Wheat allergy
Allergy to wheat proteins (distinct from coeliac disease).
About wheat allergy
Wheat is a staple cereal and one of the more common food allergens, especially in children, many of whom outgrow it. Wheat allergy is an IgE-mediated reaction to wheat proteins and is quite distinct from coeliac disease, an autoimmune reaction to gluten, and from non-coeliac wheat sensitivity. Because wheat is present in bread, pasta, cereals, sauces and countless processed foods, it is a mandatory labelled allergen in the UK.
Symptoms of immediate allergy usually appear within minutes to two hours and can include an itchy mouth, hives, swelling, stomach upset, wheeze and, in some people, anaphylaxis. A particular form is wheat-dependent exercise-induced anaphylaxis, where a reaction only occurs if physical activity, and sometimes alcohol or aspirin, follows eating wheat; this is linked to a wheat protein called omega-5 gliadin. Bakers can also develop respiratory allergy to inhaled flour, known as baker's asthma.
Diagnosis uses the history alongside skin-prick or specific-IgE testing, including component tests such as omega-5 gliadin, and sometimes a supervised challenge, while coeliac disease is investigated separately. Management means avoiding wheat and reading labels carefully, with dietetic support to keep the diet balanced. People at risk of severe reactions carry an adrenaline auto-injector. A severe reaction is a medical emergency needing adrenaline and a 999 call.
Common triggers
- Bread, pasta and cereals\nBaked goods\nMany sauces and processed foods
Symptoms
- Itching or tingling in the mouth
- Hives, itching or eczema
- Swelling of the lips, face, tongue or throat
- Stomach cramps, nausea, vomiting or diarrhoea
- Wheezing or trouble breathing
- In severe cases, anaphylaxis
Avoidance & management
- Read ingredient labels every time
- Ask about ingredients and cross-contamination when eating out
- Keep the food out of shared cooking areas
- Carry prescribed antihistamines or an adrenaline auto-injector
- Seek emergency help for any severe reaction
Sources & references
Allergy safety: what everyone should know
Mild-to-moderate reaction signs
- Itching, hives or a raised rash
- Swelling of lips, face or eyes
- Tingling mouth, sneezing, runny nose
- Stomach pain, nausea or vomiting
Anaphylaxis — call 999 (UK) or 112 (EU) immediately
- Difficult or noisy breathing, wheeze, persistent cough
- Swelling of the tongue or tightness in the throat
- Dizziness, collapse, pale and floppy (young children)
- Use an adrenaline auto-injector (e.g. EpiPen) at once if prescribed, then call an ambulance even if symptoms improve
Allergy or intolerance? A true allergy involves the immune system and can escalate quickly; an intolerance (e.g. lactose intolerance) is unpleasant but not life-threatening. The symptoms overlap, so self-diagnosis is unreliable.
Getting tested: home-testing kits based on IgG are not diagnostically valid. If you suspect an allergy, ask a GP for referral to an allergy clinic for skin-prick or specific-IgE testing and a supervised food challenge where appropriate.