it can also affect the lungs.[6] The symptoms can occur within 3 hours of being around or eating wheat.
The symptoms include:
- Abdominal pain
- Vomiting
- Worsening of eczema
- Angioedema (swelling of the mouth, eyelids, and genitals)
- Asthma[7]
A skin prick procedure involves placing a row of allergens in liquid form on your forearm and is pricked into the skin with a needle.[8]
After a 20-minute wait, if the test site of the wheat allergen is swollen and itchy then it is positive that you have a wheat allergy.
Conclusion
If you follow a gluten-free diet regardless of testing positive for Coeliac disease, non-coeliac gluten sensitivity or wheat allergy, it is important to know why you are not able to tolerate gluten.
With wheat allergy (depending on the severity) and non-coeliac gluten sensitivity, you may be unknowingly eating foods possibly exposed to gluten through cross-contamination.[3]
If you are looking for great dishes that are gluten-free, we suggest checking our Recipes.
Remember:
If you haven’t already, please speak to your GP about your concerns to rule out any serious issues that may contribute to the symptoms you are experiencing. Also, ask for an appointment with a Dietitian who can safely guide you through dietary changes.
With Masters in Nutrition and Dietetics, Bachelor’s degree in Sport and Recreation and NZIHF (New Zealand Institute of Health and Fitness) Certificate in Personal Training, Anishka’s also interested in weight loss and muscle gain, with a particular focus on encouraging positive behaviors and decisions.
References
(1) Parzanese, I., Qehajaj, D., Patrinicola, F., Aralica, M., Chiriva-Internati, M., Stifter, S., … & Grizzi, F. (2017). Celiac disease: From pathophysiology to treatment. World journal of gastrointestinal pathophysiology, 8(2), 27.
(2) Lebwohl, B., Sanders, D. S., & Green, P. H. (2018). Coeliac disease. The Lancet, 391(10115), 70-81.
(3) Leonard, M. M., Sapone, A., Catassi, C., & Fasano, A. (2017). Celiac disease and nonceliac gluten sensitivity: a review. Jama, 318(7), 647-656.
(4) Barbaro, M. R., Cremon, C., Stanghellini, V., & Barbara, G. (2018). Recent advances in understanding non-celiac gluten sensitivity. F1000Research, 7.
(5) Molina-Infante, J., & Carroccio, A. (2017). Suspected nonceliac gluten sensitivity confirmed in few patients after gluten challenge in double-blind, placebo-controlled trials. Clinical Gastroenterology and Hepatology, 15(3), 339-348.
(6) Cianferoni A. (2016). Wheat allergy: diagnosis and management. Journal of asthma and allergy, 9, 13–25. https://doi.org/10.2147/JAA.S81550
(7) Leccioli, V., Oliveri, M., Romeo, M., Berretta, M., & Rossi, P. (2017). A new proposal for the pathogenic mechanism of non-coeliac/non-allergic gluten/wheat sensitivity: piecing together the puzzle of recent scientific evidence. Nutrients, 9(11), 1203.
(8) Patel, N., & Samant, H. (2020). Wheat allergy. StatPearls [Internet].
