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Myth vs. fact: Celiac disease vs. wheat allergy

MYTH: Celiac disease is the same thing as a wheat allergy.

FACT: Celiac disease (also known as gluten-sensitive enteropathy or sprue) is not the same as a wheat allergy.

Although celiac disease may appear to be similar to a wheat allergy because of the need to avoid certain foods, these two conditions are entirely different, with different health effects and treatments.

Wheat contains a protein called “gluten” which is also in other foods, including rye and barley. Importantly, not all gluten-free foods are wheat-free. And not all wheat-free foods are gluten-free.

The term “gluten-allergy” can be confusing. Some people use this term to mean celiac disease, and some use this term to mean wheat allergy, and others use this term if they choose to avoid gluten for other reasons such as intolerance or preference. Clear communication about the type of reaction to wheat or gluten can inform the type of avoidance and treatment required. If you are not sure about the type of reaction you may have, please ask your doctor.

Wheat allergy is one of the most common food allergies in Canada. A food allergy is your body’s immune system overreacting to a specific protein in a food, such as wheat, milk, or peanut. Consuming food you are allergic to can trigger a reaction involving different symptoms, from itching, redness, and hives, to wheezing, inability to breathe, and loss of consciousness. A severe allergic reaction (anaphylaxis) can even be fatal. People allergic to wheat are allergic to a part of wheat, which is not always the gluten part.

Celiac disease is also a serious immunological condition, and individuals with celiac disease need to completely avoid certain ingredients just as people with food allergies do, but the similarities end there. Celiac is a chronic autoimmune disorder of the small intestine, triggered by eating the protein gluten which is contained in foods like wheat, rye, or barley. Over time, the immune system damages the lining of the small intestine which can lead to the malabsorption of nutrients, and eventually, to malnutrition. Other symptoms may include chronic diarrhea, fatigue, weight loss, bloating, and anemia. People with celiac disease do not get anaphylaxis when they eat gluten.

Bottom line: Celiac disease and wheat allergy are very different conditions with different health effects and treatments.

Medical content reviewed by: Dr. Julia Upton, MD, FRCP(C) Clinical Immunology and Allergy