Gluten allergy or intolerance?

Which is correct?

Food Allergies

A true food allergy is uncommon, said to only affect 1-5% of the population, but can be serious, even fatal.

A food allergy involves an immune response to eating certain foods, such as peanuts. The first time someone eats this food their body can react by producing antibodies called immunoglobulin E (IgE) which circulate through the blood and attach themselves to mast cells. When the food is eaten again, it prompts these mast cells to release chemicals such as histamine. There are more of these mast cells in certain areas of the body including the nose, throat, skin, lungs and the gastrointestinal tract. These are typical sites of an allergic reaction.

The result of eating a food you are allergic to can cause a swollen tongue, a rash, breathing problems or severe diarrhea and stomach pain. It can also result in a drop in blood pressure, unconsciousness or even death.

Avoidance of the allergen is of utmost importance as no medicines are available that can cure the allergy. For patients that have severe, life-threatening allergies a special device called an epi-pen should be carried at all times. The epi-pen contains a drug called epinephrine that can treat the reaction.

A person who cannot tolerate gluten does not react in the same way as someone with an allergy. Therefore saying they are allergic to gluten is perhaps not the best way to describe their problem, although using the term in restaurants can be more understandable to the general public than telling them you have coeliac disease. Although they may not know what gluten is, "I have a gluten allergy" can make them sit up and take notice in case you pass out on their floor!

Visit Eating with food allergies or wheat allergies for more information about coping with food allergies.

Food Intolerance

There are several problems that can arise from eating certain foods, most of which are nothing to do with an allergy. This list of problems would include food intolerance, food poisoning or even a toxic reaction to eating things like poisonous fungi.

The term food intolerance tends to relate to an inability to digest or process a certain food.

Food intolerance is more common than having an allergy to a certain food. It normally does not involve an immunological reaction but can cause discomfort, wind, bloating and stomach pain.

Gluten intolerance, however, does spark a different type of autoimmune reaction.

In a person with gluten intolerance or coeliac disease (or celiac disease if you live in the US) there is an abnormality in the lining of the small intestine. Ingesting products such as wheat, rye or barley, which all contain a protein commonly known as gluten, can destroy finger-like projections called villi along the length of the intestine.

These villi help to both move the food through the gut and absorb the nutrients from the food. Over time malabsorption can occur and the patient is likely to loose weight and suffer from diarrhea and sickness amongst other symptoms of celiac disease.

How do I know if I have a gluten allergy or gluten intolerance?

Sorry, I am not the person to tell you that. Your doctor is.

Diagnosing gluten allergy or intolerance can be difficult. To help your doctor found out what the problem is, it can be useful for you to keep a food diary. After a problem occurs pop a note to that effect beside the questionable meal or food item.

If you keep the diary for a few weeks a pattern may start to emerge. This along with your medical history, maybe some blood tests or a skin prick test will help your doctor begin to work out what may be wrong.

He may suggest an elimination diet, where you narrow the foods you eat down to just a few and then gradually re-introduce things that may cause problems.

If the doctor thinks coeliac/celiac disease could be the culprit he may organise a biopsy of your small intestine to look for those villi I mentioned earlier.

Do not put yourself on a gluten diet before a diagnosis is made. If you eliminate foods containing gluten the villi are able to grow back and the biopsy would be inconclusive or even negative. If you have undiagnosed celiac you run the risk of certain types of cancer in later life.

I hope this information has helped you see the difference between gluten allergy and gluten intolerance.

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